WILLMAR — As Rice Memorial Hospital leaders prepare to dig into the budget process for 2014, they are projecting a patient volume expected to remain mostly flat. The hospital board’s finance committee reviewed the numbers this past week, along with a comparison of volume trends at the city-owned hospital for the past five years.
There has been a gradual but steady decline in overall patient volume, said Bill Fenske, chief financial officer for the hospital.
“You can see the downward trend that we’ve had with our inpatient and total patient activity,” he said.
The decline has not been confined to Rice Hospital. Hospitals across the U.S. are reporting lower utilization, particularly for inpatient care as services continue migrating to the outpatient setting.
The implication for hospitals is that revenue growth from new services and increased patient volume is unlikely to happen, Fenske said.
“What we’re going to have to do is keep going after our expenses.”
For next year, Rice is projecting 10,000 adjusted admissions, virtually the same as in 2013 and 900 lower than in 2011, when adjusted admissions peaked at almost 11,000. An adjusted admission is a measure that includes both inpatient and outpatient volume and reflects overall hospital activity.
Emergency room volume and surgical procedures, two key indicators of hospital activity, also are expected to remain flat next year.
Starting in late 2008, emergency room visits began to climb, peaking in 2011 at more than 1,200 a month. Since then, they have declined and leveled off at around 1,000 inpatient and outpatient visits a month.
A similar trend has been happening with surgery, Fenske said. “We’ve seen a leveling off of our inpatient procedures.”
Because inpatient surgeries tend to involve more ancillary services such as the pharmacy and the laboratory, surgery volume can help make or break the hospital’s financial performance in any given month.
“They’re usually a high reimbursement area for us,” Fenske said. “Those inpatient surgical procedures are so critical to us.”
The next step for the hospital budgeting process is to begin building revenue and expense projections based on anticipated patient volume. A final version of next year’s budget likely will be presented to the hospital board finance committee and the full board in November, followed by presentation to the Willmar City Council.