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Health Care in Crises Perspectives of Rural Hospital CEOs

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VOLUME 3, ISSUE 3 MARCH 2008





Health Care in Crises: Perspectives of Rural Hospital CEOs

By David Peel (3) all counties outside of metro- in Snoqualmie, Vic Dirksen,

Publisher and Editor politan and micropolitan statisti- Chief Executive Officer of Jeffer-

Washington Healthcare News

cal areas. son Healthcare in Port Townsend,

We’ll confine our focus to issues and Tom Martin, Administrator

facing executives at rural hospi- of Lincoln Hospital in Davenport

tals holding the Critical Access – all of whom lead CAH hospitals

Hospital (CAH) designation. – to find out. Statistics and other

A result of the 1997 federal Bal- information from the Washington

anced Budget Act, the CAH pro- State Department of Health, Of-

gram was intended to be a safety fice of Community and Rural

net that assures Medicare benefi- Health reinforced their assess-

ciaries access to health care ser- ment.

vices in rural areas. It was in- Patient health status and mix

tended to simplify billing meth- Peel: The Office of Community

Rural hospitals face difficult ods, allow more flexible staffing Please see> Rural, P4

times. Patient health status and options relative to community

mix, access to capital, staffing Inside This Issue

need, and provide incentives for

constraints, coordination of care Health Care in Crises: Perspectives of

local development of integrated Rural Hospital CEOs

1

with urban hospitals and other health delivery systems including Healthcare Law: The Importance of

providers, and the percentage of 10

acute, primary, emergency and Medical Staff Credentialing

uninsured relative to insured are long-term care. Because reim- Healthcare Agency: Workplace

12

serious challenges testing some of bursement is cost-based, it can be Wellness: Why Promote Wellness?



our most seasoned hospital execu- proportionally higher than those Healthcare Company Profile: Derry,

14

Nolan & Associates

tives. amounts that urban hospitals re-

Healthcare Performance Improvement:

What is “rural”? ceive for treating patients with Time is of the Essence: Reducing AMI 16

similar conditions. Of the 39 Door to Dilation Time

While there is no single, univer-

CAH hospitals in Washington Healthcare Marketing: It’s Time for

sally accepted definition for what

Healthcare Marketers to Wake-up and 18

constitutes a rural hospital, com- State, all fall into at least one of Smell the Digital Revolution!

monly acknowledged ones in- the three common definitions for Healthcare Opinion: Raising the

20

clude: rural hospitals. Profile of Dental Benefits



Healthcare Opinion: First Change the

(1) those counties with a popula- Interviewing the leaders Rules of Health Care

22

tion density under 100 persons How difficult has it become for New or Recently Promoted Healthcare

26

per square mile; our state’s rural hospitals? In late Leaders



(2) all territory located outside of January, I spoke with Rodger Career Opportunities 27-30



urbanized areas and urban clus- McCollum, Chief Executive Offi- Plan and Hospital Financial

31

Information

ters, or cer of Snoqualmie Valley Hospital

Letter from the Publisher and Editor

Dear Reader,

Publisher and Editor

From 1996 to 2006 I held Chief Financial Officer positions at three separate

David Peel Washington State health insurance companies. I didn’t always do the best job

Business Address of passing on information that may have benefited others. I thought my em-

631 8th Avenue ployees, peers and superiors were either too busy or not interested in reading

Kirkland, WA 98033 some of the material that came across my desk. When I received something

that was “passed on”, I was often the last to get it and wasn’t always sure

Contact Information whether to return it to the sender or throw it away!

Phone: 425-577-1334 Is the Washington Healthcare News one of those publications you read and

Fax: 425-242-0452 then distribute to others? To help you decide, I’ve listed some of the reasons

E-mail: dpeel@wahcnews.com to consider passing the Washington Healthcare News on to others at your or-

Web: www.wahcnews.com ganization.

 The Healthcare Law, Healthcare Administration, Healthcare Agency,

TO GET YOUR COPY

Healthcare Performance Improvement and Healthcare Marketing section

If you would like to be articles are written by well-known experts in their field and contain valu-

added to the distribution, able information to help protect, manage, insure, improve and grow your

send your contact business.

information including name,  New or recently promoted health care leaders are announced each month.

title, organization, address,

 The most current hospital and plan financial information is presented to

e-mail and phone number to help you better understand your business partners, vendors and competi-

dpeel@wahcnews.com. Charges tors.

may apply for special requests.  Healthcare Opinion articles are published that provide insight into the is-

LETTERS TO THE EDITOR sues most relevant to our health care system.

If you have questions or If you decide to pass it on, just make sure you indicate whether they should

suggestions regarding the return it to you or throw it away!

Washington Healthcare News Until next month.

and its contents, please reply to

dpeel@wahcnews.com. David Peel, Publisher and Editor



Washington Healthcare News 2008 Editorial Calendar



Month and Year Theme of Edition Space Reservation Distribution Date



January 2008 Healthcare Public Policy December 3, 2007 December 21, 2007

February 2008 Urban Medical Clinics January 7, 2008 January 25, 2008

March 2008 Rural Hospitals February 4, 2008 February 22, 2008

April 2008 Insurance Carriers March 3, 2008 March 21, 2008

May 2008 Healthcare IT April 7, 2008 April 25, 2008

June 2008 Rural Medical Clinics May 5, 2008 May 23, 2008

July 2008 Healthcare Facilities June 2, 2008 June 22, 2008

August 2008 Healthcare Human Resources July 7, 2008 July 25, 2008

September 2008 Community Health Centers August 4, 2008 August 22, 2008

October 2008 Third Party Administrators September 8, 2008 September 26, 2008

November 2008 Insurance Brokers and Agents October 6, 2008 October 24, 2008

December 2008 Urban Hospitals November 3, 2008 November 21, 2008



Page 2

Health Care in Crises: Perspectives of Rural Hospital CEOs

Rural P6

Page 4

Health Care in Crises: Perspectives of Rural Hospital CEOs

Rural, P8









www.grubb-ellis.com









Page 7

Health Care in Crises: Perspectives of Rural Hospital CEOs

Workplace, P24



Page 12

Healthcare Company Profile Washington Healthcare News | Mar 2008 | www.wahcnews.com







Healthcare Consulting Firm Celebrates Five Successful Years of Serving

Pacific Northwest Medical Clients

Neither an unsettled economy nor billing auditing, provider educa- ciency. Improvements in the areas

a declaration of war could hold tion through their Certified Cod- of provider and nursing clinical

back Barbara Derry and Crystal ers, and revenue cycle analysis documentation templates, billing

Nolan as they set out to follow for both hospital and outpatient compliance and revenue enhance-

their passion in March 2003. Car- settings. For situations where cli- ments and patient workflow de-

ing for the health of healthcare ents request a physician-to- sign also reap rewards for the or-

organizations was paramount. The physician approach, William ganizations.

two owners, both Fellows in the Fallon, M.D. provides counsel on Doing it right the first time is

American College of Medical governance, grievance or com- “business as usual” for Derry

Practice Executives, forged ahead pensation issues. But they haven’t Nolan. Whether reducing ineffi-

in their mission to bring financial stopped there. ciencies in business processes or

and operational improvement New Ambulatory Surgical Cen- optimizing an industry tool, the

strategies to medical organiza- ters (ASC) development is the firm repeatedly proves its value.

tions struggling with rising costs. latest undertaking for the group – It helps that the two principals,

Though much has changed since working with physicians on feasi- Barbara and Crystal, believe

that spring day, much remains the bility, facility design, staffing strongly in making a personal

same. The war continues, the models, operations and certifica- connection with their clients.

economy slugs along, physicians tion. Existing ASCs also benefit That’s why they’ve kept one par-

(still) face rising overhead and through financial, operational im- ticular service a constant from

technologically savvy patients, provement and recertification ser- day one – the one hour compli-

and the need for Derry Nolan’s vices. mentary evaluation meeting.

professional team is as great as Electronic medical records Their approach and methodology,

ever. Primary services remain fo- (EMRs), once the wave of the fu- the resolution to be a different

cused on: ture, are now firmly entrenched. type of consultant – one who ca-

 Waste reduction – labor, in- Multiple clients have already res, has ensured their success. It’s

ventory and inefficient workflow benefited from the company’s not about writing a report, citing a

proactive deep dive into EMRs few industry standards and mov-

 Organizational improvement –

with the Epic systems and other ing on. A Derry Nolan consultant

operational and financial assess-

EMR technology. Providers and sees their client through the im-

ments and recommendations

support staff in a number of spe- plementation of key recommenda-

 Cash flow management – in- tions and supports the organiza-

cialty clinics enjoy improved in-

creasing profitability tion through the changes. And

formation workflow within Epic

 Interim management and ex- functionalities. Derry Nolan their clients appreciate it – just

ecutive recruitment works closely with Epic analysts read the testimonials on their

When clients talk to Derry Nolan, to facilitate optimal design and website. “Caring for your prac-

they’re heard. Consultancy ex- use of the Epic EMR capabilities. tice, so you can care for your pa-

pansion has helped up the ante. The collaboration results in tients.” It’s their passion.

Enhanced compliance support greater patient satisfaction and To learn more about Derry Nolan

services include medical chart/ higher physician and staff effi- visit www.derrynolan.com.



Page 14

  R E F E R R A L S  

Face molding for radiation 

treatment using a  radiation 

oncology CT scanner 









Over 550 leaders at 350 medical clinics receive the          

Washington Healthcare News each month.  As a provider     

organization, doesn’t it make sense to target marketing to the 

people that can refer patients?   

To learn about ways the Washington Healthcare News can 

help grow your business contact David Peel at 

dpeel@wahcnews.com or 425‐577‐1334. 









631 8th Avenue, Kirkland WA 98033 | 425‐577‐1334 | www.wahcnews.com 

Healthcare Performance Improvement

Time is of the Essence: Reducing AMI Door to Dilation Time

By Lynette Jones and hospital formed a project team process. During the analyze stage

Cassie Undlin involving several cardiologists of DMAIC, a tool called a “Swim

Principals from the community, an emer- lane Diagram” was used to map

Strategic Opportunity Solutions

gency room physician, two out the process. This diagram il-

Timely access to health care treat- nurses, a unit coordinator, cath lab lustrated how each of the tasks in

ments is a critical aspect of high management and an advanced life the process moved through differ-

quality health care. A plethora of support coordi nat or from ent areas of responsibility and

research indicates that if heart at- Thurston County EMS. The team highlighted the criticality of coor-

tack victims receive angioplasty leader was an in-house process dination between the EMS per-

within 90 minutes of entering a improvement expert with a back- sonnel in the field and the hospi-

hospital emergency room (ER), tal. Tasks performed in the proc-

“Prior to the project,

their outcomes will be signifi- ess had formerly been sequential,

approximately 65% of AMI

cantly better, mortality will be but the “Swim lane Diagram” il-

patients were being treated

lower and hospital stays will be lustrated the benefits of perform-

within 90 minutes. In the

shorter. The government and ing tasks simultaneously.

third quarter of 2007, on

many private third party payers, New policies and procedures

average, 89% of AMI patients

track and benchmark numerous were developed. The team agreed

were treated within 90

measures of performance quality to increase reliance on field as-

minutes”

across hospitals. One of these sessments made by EMS person-

measures is the timeliness of Lynette Jones and nel, allowing patient, cardiologist

treating patients for acute myo- Cassie Undlin, Principals

Strategic Opportunity Solutions and cardiac cath lab transporta-

cardial infarctions (AMIs). tion to occur simultaneously dur-

ground in industrial engineering. ing off-hours. Hospital communi-

In Olympia, Providence St. Pe-

ter Hospital wanted to improve To start the project, the team used cations staff were given prompts

their timeliness for treating several sources of information to with standardized terminology for

AMIs. Specifically, the goal was benchmark its current perform- querying clinical staff to deter-

to have the time from arrival in ance against the standard, includ- mine whether cardiac cath lab

the ER to the time the patient ing external data from CMS and staff should be called to the hospi-

started treatment in the cardiac data from internal sources. The tal. In addition, once potential

cath lab span no longer than 90 team also examined best practices AMI patients arrived in the emer-

minutes. Reaching this goal at other Providence Hospitals in gency room, St. Peter’s staff pri-

meant that treatment for AMIs Portland and Everett. oritized, tracked and timed each

would have to involve finely task to assure the patient left the

The team leader utilized a combi-

tuned coordination of at least ER and was transferred to the car-

nation of the Six Sigma DMAIC

four separate functional units in diac cath lab within 45 minutes.

(Define, Measure, Analyze, Im-

the hospital, as well as with prove and Control) process and St. Peter experienced immediate

community emergency medical Lean principles. The team leader gains in meeting their 90 minute

services (EMS) personnel in the also conducted one on one inter- goal. The project formally started

field. views and examined inputs and in April 2007 with sustainable

To achieve this coordination, the outputs across each step of the Please See> Time, P24



Page 16

Healthcare Marketing Washington Healthcare News | Mar 2008 | www.wahcnews.com







It’s Time for Healthcare Marketers to Wake Up and Smell the Digital Revolution!

By Don Morgan their brand building efforts, many now about engaging the customer

Director of Marketing are moving much too slowly. A in a conversation and persuading

Palazzo Intercreative

Forrester study reported that only them to take action.

39% of visitors to hospital web When people visit your web site,

sites report that they are satisfied they aren’t there to hear your

with their experience. That same sales pitch, your slogan or to see a

Forrester study found that con- flash animation of your logo.

sumers who visit hospital web They want information, interac-

sites are accustomed to using the tion and choices. They want a

Internet for help with their health- conversation, not a lecture. It’s

care. Ninety percent of hospital time for healthcare marketers to

take advantage of the power the

Internet affords to build brand

“It’s time for healthcare

loyalty and preference, not just

marketers to take advantage awareness. With the right mes-

of the power the Internet sages to the right people, you can

In his best-selling book, The New affords to build brand lead consumers into a preference

Rules of Marketing and PR, loyalty and preference, not for your brand.

David Meerman Scott sums up

just awareness” 2008 will be a year when internet

today’s marketing environment

with this statement “The Internet Don Morgan, marketing becomes mainstream.

Director of Marketing We are already seeing the emer-

has profoundly changed the way Palazzo Intercreative

people communicate and interact gence of online advertising as an

with each other. It has also integral part of many consumer

changed the way businesses com- site visitors have sought informa- products’ marketing programs. I

municate with current and poten- tion on medical conditions, 88% am particularly intrigued by the

tial customers. In the old days, have researched general health or integration of offline media and

marketers could only communi- fitness topics, and 80% have re- online media as a new way to use

cate through the filter of expen- searched medications online. the power of the Internet.

sive advertising or media ink The web site is only one element A great example of this is the cur-

placed by a PR firm. Today, the of the new digital marketing mix rent Burger King Whopper Freak-

rules have changed entirely.” that is available to healthcare out campaign. Thirty second TV

For some time now, we have been marketers. It is important to rec- commercials direct consumers to

encouraging our clients to look ognize that the Internet is not so a special web site, whopperfreak-

for new ways to reach their cus- much about technology as it is out.com, where an eight-minute,

tomers in today’s digital age. In a about people. The history of mar- documentary-style video tells

recent article, I pointed out that keting communications has been the story of how real custom-

while hospital marketers increas- about pushing messages to pros- ers reacted to a staged situa-

ingly say they recognize the value pects. With the power and influ- tion of a Burger King that no

that web marketing can play in ence of the Web, marketing is Please see> Marketers, P25



Page 18

  R E C R U I T I N G  

Over 3,300 health care leaders in Washington State and the 

 

Northwest receive the Washington Healthcare News each 

month.   As a health care organization, doesn’t it make sense 

to target recruiting to the people qualified to fill your jobs?   

To learn about ways the Washington Healthcare News can 

help recruit your new leaders contact David Peel at 

dpeel@wahcnews.com or 425‐577‐1334. 









631 8th Avenue, Kirkland WA 98033 | 425‐577‐1334 | www.wahcnews.com 

Healthcare Opinion Washington Healthcare News | Mar 2008 | www.wahcnews.com





periodontal disease and osteopo-

Raising the Profile of Dental Benefits

rosis, kidney disease and Alz-

By Karen Brown link between oral health and over- heimer’s disease.

Communications Manager all health. Periodontal disease is Diabetes – Diabetes is twice as

Dental Health Services

often an indicator or contributing prevalent among people with

Business owners and decision factor in other serious medical periodontal disease, according to

makers usually understand how conditions that result in increased the American Academy of Perio-

important it is to have health in- medical plan costs. The Ameri- dontology. Periodontal diseases

surance benefits to attract and re- can Dental Hygienists Associa- are often more frequent and more

tain quality employees. On the tion breaks it down like this: severe among diabetics because

other hand, some employers see Every dollar spent on preventive of lowered resistance and longer

dental care as a secondary cover- dental procedures saves $8 to $50 healing process, as stated by

age that is optional. This is true in future dental treatments. American Dental Association. In

with limited budgets. However, addition, diabetics are more likely

employees consistently cite dental “About 85 percent of people to acquire gum disease, which can

coverage as one of the most who have experienced a make it harder to control their

sought after benefits. heart attack have blood sugar.

Employers may not realize that periodontal disease,

Heart Disease – People with gum

failing to offer this coverage can according to the American

disease may run twice the risk of

cost them significantly each year. Academy of Periodontology”

having a fatal heart attack. About

Dental disease or discomfort is Karen Brown 85 percent of people who have

often overlooked as a cause of Communications Manager

Dental Health Services

experienced a heart attack have

employee absence and poor job periodontal disease, according to

performance. A Surgeon General As far back as the late 1800s, oral the American Academy of Perio-

report reveals that dental ailments infections were thought to have dontology. Bacterial byproducts

and periodontal disease result in an important relationship to many from gum tissue can enter the

164 million work hours lost each systemic diseases. The mouth is bloodstream, causing small blood

year, 12.7 million days workers the greatest incubator of bacteria. clots, which may contribute to

placed on restricted activity, and In fact, the Academy of General clogging the arteries. The inflam-

6.1 million days of disability. Dentistry reports that 90 percent mation caused by gum disease

According to the American Acad- of medical illnesses first manifest may also lead to fatty deposits

emy of Periodontology, 25 per- themselves in the mouth. Oral inside heart arteries.

cent of Americans over 35 and 50 health is a factor in many medical Cancer – More than 30,000 peo-

percent of Americans 55 or older conditions including the follow- ple in the U.S. are diagnosed with

have periodontal disease, more ing: oral and throat cancer each year

commonly known as “gum dis- Respiratory Ailments – The bac- and more than 8,000 of them will

ease” or “gingivitis.” The chronic teria that grow in the oral cavity die, according to a study by Den-

nature of periodontal disease re- can travel to the lungs, causing tal, Oral, and Craniofacial Data

quires consistent, ongoing care. respiratory diseases such as pneu- Resource Center. With a five-

You can boost your business and monia, especially in people with year survival rate of only 52

provide a valuable service by gum disease. Researchers are percent, oral cancer is one of the

helping clients understand the also examining links between Continued on next page



Page 20

Volume 3, Issue 3



Continued from prior page duce labor. Pregnancy costs employees, individuals) about

deadliest types of cancer. Since through delivery can be up to 15 new benefit designs is the key to

cancer survival is directly related times higher with the birth of a showing them that they can afford

to the stage at diagnosis, it is even pre-term or low birth weight dental benefits. The dental insur-

more important to have a dental baby. The good news is that ance industry is developing more

exam. periodontal treatment during options to ease the financial strain

In addition, men with a history of pregnancy reduces premature while driving consumer responsi-

periodontal disease have a 63 per- births by 84%. bility. Our role is to provide con-

cent higher risk of developing Dental insurance has always been tinuous education so that consum-

pancreatic cancer than men with- consumer-driven since it typically ers understand how dental bene-

out periodontal disease, according offers first-dollar preventive care fits can improve their overall

to a 10-year study conducted for including regular check-ups and health and their personal and/or

the Harvard School of Public teeth cleaning. Cost sharing on companies’ bottom line—they

Health. basic and major care encourages will thank us for it.

Premature Birth – Pregnant members to become better in-

women with untreated periodontal formed consumers. As the medi- Karen Brown is the Communica-

disease are seven times more cal insurance industry moves to- tions Manager for Dental Health

likely to have a baby born prema- ward consumer-driven healthcare, Services, an employee-owned den-

turely, according to American this is likely to be a stronger con- tal benefit plan company serving

Academy of Periodontology. nection between oral and overall 100,000 people throughout WA and

Gum disease can trigger increased health. CA. Karen can be reached at

levels of biological fluids that in- Educating consumers (employers, kbrown@dentalhealthservices.com.









Page 21

Healthcare Opinion Washington Healthcare News | Mar 2008 | www.wahcnews.com







First Change the Rules of Health Care dramatically from $2,100 to $900.

This was a significant savings for

By Robert Mecklenburg, MD But the medical center is not both employer and insurer. And

Medical Director working on this effort alone. To- as a health care system, Virginia

Center for Health Care Solutions

gether with Aetna, Regence Blue- Mason was able to see five times

Virginia Mason Medical Center

Shield, Premera Blue Cross, and as many back-pain patients as be-

The cost of U.S. health care con- several major Northwest employ- fore through the optimized work-

tinues to rise with double-digit ers, Virginia Mason has looked at flow and process efficiency. Ulti-

increases every year and there’s ways to reduce costs and waste in mately, it meant patients got

no relief in sight. Millions of indi-

faster, better care for their back

viduals and families can no longer “Statistically, Virginia pain and were able to return to

afford health care. Businesses of Mason providers refer work sooner.

every size are struggling to pro- patients to expensive

vide subsidized medical coverage Another expensive workplace

emergency department health issue in both lost employee

for their staff. Medicare costs are

spiraling out of control for both

treatment for migraines only time and health care cost is mi-

seniors and the federal govern- 25 percent as often as other graine headaches. The team again

ment. The crisis is here. If we’re doctors in Washington state” looked at the process for patients

going to solve the problem, we and identified the need to provide

Robert Mecklenburg, MD

must first change the rules. Center for Health Care Solutions an effective drug treatment at the

Virginia Mason Medical Center onset of the migraine rather than

Less is more

an emergency department visit or

At the center of the problem is several of the most expensive

MRI test. Consequently, the cost

America’s misaligned reimburse- work-related care issues, such as

for treating migraines dropped

ment system. Doctors and hospi- back pain and migraines.

dramatically as well. Statistically,

tals are rewarded and reimbursed The patient-centered efficiency Virginia Mason providers refer

at higher levels for the volume of team analyzed the process a pa- patients to expensive emergency

services and expensive tests pro- tient went through to get his or department treatment for mi-

vided to patients, rather than the her back pain treated and back to graines only 25 percent as often

results or value-added care given. work. Several layers of waste as other doctors in Washington

Focusing on outcomes and elimi- such as initial doctor visits and state.

nating unnecessary steps will unnecessary MRI diagnostics

While the cost savings for back

drive down the costs in health were identified. The solution for

pain, migraine and other stream-

care. back pain became clear. The most

lined treatments is good for health

Virginia Mason Medical Center value-added results for patients

plans and employers, it proved to

has interwoven waste reduction came from physical therapy. So

be a challenge for Virginia Ma-

into its system-wide management physical therapy was placed first

son. By reducing the number of

methodology, called the Virginia rather than last in the care deliv-

expensive steps involved in treat-

Mason Production System. By ery system.

ment, reimbursement rates were

focusing on removing waste from By streamlining the process, the no longer profitable for the health

processes in order to eliminate wait time for appointments was system. Improvements were sav-

defects, the medical center oper- reduced from about a month to ing employers and health plans

ates more efficiently and provides less than a day, and the average

better quality care for patients. cost of back-pain care dropped Please see> First, P25

Page 22

Workplace Wellness: Why Promote Wellness? Time is of the Essence:


From Page 12 companies save money by retain- Dilation Time

your employees may miss less ing workers who appreciate the

work caring for ill family mem- benefit of a wellness program and
bers as well. The cost savings of they can attract new employees in From Page 16

providing a wellness program can a competitive market. improvements achieved by July

be measured against reduced 2007. Prior to the project, ap-

overtime to cover absent employ- Joan Flood, RHU, is an employee proximately 65% of AMI patients

ees and other aspects of absentee- benefits consultant at Parker, were being treated within 90 min-

ism. Smith & Feek, Inc., a full service utes. In the third quarter of 2007,

Improve morale and enhanced brokerage and consulting firm in on average, 89% of AMI patients

image for the organization Bellevue, WA. She can be were treated within 90 minutes.

A company that cares about its reached at 425-709-3645 or by At St. Peter, AMI patients are al-

employees' health is often seen as email at jiflood@psfinc.com ready experiencing better care.

However, St. Peter should also

begin to realize other benefits. In

addition to improving their per-

formance against other hospitals

in the country, the change should

lower St. Peter’s adjusted mortal-

ity rate. Since some third party

payers are either already paying

hospitals for superior quality per-

formance or are planning to do so,

improvement in the AMI process

may also have a direct impact on

the bottom line.

For more information about this

project, contact Kurt Miller, Heart

Program Director, at

Kurt.Miller@providence.org or

Alan Messegee, Project Leader, at

Alan.Messegee@providence.org.



Lynette Jones and Cassie Undlin

are Principals in the consulting

firm Strategic Opportunity Solu-

tions. The firm specializes in en-

gagements that improve perform-

ance of health care organiza-

tions. Lynette can be reached at

lynettedjones@gmail.com.

Cassie can be reached at

cassieundlin@gmail.com.

Page 24

Volume 3, Issue 3



It’s Time for Healthcare Marketers to Wake Up and Smell the Digital Revolution!


From Page 18 its first month, about five times full-service Seattle advertising

longer offered the Whopper on its what they would have considered agency that specializes in health-

menu. It is a very creative way to successful. care. All material is protected by

engage customers in their story of copyright, and cannot be repro-

Isn’t it time for you to wake up

a taste preference for the Whop- duced without the written permis-

and join the revolution?

per versus the Big Mac and other sion of the company. For more

alternatives. According to a Bur- information, contact Don via e-

ger King spokesman, the site has Don Morgan is Director of Mar- mail at don@palazzo.com



First Change the Rules of Health Care ployers and health plans to reduce

health care costs while providing


From Page 22 and better for patients. son will continue to align its work

money and lost employee time, Introducing the Center for with results and values perceived

but the medical center was now in Health Care Solutions by patients and employers, rather

the red on specific procedures. Based on the success of stream- than the number of services ren-

Doing things the old way was bet- lining back pain and migraine dered.

ter for the bottom line but not bet- care, Virginia Mason launched

ter for patients, employers or the Center for Health Care Solu- Robert Mecklenburg, MD, is the

health plans. Several health plans tions in the fall of 2007. This new Medical Director of the Center

recognized this disincentive and program is focused on forging for Health Care Solutions at Vir-

agreed to pay more for value- partnerships with regional em- ginia Mason in Seattle.









Page 25

New or Recently Promoted Health Care Leaders

Middle Effective New or

First Initial/ Month/ Promoted

Name Name Last Name Title Year Organization Leader

Virginia Mason Internal

Alvin Calderon MD PhD Program Director Jan ‘08 Promoted

Medicine Residency

Sandy Dillman Executive Vice President Jun ‘07 Aon Risk Services New

Dave Forsell Vice President Aug ‘07 Aon Consulting New

Senior Vice President,

Janet Hirsch Oct ‘07 Aon Risk Services New

Healthcare Practice

University of Washington

Meg Kerrigan Executive Director Feb ‘08 New

Physicians Network

Keith Mock Director of Finance Jan ‘08 Virginia Mason Medical Center Promoted

Meg Paul Vice President Apr ‘07 Aon Consulting Promoted

University of Washington

Jane Perry Director of Charge Capture Oct ‘07 Promoted

Physicians

University of Washington

Jennifer Petritz Director of Human Resources Jan ‘08 Promoted

Medical Center

Yakima Valley Farm

Ross Ronish MD Chief Medical Officer Jan ‘08 New

Workers Clinic

Kristi Spurgeon Director of Marketing Dec ‘07 Walla Walla General Hospital New

VP for Program and Highline West Seattle

Paul Tegenfeldt Feb ‘08 New

Services Development Mental Health



To announce a new or recently promoted Director or higher level individual

at your organization, e-mail David Peel at dpeel@wahcnews.com.









Save the date for the WSHHRA Spring Conference! 

April 24‐25, 2008 

Suncadia Lodge 

Rosalyn, WA. 

Join us at the beautiful, new Suncadia Lodge.  Network with peers and hear speakers present timely 

and relevant topics, including: how technology changes our communication with employees; han‐

dling workplace stress, dealing with difficult behaviors, and improving self management in a time 

when leaders are expected to do more with less; how to get more recognition, respect, and reward 

as a Human Resources Professional; and much more.  Visit www.wshra.org for registration informa‐

tion.  



Interested in joining an association of human resource professionals focused on issues relevant to 

health care? 

The Washington State Healthcare Human Resources Association (WSHHRA) is a state‐

wide professional organization of human resources professionals who work in health care. We have 

an affiliation with the national association, the American Society for Healthcare Human Resource 

Administration (ASHHRA). If you are interested in joining the organization, or to learn more, visit 

www.wshhra.org, and click on the “Membership” tab. 

 



 



 





Page 26

Volume 3, Issue 3





Career Opportunities To advertise call 425-577–1334







The Communication.

The Collaboration.

Exceptional People.  Exceptional Care. 

The Spirit of Controller 



PeaceHealth. Oversees and directs the Accounting and Accounts Payable functions. Bachelor’s degree in accounting, graduate degree, 

and CPA preferred. The ideal candidate will have at least five years experience in a healthcare setting, previous Federal or 

NIH Grant experience, and at least five years accounting experience.  

Director – Emergency Services 

At PeaceHealth, we value the        

Responsible for the planning, coordination, and direction of operations for our new 42‐bed ED, which includes 4 trauma 

involvement, cooperation, and     

rooms and 10 fast track beds. Collaborates with medical staff, and services within the organization to achieve the goals 

creativity of all who work together to      

and objectives of the Nursing Division, Evergreen Hospital Medical Center, and the District at large. Minimum of 3‐5 years 

promote the health of the             

Emergency Department Director‐level experience required. Advanced Degree in Nursing, Business, or related Health Care 

communities we serve.  Serving five 

field is strongly preferred. 

regions in Alaska, Oregon, and     

Washington, this opportunity is      Medical Director – Quality Management 

located in the Lower Columbia Region  The Medical Director for Quality and Patient Safety is responsible for promoting clinical excellence and patient safety 

in Longview, WA at our 200‐bed level  throughout the organization. The medical director will provide direction, guidance and support to the medical staff and 

III St. John Medical Center.  employees. Minimum of five years post graduate experience in direct health care delivery, Doctor of Medicine, licensed 

to practice in Washington State, Board certification in specialty, Experience in either medical staff leadership or quality 

F I N A N C E / C F O









Regional VP Finance/  improvement leadership. 

Chief Financial Officer 

Develop overall financial management 

At Evergreen Healthcare we are pleased to offer competitive salaries and benefit options!  Located 12 miles NE of Seat‐

policy, oversee and coordinate all 

tle, our beautiful campus, excellent staff relationships, and a friendly and professional work environment are just the 

fiscal affairs of the lower Columbia 

beginning!   

Region.  This position serves as a 

member of the Regional Executive  To learn more about these positions and Evergreen Healthcare, visit us at: 

Team (RET) collaboratively providing  12040 NE 128th St Kirkland, WA 98034 

advice concerning resource            www.evergreenhealthcare.jobs 

allocations, setting performance  

standards, and financial implications 

of regional strategies and operating 

decisions, evaluation, and financial 

V P









planning for PeaceHealth Lower   

Columbia Region.  Conducts the long 

range financial and capital planning 

process. 

R E G I O N A L









Qualifications:  Bachelors in Business 

Administration, Finance/Accounting or 

equivalent required.  Masters in    HEALTHCARE MANAGEMENT ADMINISTRATORS, INC.

relevant field desired.  A minimum of 

six years experience in healthcare  Healthcare Management Administrators (HMA) is a market leading Third-Party Administrator with

financial management and accounting  more than 20 years of successful operations in the Northwest. We serve as the TPA for over 100

in a healthcare setting and/or with a  self-funded health plans covering 125,000 participants. We are looking for creative, innovative

major accounting firm with good  and forward-looking individuals who share our values to join our Client Services account manage-

exposure to third party                    ment teams in our Bellevue, WA and Portland, OR offices.

reimbursement and managed care.   Account Executive (Bellevue) - Primary responsibility will be the development of strategic initia-

Must possess thorough knowledge  tives specific to our clients, brokers and the Sales Team, including creation of Service Plans and

and extensive experience in           Initiatives aligned with our core strategies and market growth plans. This position will provide high

accounting theory and practice,    -cover for implementation and product/service offerings and serves as Subject Matter Expert on

financial management and healthcare  HMA products and services, as well as acting as mentor and coach for the Account Managers and

finance.  Account Service Representatives. Candidates must have excellent presentation, verbal and writ-

To view the entire job description and  ten communication skills, project management and computer skills.

apply online please visit:   Account Manager (Portland) – Responsible for a direct book of business, serving as the primary

http://www.peacehealth.org/apps/ client liaison, ensuring the benefit administration needs of the brokers and clients are met. This

JobsOnline/Default.asp   position works closely with the Account Service Representatives, and provides technical oversight

for their work.



Candidates must have 7 years experience in the health insurance industry, including 5 years work-

ing with clients/brokers and 4 years account management. Extensive knowledge and understand-

ing of ERISA and Benefit Plan Management, Self-Funded Benefit Plans and Stop Loss. BA de-

gree (or combination of education and experience). State Agent’s License, Life & Disability or

other professional designation (i.e., CEBS, HIAA). Excellent presentation, verbal and written com-

munication, project and time management and computer skills. Salary DOE + Quarterly Incen-

FINANCE  tives + opportunity for Profit Sharing Bonus.



For more information, please visit: www.accesshma.com.



Page 27

Career Opportunities To advertise call 425-577–1334









Chief Financial Officer 

Deering  and  Associates,  has  been  retained  to 

assist  the  Family  Health  Center’s  of  Okanogan  in 

recruiting for their Chief Financial Officer. 

FHC  enjoys  strong  community  support  and  is 

strong financially. The Center has 136 employees, 

13 medical providers, and 4 dentists. 

The  CFO  is  responsible  for  the  overall  financial 

activities  of  FHC  and  serves  as  a  member  of  the 

Board Finance Committee. 

This  is  a  rewarding  opportunity  to  assist  a  very 

successful  community  based  health  center.  Oka‐

nogan  is  large  enough  to  provide  community 

amenities  and  retain  its  small  town  feeling  and 

sense of community. 

A  Bachelors  degree  in  Business  Management, 

Finance or  Accounting is required, a  CPA or MBA 

preferred.  5  years  experience  in  community 

health  centers  is  highly  desirable,  with  at  least  3 

years executive level experience. 

If you or anyone you know might be interested in 

this  opportunity,  please  reply  in  the  strictest 

confidence with a resume to Deering and Associ‐

ates by calling toll free (888) 321‐6016 or email at 

dewey@deering‐associates.com. 

 









Manager - Contract Performance

Position Summary:

Responsible for the oversight and manage-

ment of payor contracts including: monitoring

compliance and performance with financial

and contractual obligations, for commercial

and government business. Supports UWP

and the Contracting and Payor Relations team

by providing analysis of payors and their per-

formance, marketplace trends and other perti-

nent health care industry trends. Manages a

small team of support analysts. Maintains

positive relations with UWP department per-

sonnel. Interested in posting a

position or

Required Qualifications:

announcing an

Bachelors degree in business administration,

finance, health services administration, or employee’s recent

equivalent combination of education and ex- achievement?

perience; Five years experience in health care

field with an emphasis on claims administra- Use the News!

tion and/or contract management; Knowledge

of local payor market, desirable; Comprehen-

Deadline for reserving

sive understanding of physician practice plan space in the April 2008

operations with emphasis on operational is- edition is March 3,

sues relating to contracting / and payor re- 2008.

quirements.

Contact David Peel at

For information on the application process,

visit www.uwphysicians.org and click on dpeel@wahcnews.com

“Careers at UW Physicians.” to learn more.



Page 28

Volume 3, Issue 3





Career Opportunities To advertise call 425-577–1334





Physician Assistants & 

Nurse Practitioners   The Communication.

Join the exceptional staff of Community Health      The Collaboration.



Association of Spokane!  The Spirit of

 

Purpose of Job:  To improve the overall health of the com‐

PeaceHealth.

munity and to expand the availability of health care by  About Spokane

providing quality medical services.  The Spokane community At PeaceHealth, we value the        

involvement, cooperation, and     

Duties include:  Examining patients to determine general  has 201,600 residents, creativity of all who work together to 

physical condition, performing physical   examination and  443,800 in the promote the health of the             

preventive health visits, prescribing or recommending  metropolitan area. communities we serve.  Serving five 

drugs or other forms of treatment under the direct super‐ Enjoy 260 days of regions in Alaska, Oregon, and     

sunshine per year. The Washington, this opportunity is    

vision of a physician, and developing practice plans and a  located in the Lower Columbia Region, 

region is a gateway to

relationship with the supervisory physician.  in Longview, WA at our 200‐bed level 

the great outdoors with

III St. John Medical Center. 

Qualifications:  Valid licensure in Washington State, Board  76 lakes, 33 golf courses,

Certified or Eligible, able to apply for prescriptive privi‐ 11 wineries, 5 ski resorts, Regional Director,  

leges, graduation from an accredited school, CPR/ACLS  5 major national parks, PeaceHealth Medical Group 

certification, effective oral and written communication  and Columbia River Two positions:  Primary Care and 









D I R E C T O R

skills, ability to  secure credentialing through identified  Gorge all within an easy Specialty Care.  Directs medical group 

drive of the city. CHAS primary care operations, evaluates the 

agencies (Medicare, Medicaid, etc.) 

offers competitive development of new and continuation 

of existing services, participates in 

salaries outstanding physician compensation plan        

benefits. For more administration and revisions as 

information on CHAS needed, evaluates the impact of   

and employment future technologies on physician  

opportunities visit: practices and patient satisfaction, 

creates a patient centered             

WWW.CHAS.ORG

R E G I O N A L

environment that is highly satisfying to 

physicians and staff, manages       

community and interdepartmental 

The  Washington  State  Hospital  Association  is  a  membership  organiza‐

relations, and coaches/mentors    

tion  representing  community  hospitals  and  several  health‐related  or‐ physician manager team to improve 

ganizations.  The association provides issues management and analysis,  team leadership effectiveness. 

information,  advocacy  and  other  services.        We  are  currently  seeking 

Qualifications:  Bachelor’s Degree in 

the following positions to join our organization.  healthcare or related field.  Minimum 

of 4 years of progressive leadership in 

Quality Improvement Manager, Rural Healthcare Quality Network  physician practice management   

We are seeking a seasoned healthcare professional who has a passion for improving quality of  required. Previous progressive senior 

care  in  rural  settings  to  help  support  implementation  of  the  Rural  Health  Quality  Network  leadership experience in health care 

programs.  Monitors, communicates and helps hospitals implement quality improvement ini‐ administration, and experience in 

medical group administration       

tiatives.  BA, BSN or equivalent; graduate degree highly desirable.  Competitive compensation 

required.  Strong understanding of 

package 

principals of patient centered care, 

Director, Program Communication  physician compensation systems, 

medical technology, including       

We are seeking a highly organized individual responsible for developing, writing & overseeing 

electronic medical records, and qual‐

production or communications pieces for three programs.   Responsible for creating publica‐ ity/service improvement strategies. 

tions, presentations, webcasts & general communications pieces that promote programs’ ac‐

To view the entire job description and 

tivities, message and mission.  Excellent writing & interviewing skills, attention to detail, pro‐ apply please visit:  

ject development & ability to handle multiple priorities are required.  5 years of experience,  http://www.peacehealth.org/apps/

health care communications a plus;  BA preferred.  FT with excellent benefits.  JobsOnline/Default.asp  



To apply for either position, complete and download application from www.wsha.org and send  

with cover letter and resume to: 

Connie Ray 

Washington State Hospital Association 

300 Elliott Avenue West, STE 300 

Seattle, WA 98119   PEACEHEALTH MEDICAL GROUP 

E‐mail:  connier@wsha.org 



Page 29

Career Opportunities To advertise call 425-577–1334









 

 

Next month in the News-

 

 An analysis of 2007 versus

Clinical Quality Program Coordinator 

2006 financial results of

Practice Administrator  Skagit  Valley  Medical  Center,  located  in  Mount  Vernon, 

domestic health insurance

WA,  represents  a  multi‐specialty  team  of  healthcare  pro‐

An  excellent  opportunity  for  an  experienced  fessionals dedicated  to excellence and  patient satisfaction  carriers

at every level of our organization.   

health care professional to provide leadership and   A Healthcare Company profile

We  are  seeking  a  Clinical  Quality  Program  Coordinator  to 

direction  in  managing  clinical  operations  at  a  assist  in  developing  and  managing  the  clinical  quality  on Northwest Health Care

Yakima based,  medium sized orthopedic practice.    improvement program at our company.  Additional respon‐

sibilities include collection and analysis of data, preparation  Linen

Candidates  should  have  experience  in:    problem‐

of reports for providers and clinical staff and presentation 

solving  with  physicians,  contract  negotiations,  of material to small and large groups.   An interview with David Weber,

preparation  and  analysis  of  financial  reports,  Qualifications:    Experience  with  paper  and  electronic  MD, CEO of Wenatchee Valley

physician  recruitment,  oversight  of  retirement  medical  records  and  data  extraction.    Familiarity  with  Medical Center

plan,  personnel  management,  medical  billing  and  clinical quality measures (NCQA, etc.) and coding schemes 

(CPT,  etc.).    Excellent  verbal  and  written  communication 

coding,  and  clinical  policies  and  procedures.   skills.  Formal training in clinical medicine (such as RN with   A Healthcare Opinion article

Administrator  is  responsible  for  the  overall  func‐ bachelors degree) or training in health information appro‐ from State Senator Linda Evans

tioning  and  financial  success  of  the  practice,  as  priate experience.  Parlette and State Senator Mark

well as the maintenance of high staff morale and a  Applicants  should  download  and  complete  application  Schoesler

from  our  website  (www.svmc.net)  and  send  with  cover 

culture of compassionate medical care.  We  offer 

letter and resume to:   A Healthcare Opinion article

a  competitive  salary  and  benefits  package.  

Skagit Valley Medical Center, Human Resources 

Please  send  cover  letter  and  resume  to                   

1400 E. Kincaid, Mt. Vernon, WA 98274 

from Linda Tieman, RN, MN,

peuteneier@orthnw.com.  or fax to (360) 428‐6485  FACHE, Executive Director of

the Washington Center for

    Nursing

  To receive your complimentary copy

contact David Peel at

dpeel@wahcnews.com.





Page 30

Volume 3, Issue 3





Plan and Hospital Financial Information

YTD Net Income and Members through 09/30/07 for the Largest Health Plans in Washington State¹

Plan Name Net Income Members Plan Name Net Income Members

Health Plans: LifeWise Health Plans of AZ. ($11,164,137) 31,266



Regence BlueShield $66,554,186 885,521 Arcadian Health Plan ($924,311) 19,090



Premera Blue Cross $76,438,960 726,319 Timber Prod. Manuf. Trust $460,174 9,611



Group Health Cooperative $72,789,487 401,888 Washington Employers Trust ($1,560,699) 9,122



Molina Healthcare of WA $32,585,577 283,931 Aetna Health, Inc. $1,977,998 6,708

Community HP of WA $9,300,708 232,579 Washington State Auto Ins. Trust ($1,654,448) 3,100



Group Health Options $114,549 103,491 Puget Sound Health Partners ($1,675,215) 0



Asuris Northwest Health $4,047,694 90,828 Vision or Dental Plans:



LifeWise Health Plan of WA $1,623,819 89,102 Washington Dental Service $12,560,083 907,902

Pacificare $33,427,691 52,399 Vision Service Plan $6,141,567 544,640

KPS Health Plans ($943,114) 45,740 Willamette Dental $461,985 70,043

Columbia United Providers ($1,570,608) 35,681 Dental Health Services ($1,003,741) 25,664



YTD Margin and Days through 09/30/07 for the Largest Hospitals in Washington State 2

Hospital Name Margin Days Hospital Name Margin Days

Sacred Heart Medical Center $41,858,163 112,800 St. Joseph Hospital Bellingham $13,364,759 43,285



Swedish Medical Center $79,937,119 107,202 Good Sam. Comm. Healthcare $36,754,790 41,629



Harborview Medical Center $11,535,000 101,165 Valley Medical Center $24,428,199 40,121



Providence Everett Med Ctr. $23,002,895 75,599 Yakima Valley Memorial $5,485,968 37,569



University of WA Med Ctr. $24,366,972 73,583 Highline Medical Center $6,459,112 35,552



St. Joseph Medical Center $59,093,249 69,277 Northwest Hospital $4,222,277 30,934



Virginia Mason Medical Ctr. $11,629,102 64,481 Swedish Cherry Hill Campus ($10,398,308) 30,925



Southwest WA Med Ctr. $2,382,889 63,986 Kadlec Medical Center $6,098,901 30,386



Providence St. Peter Hospital $20,180,986 62,386 Central Washington Hospital $10,563,706 30,235



Tacoma General Hospital $37,433,609 62,046 Holy Family Hospital $799,029 28,828



Children’s Hospital $34,197,000 49,936 Legacy Salmon Creek Hospital ($4,541,322) 24,029



Deaconess Medical Center ($687,439) 49,514 Auburn Regional Medical Ctr. ($1,650,027) 23,463



Harrison Medical Center $20,068,173 48,955 St. Clare Hospital $9,523,855 21,384



Overlake Hospital Med. Ctr. $10,582,844 44,677 Yakima Regional Medical Ctr. $8,585,803 20,969



1

Per filings with the WA State Office of Insurance Commissioner. 2Per filings with the WA State Department of Health. Evergreen

Healthcare and Stevens Hospital were among the largest hospitals but their complete financial information wasn’t available on the

WA State Department of Health website at press time and therefore wasn’t reported.



Page 31

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