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Mercyhealth clears up miscommunication with FAQ

Like many organizations, we have been confronted with a variety of economic challenges, and we have had to make some very tough decisions.

There has been misinformation and rumors circulating in the community. We also know we have not communicated adequately with our employees/partners and the community regarding the critical reasoning behind these changes, and for that, we apologize.

What is very true is our commitment to our employees/partners, our patients, the Rockford region and the remarkable people in our community.

Below is a list of frequently asked questions about recent changes:

Is the Rockton Campus closing?

The Rockton Campus is not closing. The idea we are systematically closing the Rockton Campus is the farthest from the truth. It is unfortunate there is misinformation circulating in the community. What is missing in the equation is all the newly remodeled facilities and new clinical services we have added to the Rockton Campus to enhance health care quality on the west side. We have invested over $50 million in new ancillary departments and other renovations to continue all outpatient hospital and clinic services, including:

  • Emergency services
  • Surgery services
  • Full operating rooms
  • Cancer services, including outpatient chemotherapy infusion treatment
  • Endoscopy
  • Family medicine
  • Laboratory
  • Pain Center
  • Inpatient pharmacy
  • Radiology
  • Pulmonology
  • Cardiac/pulmonology rehabilitation
  • Endocrinology
  • Gastroenterology and GI Procedures–newly renovated
  • Neurology
  • Pediatrics
  • General surgery
  • Ophthalmology
  • Orthopedics
  • Sub-acute inpatient services
  • Outpatient EEG/EMG
  • Physical therapy
  • Podiatry
  • Rheumatology
  • Wound Center

ON EMERGENCY CARE IN ROCKFORD:

How are emergency services changing on the Rockton Campus? Will the Rockton Avenue emergency room still have emergency doctors on staff?

First and foremost, we must allay some fears: we will always care for patients who walk in for service at our Rockton Avenue emergency department. The changes being made relate to the coordination of patient care in our emergency departments, due to a shift in lower patient volumes brought on by COVID-19.

Emergency department volumes have dropped due to several months of the “shelter in place/safer at home” orders. People have learned they do not need to go to the emergency department for every lump, bump, or pain. Despite the rumors, Rockton Avenue will stay an emergency department.

Collaborative planning is also underway to help patient’s access timely trauma and emergency care in the future. We will be working with local EMS and local hospitals in Rockford to ensure patients have access to the appropriate emergency care at the right location.

 Our plan is for the Rockton Avenue Campus to stay a 24/7 emergency department with residency trained board certified emergency medicine physicians, nurses, and support staff, but we will discontinue our Level II certification, which means we will not have an on-call anesthesiologist, operating room staff, and trauma surgeon. Our Riverside Campus will continue to serve as a Level I Trauma Center, meaning we have on-site 24/7 anesthesiologist, operating room staff, and trauma surgeon.

Are you concerned with the distance they now have to travel for trauma care?

Patients will continue to be treated in the same way they are currently cared for. Mercyhealth’s residency trained, board certified emergency physicians, nurses, and support staff are experts at caring for all patients who come through the doors, stabilizing the patient and transferring to the appropriate hospital. When calling 911, Rockford areas exceptional paramedics know where to take the patient based on the patient’s care needs. Keep in mind that the City of Rockford has more trauma centers (three) than any other city in Illinois of its size.

If the plan was to keep the emergency room open, why was staff initially told that it would be a standby ED?

This was a miscommunication, and for that, we apologize.

The Rockton Campus emergency room has been the safety net for many people. These people now think it closing. What is the plan to distribute correct information to these people?

We are communicating through many media and social media outlets that we have and will continue to provide 24/7 emergency services.

ON MEDICAID IN ILLINOIS:

How long has Medicaid/the State of Illinois not been paying Mercyhealth? If it has been longer than this past year, why was the new Women’s/Children’s hospital built when you were aware that over 1/3 of the patients in need of services would not be paid for?

This is a complicated question. Approximately five years ago, the State of Illinois aggressively expanded its use of for-profit managed care organizations (MCOs) such as Meridian, IlliniCare, and BCBS-Medicaid to administer the Medicaid program.

Over the last few years, Medicaid patients have moved from the State of Illinois fee-for-service plan to the MCO plans, and the MCOs are delaying, denying or not paying our claims. Our percent of Medicaid in Illinois increased to 35%, meaning 1/3 of the patients we treat are Medicaid and we do not cover our costs for this care. Our competitors are at a much lower Medicaid percentage, approximately 10% (OSF) and 20% (SwedishAmerican). We cannot continue to provide care below our cost of care and not receive correct or timely payments from the MCOs.

Too often the Medicaid managed care plans deny claims and take months (extending sometime into years) to pay, if they pay at all. We have been working with the State of Illinois and the MCOs for months, and nothing has changed.

How does Medicaid work in Wisconsin? Do you have the same issues? How is it different?

There is a vast difference between Medicaid in Illinois versus Wisconsin. Mercyhealth works with only one MCO in Wisconsin, our own health plan, MercyCare. As a result, claims are paid timely and any disputes are resolved internally. Wisconsin also takes a much more active role regulating and monitoring the activities of its MCOs resulting in more accurate and timely payment of claims statewide. When the State itself is the payer, claims are paid much more rapidly and with fewer denials than in Illinois.

Although we still do not cover all costs with Wisconsin Medicaid, they pay the claims when submitted and audit the paperwork after care is delivered. This is a very typical practice as most insurance companies and Medicare nationwide does it this way. This means these organizations send auditors to us, and we provide documents to verify the expenditure

How will the change in Medicaid affect the cancer patient base and the cancer center itself?

Mercyhealth will continue to treat those existing IlliniCare or Meridian patients undergoing active chemotherapy or radiation therapy until that treatment is complete. As we have cancelled these Medicaid contracts, we will not be taking new patients. Mercyhealth does accept Molina Medicaid.

The MCOs sound just like Medicare Advantage plans. Can the Medicare Advantage plans become just like the MCOs?

Medicare Advantage Plans are somewhat similar to Medicaid MCOs, but there are some important differences.

First, members must choose to be in Medicare Advantage plans. They are never assigned to these plans by the government as is frequently done in state-based Medicaid MCOs. Thus, the plans must compete for business by providing good service to their customers who have many options for Medicare Advantage plans as well as the option of remaining in traditional Medicare. The plans must also provide good service to the medical providers and pay claims appropriately to assure an adequate panel of choices for the Medicare members.

Second, these plans are highly regulated by the federal government who maintains standards regarding claim payment timeliness and accuracy. Plans can be penalized for failing to meet Federal standards and they are frequently audited to insure compliance.

ON FINANCES:

What has Mercyhealth done with the funds received from the COVID-19 relief package that hospitals received?

Mercyhealth has a significant increase in costs in providing the necessary treatments for our COVID-19 patients. An example of some of these increased costs include extra supplies, higher cost items due to shortages, increased and higher cost medications, and extra labor costs for cleaning and disinfecting.

We greatly appreciate the support of the COVID-19 relief bills, but these payments were used to help offset the higher costs in treatments for our COVID-19 patients. There were not enough funds to offset the losses from decreased and lower volumes caused by the COVID-19 pandemic, which significantly negatively impacted (and still impacts) us today.

Do you see telemedicine visits becoming the norm for you even when COVID-19 is over?

Yes, Mercyhealth has seen a substantial increase in telehealth visits. The vast majority of our physicians are offering this service, and we see this continuing. We are closely monitoring Medicare telehealth rules (as most health systems follow Medicare) to ensure we are following the regulation and reimbursement guidelines.

ON BEHAVIORAL HEALTH IN ROCKFORD:

There are reports the inpatient psychiatric unit was always full on the Rockton Campus. How do we explain this discrepancy?

Behavioral health is very specialized. No one organization is an expert in all the specialties associated with each type of mental health issue. Thus, patients need to be treated in an appropriate facility to care for their specific needs. Mercyhealth’s inpatient behavioral health unit was an adult unit. We did not specialize in any specific behavioral health issue. Our daily volume fluctuated in the low single digits. With this low census, we could not retain psychiatric physician coverage or provide the same quality of care as a larger inpatient unit that can provide more significant support resources.

How can you say Mercyhealth has a robust mental health program when it takes months to get into a doctor?

We are fully committed to continuing to offer our clinical and enhanced telemedicine behavioral health services. Through our emergency departments at both the Rockton and Riverside campuses, psychiatric assessors will work with telehealth board certified psychiatrists to help patients get to the right services at the correct location.

What is the response to the mental health task force, and how they’re taking action due to the psych unit’s closer?

We are engaged in conversation with many of the local mental health agencies to enhance our relationships.

ON PEDIATRIC SERVICES IN ROCKFORD:

There are reports the Pediatrics unit was closed? You then said Mercyhealth has a pediatric unit at Riverside?

Our pediatric specialists will provide oversight to their pediatric patient(s) admitted to the Riverside Hospital.

Are the pediatric outpatient contracts with KP Counseling and other former service contracts for counseling still active?

Yes our pediatric outpatients contracts with KP Counseling and others are still active.

OTHER QUESTIONS:

What will happen to Rockton employees who support inpatient services if you move inpatient all to Riverside?

If Mercyhealth has openings at Riverside because of the shifting of services, employees may be moved. We may also have other areas in the health system that employees could consider for transfer.

Will Mercyhealth still have hospitalists at the Rockton Campus?

Yes, we will have hospitalists at the Rockton Campus.

What exactly does the sub-acute unit refer to?

Mercyhealth is adding a 17-bed sub-acute unit at Rockton Avenue to care for those patients no longer needing hospital care, but not ready for nursing home environments. Health problems like stroke, congestive heart failure, lung disease, joint replacements, and hip fractures can affect the entire body. At Mercyhealth Transitional Care Center, we approach each individual with a whole-person approach. Our highly qualified rehabilitation experts specialize in pain management, wound care, physical therapy, occupational therapy, and speech therapy.

Much like our Mercyhealth Transitional Care Center, located at Mercyhealth Hospital and Trauma Center–Janesville, this short-term care unit will provide continuity of care for patients who no longer need more intense hospital care but are not yet ready to go home. Our team approach to care is based on the patient’s functional goals—being able to walk or climb stairs, improve a disability, or participate in more intensive rehabilitation.

As we cannot give radiotherapy at the Riverside campus to inpatients, can you be assured that inpatient beds will still be available to our cancer patients who need these treatments at the Rockton Campus?

Yes, inpatient beds will be available at the Rockton Campus.

What is the future of the cancer center? Remain on Rockton?

Yes, the Cancer Center services will remain on the Rockton Campus.

Will cardiology be at Rockton? Outpatient testing for cardiac patients?

Yes, cardiology will be at the Rockton Campus. Yes, we will have outpatient testing for cardiac patients at the Rockton Campus.

Will all specialties be located at the Rockton Campus? Who is where?

We have invested over $50 million in new ancillary departments and other renovations to continue all the outpatient hospital and clinic services, including:

  • Surgery services
  • Full operating rooms
  • Cancer services, including outpatient chemotherapy infusion treatment
  • Emergency Department 24/7
  • Endoscopy
  • Family medicine
  • Laboratory
  • Pain Center
  • Inpatient pharmacy
  • Radiology
  • Pulmonology
  • Cardiac/pulmonology rehabilitation
  • Endocrinology
  • Gastroenterology and GI Procedures– newly renovated
  • Neurology
  • Pediatrics
  • General surgery
  • Ophthalmology
  • Orthopedics
  • Sub-acute inpatient services
  • Outpatient EEG/EMG
  • Physical therapy
  • Podiatry
  • Rheumatology
  • Wound Center

Will there be any other inpatient units besides the sub-acute unit? Med/Surg? 24-hour observation unit?

Yes, we are determining the appropriate number of beds that will be staffed.

Are there currently/have there been any discussions with any other health systems regarding the sale of the Rockton campus in Rockford? Or other parts of Mercyhealth?

No, we are not selling Mercyhealth or any part of the organization.

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