Susan Turley is CFO of Doctors Hospital at Renaissance, McAllen, Texas.
Doctors Hospital at Renaissance (DHR) is a 503-bed general acute care hospital and one of the largest physician-owned facilities in the United States. DHR was ranked among the top 20 large hospitals in the U.S., the category for general acute care hospitals with over 250 beds.
DHR was recently named one of the Thomson Reuters Top 100 U.S. hospitals. What are some factors that contribute to excellence?
I believe that a three-pronged approach has made us successful. The first is putting the patient at the forefront in terms of how you manage the organization. Quality and patient satisfaction are of utmost importance. The 2nd approach is to remain community-focused. We tailor our community service efforts to the specific needs of our community. We want to assist in the economic development in our community, so we invest in projects like community gardens to improve local eating habits and partner with schools to offer culinary education. And thirdly, we strongly believe that healthcare is very local, and should be accessed locally. We need to make sure that access to care is maintained, and we do things like bring in sub-specialists from other facilities (like UT-Galveston) to treat our patients.
Doctors is a physician-owned hospital. Does that make any difference in the way you run the business office?
Absolutely it does. Being a physician-owned hospital is very beneficial in a few ways. Physicians are, of course, very focused on the patient. Because physicians own the hospital, they are very aware of the cost structure of the hospital and very interested and attentive to our concerns. We are able to go into negotiations with vendors shoulder to shoulder with our physicians. Our ownership model is very conducive to what we call a “bedside to boardroom” perspective. We have very strong lines of communication, which leads to improved efficiencies on both ends. We can streamline our processes and act very rapidly when necessary.
You have a very challenging payer mix in McAllen. How does that impact finance?
Yes, it is challenging. We don’t have a lot of commercial insurance in our region. We’re about 80 percent Medicare/Medicaid and we have about 15 percent commercial payers. But even in the recession, our volumes have remained steady. We have high poverty levels in our community, so we did not see an increase in bad debt that other facilities might have. In addition, not only did we not have to shelve any capital spending projects. In 2009, we opened an additional 100 beds devoted to our pediatric practice and expanded our emergency room. We also committed to an 18-month information technology project.
Did the recession affect your labor costs?
Not so much. We already run a very lean operation. We have about 3,000 employees, and we were one of the few MSAs that actually added jobs during the recession. Our philosophy is that we are committed to the community and keeping people employed. We always try to hire locally, and to purchase from local vendors.