KIM SMITH DEDAM
SARANAC LAKE — Adirondack Health plans to cut 18 more jobs from affiliated hospital and nursing-home staff as part of ongoing fiscal restructuring.
In addition, hours for 15 full- and part-time employees will be scaled back.
The move comes less than four months after 17 jobs full-time jobs were cut in December and a freeze set on salaries through 2013.
The job losses are due in large part to federal aid cuts to Medicaid and the added challenge posed by federal sequestration, officials say.
Adirondack Health is implementing what they consider to be “broad reforms” in accordance with the Affordable Care Act.
“These reforms have resulted in a greater focus on preventive care to improve patient outcomes and have generated a significant savings for the federally funded Medicare and Medicaid programs,” hospital CEO Chandler Ralph said in a statement.
“The reality is that health-care reform and other quality and patient-care initiatives implemented by Adirondack Health have contributed to fewer patients needing inpatient services.”
The reduction in staff will not affect health-care services, according to hospital spokesman Joe Riccio.
Specific information about how job loss is being spread throughout the organization was not yet available.
“There is no break-down by department,” he said in an interview Friday. “(But) there are no cuts to hospital-employed physicians. We are actively recruiting physicians.”
Employees have been notified of the planned layoffs and decreased hours, Riccio said, and they will receive support in outplacement services through human resource programs.
“The employees affected by these cuts have contributed to the success of Adirondack Health, and they will be missed,” he said.
The need for fewer workers is an adjustment to declining revenue.
“Revenue reductions from sequestration is about $500,000. That has gone into effect,” Riccio said.
The sequestration measure was approved in Congress on Thursday.
“Another $1.2 million in revenue reduction comes from a Medicare provision,’ Riccio said. “Together, it represents almost $2 million in reduction in the 2013 fiscal year. Coupled with reduction in patient volumes, that’s where we are right now.”
Patient volume at Adirondack Medical Center has declined in the past five years, according to data provided by Riccio.
Inpatient days at 14,131 in 2007 dropped to 10,634 in 2012.
There were an average 38.7 patients in the hospital daily in 2007; that was 29.1 in 2012.
Riccio said Adirondack Health’s push toward prevention and primary-care services could account for some of that drop in need for acute and inpatient care.
Adirondack Health launched a series of community-based prevention and primary-care services in recent years to address diabetes, cardiology and wound care, along with other health-maintenance and well-being outreach programs.
“I think we can say that what we’re doing with specialty clinics like the Medical Home Project, wound care, cardiology and diabetes addresses our idea of patient-centered care by getting the different services to the patient in order to help them enjoy a quality of life so they don’t have to go to the emergency room or to be admitted to the hospital,” Riccio said.
“We’re seeing the result partly as lower inpatient volumes. It is important to focus on the gains we’ve made on patient care.
“That’s always been our mission.”
In February last year, Adirondack Health opened the $2.7 million outpatient Wound & Hyperbaric Treatment Center, designed to use hyperbaric chambers in treating chronic wounds from medical conditions such as diabetes and cancer treatments.
That project is managed in cooperation with the National Healing Corporation, based in Florida.
And, despite job cuts, Adirondack Health remains a large economic driver in the region.
The Medical Center and its satellite facilities feed $148 million into the local economy, according to a report released earlier this month by the hospital.
The largest employer in the Adirondacks, Adirondack Health and its affiliates employ nearly 900.
In addition, the report found “Adirondack Health spends about $32 million per year on goods and services necessary to provide health care. Employees and the jobs supported indirectly by Adirondack Health facilities generated $5.7 million in federal income tax and $2 million in state and local income taxes in 2010.”
NO DECISION ON ER
Beyond job cuts, Adirondack Health is assessing hospital services, and, last June, announced it may move emergency services out of Adirondack Medical Center Lake Placid into Uihlein Living Center.
Riccio said Friday that the hospital has made no final decision yet about that move or reducing hours of emergency-room operation in Lake Placid.
“We have to evaluate all our programs and services to make sure long-term patients are receiving highest level of care in the appropriate setting at the appropriate time,” he said. “We have to do what is best for all of the patients.”
The loss of health-care jobs and cuts to health-care revenue comes as private payers in private sector jobs, along with schools and public-service jobs, face continued double-digit increases in health-insurance premiums.
“Hospitals agreed to $155 billion in reduction as part of the Affordable Care Act,” Riccio said. “Part of that measure was to expand coverage to 32 million Americans, and that’s doing the right thing.
“We want to lower costs and improve patient outcomes. It’s very difficult to do that when you face revenue reductions. And if you continually cut reimbursement for health care, it makes our job all the more difficult.
“It’s a very challenging fiscal environment right now,” he said.
Email Kim Smith Dedam:firstname.lastname@example.org
Adirondack Health operates eight regional facilities: