Fremont-Rideout Health Group: Theresa Hamilton, Chief Executive Officer

by webadmin on February 19, 2013

The Fremont-Rideout Health Group (FRHG) is an independent, non-profit, community-based health system located in Northern California that serves Yuba and Sutter counties with primary and specialty care and also offers specialty-care services to the Nevada, Butte, and Colusa counties.

FRHG is made up of two acute-care hospitals, a Level III trauma center, an urgent-care center, an ambulatory-surgery center, a cancer center (in partnership with UC Davis Medical Center), an outpatient lab and imaging centers, and a senior living campus that features facilities for skilled nursing, dementia and Alzheimer’s care, and assisted living.

The system also has a home healthcare and hospice service and a durable medical-equipment company. In its bi-county area, it is the largest private employer, with 1,800 people on staff and 260 physicians. FRHG prides itself on having a high level of regard and respect for all of its clinicians and employees.

Theresa Hamilton, chief executive officer, first joined FRHG in 2000 as vice president and was appointed CEO in 2007. Since her appointment, she has overseen an unprecedented period of growth and development at FRHG.

Broadening the system’s scope

For several years, Hamilton said that FRHG has been making significant gains in all quality outcomes and metrics. Financially, FRHG is on a strong footing, especially compared to four years ago when the global and national economies went into a tailspin. The communities FRHG serves were heavily impacted by this collapse.

Hamilton said FRHG was forced to make some very difficult decisions to “right-size” the organization in order to continue providing high-quality, yet financially viable care for the volume of patients it was receiving.

“We took some very bold steps during that process,” she stated, “but the result of that was that we accomplished our financial goals and did not forsake quality in the process.”

These steps included FRHG stepping up its recruitment efforts, successfully attracting more specialists to the organization; increasing advanced training of staff; improving quality outcomes; and proceeding with a $250-million building project to expand Rideout Memorial Hospital into a regional medical center, capable of providing advanced medicine to its service areas.

“We wanted to broaden our scope of services and our ability to take care of more acute patients in the community,” Hamilton said.

There were two reasons for the new building. First, FRHG needed a state-of-the-art facility that matched its desire to expand its specialty services. Second, it would enable FRHG to consolidate inpatient hospital care into one location.

This expansion was a very expensive proposition, especially since the strategic plan also called for a concurrent expansion of FRHG’s emergency department and cancer center.

In spite of the pressing economic challenges, FRHG is accomplishing these goals. The cancer-center expansion will be completed this fall, and ground was broken in March on the new six-story addition to Rideout Memorial, on schedule to be completed in December 2014.

Working on efficiency and wellness

Hamilton said that FRHG is continuing to work on operational efficiencies with the goal of modeling a cost structure that can deliver cost-efficient care, while still delivering high-quality outcomes and eliminating unnecessary costs and wastes from the system.

In preparation for healthcare reform’s roll-out in 2014 and the new people that will be joining the system, FRHG is also seeking to expand its outpatient network by opening its own urgent-care center and starting up a clinic system that partners with doctors and other providers in the community so that there are additional access points for outpatient care.

Hamilton emphasized that FRHG does not want the only location for outpatient to be in a crowded and costly emergency room.

FRHG is also in its last two years of a seven-year strategic plan for the implementation of electronic medical records (EMRs). Hamilton said she expects that in the next 24 months or so, FRHG will be completely electronic with medical documentation for doctors, nurses, and testing, with the great hope being that FRHG will be able to offer scheduling online.

FRHG is also on track to meet all of meaningful use’s standards.

Confronting the reimbursement challenge

In spite of all its successes, FRHG is like other healthcare systems throughout the country and trying to juggle progress with potential setbacks.

Chief among these challenges is the continuing decline in reimbursement from the largest payer that most hospitals have—Medicare and for the state of California, Medi-Cal.

“The continuing decline in reimbursements countrywide and statewide is of great concern to all hospitals and ours included,” Hamilton said. “Trying to plan for reinvesting in our staff and reinvesting in our facilities for our community is made more difficult if we don’t have very constant, predictable revenue streams.”

Hamilton foresees this problem becoming even more profound going forward and said this is why it’s so important for FRHG to achieve efficiency with its cost structure.

“There’s nothing more important in our day than the care we deliver to our patients because that’s the only business we’re in,” Hamilton stated. “The only reason we exist is to take care of sick people, and the more dedicated and focused we are on that mission and the more we truly grasp that as being the essence of what we are, the better we’re going to be.”

-by Pete Fernbaugh

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