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JOHNSON CITY, Tenn., Aug. 15, 2019 (GLOBE NEWSWIRE) -- Ballad Health today announced quality, investment and financial results from its first full fiscal year of operation as a combined system.
“Despite the national challenges faced by hospitals, including nursing shortages and the phenomenon of ‘ER boarding’ of patients in need of behavioral health services, Ballad Health’s operational performance has been demonstrably exceptional, as evidenced by objective performance measures,” said Alan Levine, chairman and chief executive officer of Ballad Health. “This is attributable to the incredible work of our doctors, nurses and support team members who focus every day on better quality and lower cost.
“The improvement in our financial and quality performance has led to lower costs, which translates into savings for the employers in our region, a goal we remain committed to. This improvement has also allowed us to make additional investments in nursing resources, which we hope will help alleviate the stress of the nursing shortage on our staff.”
Nursing shortage an imminent and growing issue for the nation
According to the United States government, there is a projected national shortfall of 800,000 nurses by the year 2020. The U.S. Health Resources and Services Administration projects that Tennessee will only be able to meet half of the demand for registered nurses by next year.
The National Rural Health Association has called the nursing shortage “a plague throughout the United States, and rural communities are hit harder than their urban counterparts.”
In a comprehensive report released by the NSI Nursing Solutions, Inc., titled “2019 National Health Care Retention and RN Staffing Report," the shortage of registered nurses will reach 1.13 million by 2024. The report cites a “rising turnover and a retirement wave about to break,” with nursing turnover about to “set a new high-water mark for the decade.” Finally, the report states, “half of hospitals would like to decrease their reliance on supplemental staffing.”
Data released from the National Council of State Boards of Nursing provides a sobering reminder of the looming challenges for meeting nursing workforce demands. According to the data, the average age of registered nurses in 2017 was 51, and half of all nurses practicing today are older than 50. This data supports the finding by the NSI Nursing Solutions survey that indicated a breaking retirement wave, and it might also help explain why national nursing turnover is increasing to its highest levels in recent history.
“Ballad Health has not been immune to the effects of the national nursing shortage, and no doubt this shortage is being felt throughout our system, both by our team members and by our patients,” said Lisa Smithgall, Ballad Health’s chief nursing executive. “We have taken, and continue to take, steps to alleviate this problem – a problem not created by Ballad Health, but certainly one we must deal with.”
Certain steps have been taken by Ballad Health to alleviate this issue, including:
Speaking to Ballad Health’s results for the year, on behalf of the independent members of the board of directors, lead independent director David Lester said, “The board of directors of Ballad Health is composed of people who live here, employ people here and whose families rely on the services here. We are pleased with these operating results, which demonstrate that, against serious headwinds for all hospitals in the nation, Ballad Health is taking the right steps to ensure patient safety, demonstrably higher quality and stable financial performance – all of which are necessary and important.”
Quality improvement results
Driven by clinical leadership and the contributions of physicians and team members across the system, Ballad Health has seen significant improvements in objective quality measures since the creation of the system on Feb. 1, 2018.
Recently, US News reported that all four of Ballad Health’s flagship hospitals – Johnson City Medical Center, Holston Valley Medical Center and Bristol Regional Medical Center, in Tennessee; and Johnston Memorial Hospital in Virginia – are among the top-performing hospitals in Tennessee and Virginia in several specialties, with each hospital providing “top performing” services and programs in heart failure and COPD in both states. In each state, less than 30% of all hospitals had any top-performing programs, according to US News. In Tennessee, all three of Ballad Health’s flagship hospitals were among the top-performing hospitals, while in Virginia, Johnston Memorial was among the top performers.
Additionally, in the US News rankings, Bristol Regional and Holston Valley moved up in overall rankings from No. 10 in Tennessee last year to No. 7 this year. And recently, ForbesMagazine named Johnson City Medical Center as one of the best employers in Tennessee, among all employers.
In partnership with physicians and clinical staff, Ballad Health has seen a focused effort on quality improvement significantly benefit patients. Specific examples include:
Investments by Ballad Health also are beginning to generate benefits for the region. Recently, Ballad Health announced the opening of the region’s newest assisted living facility in partnership with Signature HealthCARE, a facility focused on the emerging needs of the elderly. Ballad Health also announced a new dental residency program in Southwest Virginia, the funding of a new master’s program in addiction counseling in partnership with Milligan College and an addiction medicine fellowship program at East Tennessee State University’s Quillen College of Medicine. Ballad Health also announced plans to open a new rural hospital in Lee County, Virginia – an effort not required by the Certificate of Public Advantage (COPA) or Cooperative Agreement, but supported by the board of directors to improve access.
In the past year, Ballad Health also announced it was one of only 21 Accountable Care Organizations in the nation to help Medicare achieve cost savings in each of the first several years of the program – saving taxpayers more than $45 million. These savings have not only benefitted federal taxpayers; evidence shows area employers are benefitting from partnering with Ballad Health.
Recently, the mayor of Washington County, Tennessee, released data demonstrating that county employee healthcare costs have decreased due to efforts by Ballad Health to partner with the county and BlueCross BlueShield of Tennessee – resulting in a 10% decrease in healthcare costs and premiums for employees.
“Lower cost and higher quality go hand in hand,” said Dr. Amit Vashist, chief clinical officer of Ballad Health. “Not only are we demonstrating that reducing lower acuity admissions is beneficial to patients and the payers, but we are also seeing improvement in measures of quality within our hospitals. We strive to be a zero-harm, top-decile institution, and so far, the work of our unique clinical council in partnership with our administrative leadership is showing promise.”
Ballad Health was selected by the High Value-Care Collaborative to participate with leading health systems to adopt strategies that will reduce unnecessary costs and deliver evidence-based care that’s been demonstrated to reduce the burden on patients. The High Value-Care Collaborative is a joint project between the American Hospital Association, the American Board of Internal Medicine Foundation’s Choosing Wisely Campaign and the Costs of Care organization.
“Our priority is exceptional patient care,” said Dr. Clay Runnels, chief physician executive of Ballad Health. “Our physicians stand alongside leadership as we seek to become one of America’s leading health systems. The recent investment into physician leadership is demonstrative of Ballad Health’s determination to ensure this is a place where physicians want to practice.”
Investment into new physicians and advanced practice providers for region
Since the closing of the merger, Ballad Health has recruited more than 150 new physicians and advanced practice providers to serve the region. Successes include the recruitment of cardiology in rural Wytheville and Norton, Virginia; nephrology in Abingdon, Virginia; and urology in Kingsport. Throughout the region, Ballad Health has also recruited neurology, orthopedics, pain management, hospitalists, psychiatry and other needed specialties.
“Ballad Health has so far been successful providing lower overall costs to consumers while also improving its own financial performance, proving that better quality should mean lower costs,” Levine said. “Our improved financial performance is positive proof that by reducing lower acuity admissions and working with our payers across Medicare, Medicaid and commercial lines of services, we can reduce the cost of care for employers and consumers. These opportunities will expand as payment models move further toward increased sharing of risk between the payers and Ballad Health. By focusing on reducing unnecessary duplication in cost, we can be stronger financially as we continue to see a decline in inpatient utilization.”
Financial results for the year include:
Ballad Health’s improved financial performance for the year follows dedicated expense management, improvements in productivity, reduced reliance on temporary/contract labor and focused supply cost management.
Ballad Health’s investment into the region’s labor force is extremely powerful, with Ballad Health spending $1.043 billion on salaries, wages and benefits for the year.
These improvements are in spite of challenges, both reflective of what all providers are facing and some that are unique to Ballad Health and the region.
“Ballad Health is facing a rapidly changing landscape where our financial success is no longer judged solely by volume, but increasingly, how we care for fewer people more efficiently, effectively and with better outcomes,” Levine said. “Many of the quality metrics that we’ve seen improve have led to lower costs. Lower lengths of stay, reduced rates of hospital-acquired conditions, reduced readmissions and better integration with physicians have helped reduce the cost of care and helped Ballad Health achieve success with the new value-based purchasing environment.”
Reinvestment of capital throughout the region
While Ballad Health has focused on improved financial performance, it has also continued to invest nearly $200 million in capital for new equipment, diagnostic technology, building improvements, information technology infrastructure and a common electronic health record. Just a few examples of capital spending in the year included:
About Ballad Health:
Ballad Health is an integrated healthcare delivery system serving 29 counties of Northeast Tennessee, Southwest Virginia, Northwestern North Carolina and Southeastern Kentucky. Ballad Health was created in 2018 to improve the health of people in these regions. Ballad Health operates a family of 21 hospitals in Northeast Tennessee and Southwest Virginia, including three tertiary medical centers, a dedicated children’s hospital, several community hospitals, three critical access hospitals, a behavioral health hospital, an addiction treatment facility, long-term care facilities, home care and hospice services, retail pharmacies, outpatient services and a comprehensive medical management corporation. Learn more about Ballad Health at www.balladhealth.org.