Local hospitals whose main focus is on medical and surgical services can have a difficult time offering a fiscally viable behavioral health unit, according to David Moulthrop, president and chief executive officer of Oconomowoc-based Rogers Memorial Hospital.
“Behavioral health care is really an area of health care where funding is very poor,” Moulthrop said. “There are caps on typical insurance benefits, so reimbursements are often money losers for hospitals.”
Insurance companies often impose reimbursement caps for behavioral health treatment at no higher than $8,000, Moulthrop said.
Hospitals generally lose money on mental health services, not only because of the low insurance reimbursements, but also because of the small number of patients.
Three years ago, Rogers Memorial, which specializes in mental health services, was full to capacity. The hospital did not have the capital resources to buy or build another hospital.
At the same time, Community Memorial Hospital in Menomonee Falls, a member of Froedtert & Community Health, was seeking guidance in creating a sustainable behavioral health unit.
Community Memorial Hospital had a 19-bed inpatient adult and older adult mental health unit with 23 employees on staff in 2003. However, its daily average number of patients, called a census, did not exceed 4.8.
“Our desire was to determine whether or not we were adequately meeting the needs of our service area, we assessed that we were not doing that, and as a comprehensive medical and surgical hospital, behavioral medicine was a unique specialty where we
probably needed some additional expertise,” said Dennis Pollard, senior vice president of planning and program development for Froedtert & Community Health. “This led us to look at local providers who had a level of expertise and who we could work with to bring services and a comprehensive program to the community.”
Rogers Memorial formed a partnership with Community Memorial in which a Rogers Memorial employee is located in the behavioral health unit to serve as the unit manager and to guide the rest of the staff, which is made up of Community Memorial employees and doctors. Community Memorial continues to operate under its own license, Moulthrop said. The partnership boosted the patient census at Community Memorial. In September, the daily census of the Community Memorial mental health unit averaged 11.8 patients, and the unit staff increased to 40 employees.
“Our role is to help build clinical programs and census,” Moulthrop said. “It is an unusual circumstance for hospitals to partner this way.”
In 2005, Rogers was approached by Columbia St. Mary’s health system based in Milwaukee for similar reasons. Rogers now partners specifically with the Columbia St. Mary’s Columbia campus in Milwaukee and the Columbia St. Mary’s Ozaukee campus in Mequon, Therese Pandl, executive vice president and chief operating officer for
Columbia St. Mary’s said.
“We have been pleased with the relationship with Rogers Memorial,” Pandl said. “We have completed a strategic plan for behavioral medicine with Rogers Memorial that will focus on continued integration of behavioral health with medical heath, improved patient access to care and the development of specialized programs in areas of core need identified by physicians.” Since partnering with Rogers, Columbia St. Mary’s improved its average daily census, specifically improving discharges by 6 percent in one year and improved the cost per patient per day by 0.8 percent less than budget.
“Rogers Memorial Hospital also helped us open the Huiras Center in Ozaukee County in response to an increased use of significant drugs, including heroin, in Ozaukee County by adolescents,” Pandl said. “Private sustained treatment for substance use for adolescents had some significant positive results in terms of interventions, decreased substance use in the long term, improved behavioral health problems, decreased problems at school and decreased family problems.”
The Huiras Center, which opened in March, was possible in part because of a donation from Ralph Huiras, an Ozaukee County resident, Pandl said. Columbia St. Mary’s worked with the staff at Rogers Memorial to design an effective program that would meet the needs of adolescents and to evaluate the outcomes, which was important to Huiras, Pandl said. Both hospital partnerships with Rogers Memorial have the same goals: to share psychiatric services, to avoid the duplication of services and to keep high quality mental health care accessible to Milwaukee area families.
“We did this because our mission is to provide mental health services to southeastern Wisconsin and because of a physical cap on who we can serve,” Moulthrop said. “Partnering gave us an opportunity to reach out to more people in the community and for the hospital partners so they could export our expertise to their sites and enhance the programming and services they provide.”
