Hill Health ​“Stops The Bleeding”

During the ​“dark days” last year, Cornell Scot Hill Health Center faced a projected $3 million deficit. Now, said new CEO Michael Taylor, the center is looking at a $850,000 surplus, without any lay-offs.

In an interview in his office at Hill Health’s Columbus Avenue headquarters, Taylor claimed his team has turned around the troubled community health center, and set it on a course toward better and more efficient service, as well as a positive cash flow.

Taylor and Rob Rioux, head of strategic development, said they turned Hill Health around by scrutinizing every aspect of operations and by getting back to basics, like making sure bills are going out fast and coming back paid.

Their numbers could not yet be independently verified; Taylor said an audit to be completed by the end of October will verify the $850,000 surplus projection. Rioux said Hill Health has not had to lay off any employees to fix the budget.

Meanwhile, turnover continues: The center’s medical director, Dr. Tom McNamee, resigned on Friday. Rioux said he didn’t have ​“any details on the rationale for his decision.” McNamee couldn’t be reached for comment.

Hill Health has 475 employees, 19 clinics, and served 36,000 patients last year, most of whom live below the poverty line. For several years the center has been plagued by complaints of mismanagement and faced dire financial difficulties. The center laid off 30 workers in 2011, then 25 more in 2012. It instituted company-wide furloughs, pay cuts for senior staff, and even canceled Christmas.

In Nov. 2012, CEO Jamesina Henderson resigned. Henderson had taken over in 2009 following the death of founder Cornell Scott, who ran the center for 35 years, overseeing significant expansion. After Henderson’s departure, Taylor, who had been the chief operating officer, took the reins.

When Taylor (pictured) took over, the center was in trouble. When the federal Health Resources and Services Administration (HRSA) audited Hill Health, ​“they came in and said, ​‘You guys have some issues. You could close your doors,’” Rioux said. 

In Sept. 2012, the center was looking at a projected $3 million deficit.

“It’s not unusual for an organization to stub its toe and have a bad year,” said Taylor. ​“But this was the latest of many bad years. We were really in dire straits.”

Hill Health was ​“rudderless” after the loss of Scott, the founder, said Rioux.

“It takes a while to find your footing,” said Taylor. ​“We have moved beyond what I now call the dark days.”

At the end of the fiscal year, on June 30, the financial projection had shifted from red to black, the projected $850,000 surplus, Rioux said.

Taylor rattled off a list of other changes: Patient volume is up 9 percent. Patient satisfaction scores are on the rise. Hill Health has new care sites at Connecticut Mental Health Center and Gateway Community College, new relationships with Yale-New Haven Hospital, the housing authority, and other organizations.

By the end of September, Hill Health will have fully moved to electronic health records, Taylor said. This means better coordination, more efficiency, lower costs, and better care, he said.

Tweaks

When fixing Hill Health’s finances, officials first had to ​“stop the bleeding,” Rioux (pictured) said. ​“We managed costs.” Management did that by cutting expenses like the annual Christmas party, which saved $15,000 the center could put toward keeping someone’s job, Rioux said.

The center made a granular analysis of each ​“business unit” — assessing the staffing, the work flow, the documentation — and made ​“tweaks.”

For instance, Rioux said, for every ​“patient encounter” the health care provider is meant to fill out the appropriate paperwork, so that the center can be paid for the visit. The analysis found a big lag in the billing: Some of the paperwork was filled out late, some not at all.

“We tore that process apart,” Rioux said. Management created a new system to make sure all bills go out on time.

“We really rebuilt our billing department,” Taylor said. More bills doesn’t mean higher costs for patients, it means better collection from Medicare, Medicaid, the Department of Social Services, and private insurers, Taylor said.

Taylor said management sat down with the director of every department and scrutinized that sector’s workflow. Administrative staff would also go and see for themselves. ​“We would go and sit and watch” how work was being done, to refine all processes, Rioux said.

Hill Health found other savings by revisiting it’s agreements with contractors. ​“We probably renegotiated every contract,” Taylor said. That included leases on property, and service agreements with cleaning and maintenance companies.

“People Smile Now”

Taylor said he committed early on to getting Hill Health in order without laying anybody off. After looking at the workings of the departments, management found that some jobs needed to be eliminated. The administration shifted people to different jobs rather than fire them, Taylor said.

As the management changes started to bear fruit, Hill Health found it was no longer ​“living hand to mouth,” and now had cash on hand, Taylor said. ​“We were able to give the vast majority of staff a cost of living adjustment” — raises, Taylor said.

With all the statistical improvements, what’s most astounding is the difference it’s made for the people who work here,” Taylor said. Morale is way up, after being at an all-time low a year ago, he said. ​“People smile now. It’s nice to see that joy and pride re-emerge.”

State Sen. Toni Harp, who works for Hill Health as a homeless outreach coordinator, said she has seen a turnaround at the center. She said the shift to electronic medical records has made a big difference for staff and patients. ​“People always felt they were doing important work. They didn’t always feel they had the tools to do that work. Now there’s a knowledge that we have the most modern tools,” she said.

“It’s fantastic. The change is really dramatic,” said Hill Alderwoman Andrea Jackson-Brooks, the chair of Hill Health’s board of directors. ​“If things continue like they are, we should be really heading back to the good old days of good camaraderie, good relationship with the community, good staff relationships.”