Doctor: Changes could save UMC $60 million

Tuesday, March 18, 2003 | 9:45 a.m.

A doctor is arguing that Clark County can correct all of the public hospital's financial problems with relatively cheap computers and a handful of new staff.

Dr. Brad Walker, a physician in the University Medical Center Quick Care system and shop steward for the physicians in the union local, said he agrees with a recent audit that showed profound problems with billing -- obtaining medical insurance from UMC patients and getting those patients their bills.

The billing system was identified as a major problem in the audit released earlier this month by Deloitte & Touche. Clark County Manager Thom Reilly said March 4 that billing changes could save UMC and the Quick Care system $20 million per year, and more aggressive collection of insurance information could save the system another $5 million a year.

But Walker said the Service Employees International Local 1107, which represents county workers including those at the hospital, found that changes to the system could save more than $60 million a year.

"If UMC is able to correct their billing problems, they could not only eliminate their $36 million deficit, they'd turn a profit," he said. "It's impossible to expect the organization to do well until you fix the billing problems."

Walker said the union's doctors planned to argue their case to a meeting of the UMC citizens advisory task force this afternoon.

The task force was created by the county in response to financial hemorrhaging that required the County Commission to pump $38 million into the system last year. The commissioners have said the cash-strapped county cannot afford to keep propping up the ailing system.

A host of in-house and contracted audits have been done or are under way, including the Deloitte & Touche audit. Walker said while the doctors generally agree with the Deloitte & Touche conclusions, they do not agree with another audit turned in earlier this month by the Lewin Group.

The Lewin Group's recommendations included the possibility of cuts to the number of UMC Quick Care centers as well as to staffing levels and pay. Walker and other union members have argued against those alternatives.

Walker said with the savings provided by a revamped billing system and a way to sign up people for government-funded programs, the cuts would not be necessary. He also takes issue with the recommendation from Deloitte & Touche that the county purchase a new $10 million computer to handle billing to replace the 20-year-old system in place -- an existing system that everyone, apparently, thinks is inadequate for the hospital's needs.

Walker said a much smaller, decentralized computer system operated by a relative handful of people could serve the hospital and the Quick Care centers.

County spokesman Eric Pappa agreed with Walker that changes to the billing system could save millions of dollars. But he didn't agree that a small computer system would work or that the Lewin Group's recommendations should be rejected.

"I wish it were that easy," Pappa said. "I think he's over simplifying. There are definitely some serious challenges over there that we are addressing, and a new computer system is definitely going to be a part of that.

"And we have to at least consider seriously the proposals from the Lewin Group," he said. "It's a complex problem. It involves a lot of different answers."