Altru Cuts Costs

[yzerman19]

this has started to turn political.

End of the day, money doesnt grow on trees

[MafiaMan]

this has started to turn political.

You're right, I apologize for de-railing the thread. As much as I'd like to reply to some previous comments, I like my membership here and will let it go.

[The Sicatoka]

Only senior staff is taking a paycut.

So just the trust fund babies, not the little people ... <whistles past graveyard>

[Goon]

Where did you read THAT? MSLSD.com ("Lean Forward") or The Huffington Post?

Fixed your post.

[Cratter]

Only senior staff is taking a paycut. They are not in trouble financially. They are missing a budget target.

If I have a million in savings, but my monthly expenses are running a thousand bucks in the red, do I stop investing? Do I pull out of savings? No, I'd rather do things like spend less on beer.

Read the bios of senior staff- masters degrees and twenty plus years in the business- they get it.

They aren't just missing a budget target they are short on cash.

It's not just senior staff taking pay cuts...Pto is getting cut across the board...I will wait for the article where Sanford is cutting wages.

There's no beer money left....wage cutting. Not hiring needed positions is essential cutting to a business it's people....your now getting rid of cable tv and eating ramen noodles....last resort kinda stuff cause you ain't for no cash...it's tied up in overspending bills...no "cushion" for these hard times.....wage cutting is a last resort in any business!

[yzerman19]

Do a days cash on hand analysis. Check their bond rating. Get an MBA.

The financials are very strong and stable.

There is an alternative to their plan, they could raise the cost of healthcare.

[The Sicatoka]

If you didn't think changes to prices and costs in health care were coming with mandated coverage you are naive.

[Cratter]

Yeah why did Altru not see it coming?!

[The Sicatoka]

Altru sees the changes they need to make to the changing landscape, and they are changing.

I predict this is merely the a ripple in the first wave of change hitting health care nationally.

"Every nation gets the government it deserves." -- Joseph de Maistre

[yzerman19]

They are very aware of impacts. The mandate isn't in effect yet, the exchanges just opened. Major adjustments haven't happened yet, but they will.

This is being done to prepare for the future, not because they are in trouble. Their awareness and adjustments show that they are paying close attention, not the other way around.

[yzerman19]

Sicatoka beat me to it, but is exactly right.

The long term impact of affordable care act will be to impact jobs and access to healthcare. Communities like GF will be hardest hit.

[jodcon]

Looking at their 990's they're just tightening their belt a little, they have more working capital than debt and are holding about even, not a lot more but not a problem by any means.

[yzerman19]

And 990's are tax accounting, not financial reporting. They are not for profit, so they should be holding close to flat. Debt if structured well" which theirs is, is a good thing when the weighted average cost of capital is less than 4 percent.

If they were making tons of money, the community would come unglued for monopolistic behavior.

They are well balanced, solvent, and simply adjusting for the future- as many have said.

[jodcon]

And 990's are tax accounting, not financial reporting. They are not for profit, so they should be holding close to flat. Debt if structured well" which theirs is, is a good thing when the weighted average cost of capital is less than 4 percent.

If they were making tons of money, the community would come unglued for monopolistic behavior.

They are well balanced, solvent, and simply adjusting for the future- as many have said.

For clarification, I wasn't implying they weren't properly funded, just saying they were holding their cash reserves at about the same level they have been, even the non-profits have a number in mind they want to maintain as cash on hand to cover x number of days expenses and some padding, it's just business. They're fine financially.

[Cratter]

Altru will always be fine financially. That was never in doubt. People need their services and they have a guaranteed payer in the government and insurance....and doesn't pay taxes. That "business" can never fail.....unless it hired bunch of mark kauks as CEO.

[yzerman19]

keep the Kauker out of this!!

I would disagree on how the business could fail-

1. Revenue compression due to adjustments at the federal level, such as reductions in Medicare reimbursement which is real and part of ACA.

2. Employer/insurer cost shifting to patients via more out of pocket costs in order to keep premiums lower, resulting in a greater portion of revenue "at-risk" to providers. Bad debt is a huge issue for all providers.

3. Continued technology and innovation driven inflation for medical advancements.

4. Continued scarcity of resources for top skill jobs increasing wages- even though cost of living is lower in GF than say Mpls, they have to pay doctors and nurses equal or greater salaries to get them to stay in GF.

[smokey the cat]

Sicatoka beat me to it, but is exactly right.

The long term impact of affordable care act will be to impact jobs and access to healthcare. Communities like GF will be hardest hit.

Your PhD in economics comes from... While you ignore how much insurance and healthcare have gone up in the last 20 years.

[smokey the cat]

If you didn't think changes to prices and costs in health care were coming with mandated coverage you are naive.

If you do not think that this has not been happening for the last 20 years you are naïve. Companies have been raising what their employees contribute and getting less coverage for 20 years. Now there is the simple scapegoat to blame. My insurance premium with NDBLBS went up 100% in 5 years from 2004-2009. They paid out less than $500 dollars on me the entire period. So before you people blame the ACA think back at what happened with your insurance during these years. And if any of you say that your rates did not go way up in that time either your coverage was cut way back or you are a liar.

[yzerman19]

If you do not think that this has not been happening for the last 20 years you are naïve. Companies have been raising what their employees contribute and getting less coverage for 20 years. Now there is the simple scapegoat to blame. My insurance premium with NDBLBS went up 100% in 5 years from 2004-2009. They paid out less than $500 dollars on me the entire period. So before you people blame the ACA think back at what happened with your insurance during these years. And if any of you say that your rates did not go way up in that time either your coverage was cut way back or you are a liar.

But you were not the norm (with so very few services)...you were subsidizing people who were using more services in your same rating band. Now there is only one rating, so the gap you are describing will only grow via ACA.

You are correct that cost shifting has been happening for a long time. As has the purpose of insurance. True insurance is not pre-paid medical. True insurance is stop-loss protection for unlikely events that you can't pay for yourself.

In a lot of ways, the migration of insurance to pre-paid medical can be tied to continued pressure on wages and completely inaccurate reporting of inflation. If the vast majority of Americans aren't liquid $2000, they can't "self-insure" at all.

[yzerman19]

Your PhD in economics comes from... While you ignore how much insurance and healthcare have gone up in the last 20 years.

I won't take the bait, but lets just say I spent 8 years on the west bank of the Mississippi in a city to the SE of GF. I've also got 15 years of professional experience working on the payor and provider side in industry and as a consultant.

I do not ignore the growth of healthcare costs, but I do fully understand the drivers.

Health insurance is expensive, because healthcare is expensive. It is driven by a multitude of factors, but predominantly utilization increases including both volume and complexity of care. There are many more drivers, but utilization is the big one. Don't forget the quality of life indicators, life expectancy, and survival rates of chronic and catastrophic illness have all dramatically improved over that same 20 year time horizon.

[smokey the cat]

But you were not the norm (with so very few services)...you were subsidizing people who were using more services in your same rating band. Now there is only one rating, so the gap you are describing will only grow via ACA.

You are correct that cost shifting has been happening for a long time. As has the purpose of insurance. True insurance is not pre-paid medical. True insurance is stop-loss protection for unlikely events that you can't pay for yourself.

In a lot of ways, the migration of insurance to pre-paid medical can be tied to continued pressure on wages and completely inaccurate reporting of inflation. If the vast majority of Americans aren't liquid $2000, they can't "self-insure" at all.

This was an insurance program only available for full-time college students. Probably the lowest risk around.

[smokey the cat]

I won't take the bait, but lets just say I spent 8 years on the west bank of the Mississippi in a city to the SE of GF. I've also got 15 years of professional experience working on the payor and provider side in industry and as a consultant.

I do not ignore the growth of healthcare costs, but I do fully understand the drivers.

Health insurance is expensive, because healthcare is expensive. It is driven by a multitude of factors, but predominantly utilization increases including both volume and complexity of care. There are many more drivers, but utilization is the big one. Don't forget the quality of life indicators, life expectancy, and survival rates of chronic and catastrophic illness have all dramatically improved over that same 20 year time horizon.

Then maybe you can tell my retired Royal Canadian Mounted Police officer friend why Altru charges $2,000 for an MIR and his daughter did a walk up MIR in Canada for $513.

[smokey the cat]

I won't take the bait, but lets just say I spent 8 years on the west bank of the Mississippi in a city to the SE of GF. I've also got 15 years of professional experience working on the payor and provider side in industry and as a consultant.

I do not ignore the growth of healthcare costs, but I do fully understand the drivers.

Health insurance is expensive, because healthcare is expensive. It is driven by a multitude of factors, but predominantly utilization increases including both volume and complexity of care. There are many more drivers, but utilization is the big one. Don't forget the quality of life indicators, life expectancy, and survival rates of chronic and catastrophic illness have all dramatically improved over that same 20 year time horizon.

Then quite blaming it on the ACA because you know better than anyone that is not the cause.

[Melvin]

To be honest with you, I am not a fan of ALL-Through aka Altru. My spouse has worked there for 10+ years and during one of her hospital stays she almost died because of poor care. I was not happy; thank God her friend, who’s also a nurse, while visiting her, caught the errors.

During the economic downturn in 2009, they used that as an excuse to cut the employees premium pay. That’s a big chunk out of their pay check gone. There’s no incentive to work on your off days when they call you in. They’re always understaffed and wanting people to come in on their off days.

Now, she goes to a review, gets a raise and is told she can no longer make any higher rate of pay, she’s maxed out. Grand Forks is ripe for a new competing hospital…

[yzerman19]

Then maybe you can tell my retired Royal Canadian Mounted Police officer friend why Altru charges $2,000 for an MIR and his daughter did a walk up MIR in Canada for $513.

First, I assume you mean MRI. Second, charges mean nothing. Third, MRI is a generic term like "car" there is a difference between a Ferrari and a Taurus. How powerful a machine, which body part, contrast or no contrast, walk-up, inpatient, freestanding or in hospital- tons of variables. Your example is an unusual one as well, because typically there is a longer wait for services in Canada.

The ACA isn't to blame for anything other than drying up capital at this point. That is because financial markets are leading indicators. It will negatively impact the health and healthcare industry and will redistribute costs of care via subsidies- which simply means taxes paid by higher income earners will be used to buy lower income earners their insurance. Sounds like socialism to me.