The Bellevue Hospital: Get Together
Hospitals
Written by Steffen Smith   
Monday, 01 October 2007
The Bellevue Hospital: Get Together - Health Executive - RedCoat Publishing
There is an unmistakable can-do spirit in small-town America. A distinct, let’s-get-it done attitude that helps rural communities thrive in the absence of big-city resources.

There is an unmistakable can-do spirit in small-town America. A distinct, let’s-get-it done attitude that helps rural communities thrive in the absence of big-city resources.

The Bellevue Hospital: Get Together - Health Executive - RedCoat Publishing
Mike Winthrop, CEO
And nowhere is that more evident than in the Northwest Ohio city of Bellevue, where on 183 acres of former farmland sits a sparkling new community hospital built, in large part, with the help of neighboring—and competing—hospitals.

Bellevue is a rural area, to be sure: a city of 9,000, where the only thing interrupting the rolling cornfields is the occasional industrial plant. It’s also a community that takes its hospital seriously. Just ask Mike Winthrop, president and CEO of The Bellevue Hospital, who recently marked his 20th year at the hospital. “I think it says a lot about this community and this hospital that I’m only the fifth CEO in its history,” he said.

Just two years ago, the hospital made the move from the cramped four-acre site it had occupied since 1917 thanks to a group of citizens who collaborated to build a modern hospital that would allow the people of the community to receive medical care locally. The hospital board began strategic planning in June of 2000, and after two years of research, which included looking at expanding the current facility, the board voted to build a new facility. One of the most important decisions the board faced was how to cover the $36 million price tag. Collaboration with two area healthcare facilities solved that problem. Both Norwalk Area Health System and Firelands Regional Health System became investment equity owners in the facility, investing $7.5 million each. Both have a 20% equity in the hospital, along with two seats on the hospital’s board.

A $2.3 million capital campaign by the hospital’s foundation helped offset some of the costs, and the remainder of the cost was financed through bonds issued by Fifth Third Bank. “The new facility did not affect taxes in any way,” Winthrop noted.

Coming together
As far back as anyone can recall, the area’s community hospitals have joined forces around common regional issues. But that’s not to say that competition doesn’t exist. Five rural hospitals dot the area, each just 15 miles from the other. Bellevue and Memorial compete fiercely for Whirlpool (the area’s largest employer) contracts, while Fisher-Titus and Firelands compete for OB/gyn and med-surg patients. All five face competition from the large tertiary centers: Cleveland Clinic and University Hospitals to the east, and Toledo area hospital systems to the west.

In 2002, after years of informal discussions, the five area hospitals came together to form Community Care 5 (CC5), a limited liability company designed to help the hospitals take advantage of economies of scale and collaborative opportunities. The hospitals share equal ownership in the company, and the five hospital CEOs meet monthly. Collaborative successes so far include recruitment of specialty physicians and collective purchasing. For example, four of the five hospitals now share a PACS, helping them save approximately $2 million on their initial investment.

Perhaps the most visible fruit of the collaboration is the new 50-bed Bellevue Hospital. The two-story prairie-style building was designed with a focus on patient convenience, privacy, and comfort. “We wanted to deinstitutionalize the patient experience,” said Winthrop. “The patient response has been overwhelming. They say that it doesn’t seem like they are in a hospital, that it’s more like a hotel or resort.”

The new hospital boasts 32 medical/surgical suites, eight OB/gyn beds, and 10 ICU/observation beds. The hospital currently has 480 employees and 130 physicians on its medical staff, and gross revenue is expected to top $95 million this year, up substantially from revenues of $10 million when Winthrop took the helm in 1988.

Rebuilding services
With the development has come the patients. “We’re attracting patients from a much broader area than before,” Winthrop said. Strategically locating close to neighboring communities has proven to be the right move. “But when they come, we still need to provide both value and a quality experience.”

Indeed, ED visits have soared from 14,500 before the move to almost 19,000 now. The number of surgeries performed has likewise increased as the hospital has recruited top-notch surgeons. Just as important, the hospital’s birthing center is booming, noteworthy in light of the fact that the hospital got out of the obstetrics business entirely in the mid-1970s.

“At the time, they just couldn’t attract the right OB/gyn physicians,” Winthrop recalled. “But they quickly saw that you then have a cascading effect where you lose not only pediatrics and women’s care, but the entire family’s care, as females typically make the healthcare decisions.”

When Winthrop came aboard in 1988, he was challenged by the board to rebuild the hospital’s obstetrics services. “We went on a recruitment drive and now do more than 400 births a year,” said Winthrop. That figure compares to 175 births in 1988. The hospital’s birthing center also rates consistently high Press Ganey scores.

But it’s not all about babies. “We also serve an older population,” Winthrop said. “We see a lot of heart-related patients, treat many types of cancer, and do a significant amount of urological and orthopedic surgery.” To that end, an expanded therapy program features an aquatic pool with in-water treadmills and underwater cameras, and a monthly senior luncheon draws upwards of 130 people every month.

EMR and PACS
The hospital works with staff every year to determine technology needs. “The younger physicians we’re bringing in are accustomed to this technology and are pushing us to adopt it,” Winthrop said.

In addition to implementing an EMR system and a wireless network, the hospital is investing in a PACS that burns digital X-rays to disc so that patients don’t have to lug bulky films to office visits. “We are very responsive to the medical staff,” said Winthrop. “They, in turn, are very prudent about how they ask us to spend dollars.”

Winthrop notes that reimbursement continues to be a challenge at the hospital. As health savings accounts become more popular, Bellevue is seeing a significant increase in self-pay balances. “HSAs sound good in theory but, if you don’t fund them, they can provide a false sense of security.” In July, the hospital instituted a $50 point-of-service co-pay in its ED. “It went very well. There has been very little pushback from patients,” Winthrop said. “They are willing to pay. It’s just a matter of asking.”

Winthrop is no stranger to smalltown life, having grown up in tiny DuQuoin, Ill., and he’s quick to point out that the slower pace of small-town life can be a strong recruiting tool. “We jokingly warn physicians during the recruiting process that if they don’t want to run in to their patients in the grocery store, this may not be the place for them. This is a great place to raise a family and build a career, but it’s also where you literally live with your patients,” Winthrop said.

In the end, Winthrop is proud to collaborate for the common good. “It’s a wonderful legacy. By taking the leap of faith and going to a new hospital, we’re laying the groundwork to provide healthcare for generations to come.”

Steffen Smith is an Atlanta-based writer and can be reached at This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

 
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