Basically, ECH operates on expected income of costs, plus 1 percent.

“If they (the VA) would give us the same as Medicare, then we would be OK. If we were Mass. General (hospital), we could absorb any costs or losses,” Hoffmann said.

“We have a unique contract that is different than others,” Boula noted. “The VA contracts with Dr. (Herbert) Savel. He does not work for us. Perhaps they (VA) don’t like that, but they have never come to us. We can only theorize.”

Another factor that enters into the equation is that the VA calculates funding on a per-visit basis. Since the clinic is mandated to allow only one patient per half-hour, it reduces the revenue possibilities.

Boula indicated that a dollar amount per veteran per month of enrollment would be more appropriate.

SPECULATION

Boula felt the need to quell rumors that he was responsible for Alice Hyde Medical Center in Malone losing its contract with the VA clinic.

“I was not there. The VA elected to go with a private service. We have been listening to vets that come from Malone, and they say that they are not happy with their clinic, and in their views, we have better quality.”

There have also been rumors that if the VA closes the clinic in Elizabethtown, it will reduce hospital admissions.

“We have had 32 admissions for inpatient stays,” Boula said. “They were not driven by the VA. They had Medicare and other insurers as their primary methods of payment. For veterans who don’t have insurance, they can come to the ER, and then we would get authorization.”

If the contract is awarded elsewhere, Boula said, ECH has another option: to go to the contractor and operate the ECH VA clinic as a satellite a few days a week.

If all goes according to plan, ECH should know the VA’s decision in about two weeks, the hospital officials said.

E-mail Alvin Reiner at: