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HEALTH CARE: Changes in care

Altru Health System officials maintain they are not looking over their shoulders at the Aurora Hospital under construction and say they remain focused on their own operations.

Altru Health System officials maintain they are not looking over their shoulders at the Aurora Hospital under construction and say they remain focused on their own operations.

"We don't focus on the things we can't control," Altru Chief Operating Officer Dave Molmen said recently. "We focus on where we can make a difference."

Altru officials say the nonprofit health system is a strong, well-respected regional provider of a wide range of health services.

While Altru officials say they don't plan to change the way they do business in the face of the new competition, they are aware that they will face new challenges when they are no longer the only hospital in town.

New challenges

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If the new Aurora Hospital siphons off enough patients, Altru could lose its sole community provider status, resulting in a loss of as much as $9.5 million a year in federal funding, according to Dennis Reisnour, Altru's administrative director of corporate development.

Reisnour said Altru would lose its status as the community's sole provider and the $9.5 million in funding if another hospital in Grand Forks attains an 8 percent market share among local Medicare patients.

"It could have a huge impact on us," Reisnour said.

Aurora officials have maintained that they believe Grand Forks can support another hospital and have stated publicly that their goal is to capture patients who leave Grand Forks for health care.

In order to accomplish that, the new hospital presumably would need better programs in some areas than exist at Altru or programs comparable with the ones local residents now travel to in areas such as Fargo and Minneapolis.

In addition to lost revenue, Altru will face increased competition for employees, especially in areas such as nursing, which suffers from a severe shortage of workers.

Reisnour said the Aurora Medical Park already has hired several former Altru employees. With Aurora adding as many as 200 employees when the new hospital opens, that number is expected to increase.

"We have done everything we can to staff all the positions we can," Reisnour said. "(The new hospital) does create a complication."

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Molmen said Altru's staff has more than doubled in the past 20 years despite a fairly static population.

Altru employs nearly 200 physicians and has a total staff of more than 3,700 at its hospital, rehabilitation facility, more than a dozen clinics in the region, home care network and senior home.

Altru's Web site shows 120 current job openings. Reisnour said the medical group also plans to add an additional 40 positions in the next three years as Altru continues to grow.

"We are in a very tight labor market," said Molmen, adding that the shortage of health care workers is a nationwide issue. "It could be very challenging if it gets tighter."

Both hospitals may be forced to pay more for workers because of the competition for their services.

"Most physicians can go wherever they want," Reisnour said. "It's very competitive. You have to find them."

With another option available, some Altru patients inevitably will switch to the new Aurora Hospital.

Some local residents have complained about the length of waits and the service they have received at Altru.

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Molmen acknowledged that Altru and other health care providers have at times struggled to provide convenient access to health care.

"We've had a problem as have most giving service and also quality of service," said Molmen, who will take over for the retiring Greg Gerloff as CEO on Jan. 1. "We're working hard to make sure it happens."

Molmen said providing quality care and customer service are two of Altru's biggest areas of focus. He said he aims for Altru to provide the best quality of care available in the nation and to treat patients like friends or neighbors.

"We put 100 percent of our focus into making sure every one of our patients receives the best care possible," Molmen said.

Aurora Hospital

under construction

Construction is ongoing on the future Aurora Hospital on the Aurora Medical Park campus in south Grand Forks and the hospital is expected to be complete by fall 2009.

Plans filed with the city call for a two-story, roughly 200,000 square-foot hospital with 66 beds and 200 staff members.

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Site plans for the hospital have been approved and the city is reviewing building plans, which may be approved as early as this week. The building's footings and foundations have been approved and are mostly installed, according to city building inspector Bruce Melin.

Aurora officials have postponed indefinitely a groundbreaking ceremony and press conference, originally to be held this fall, over uncertainty about whether Blue Cross Blue Shield of North Dakota will contract with the new facility. But construction has not been delayed and the project is still expected to be completed on schedule, Aurora spokesperson April Steffan said.

Blue Cross Blue Shield of North Dakota officials have said that the insurance company will not contract with the new hospital for inpatient or outpatient care because it believes the addition of another hospital to the area would provide an unnecessary duplication of services and would cause insurance premiums to rise. Blue Cross Blue Shield will continue to cover services at clinics within the existing Aurora Medical Park and other Aurora facilities that it has contracts with.

The new hospital has not announced publicly what services it will offer, but with its planned size it surely will not be able to offer the range of services available at Altru.

Altru has expressed concerns that the for-profit Aurora hospital might cherry-pick financially lucrative areas of health care and leave Altru as the lone local provider of money-losing services, something Aurora officials have disputed. With less revenue, Altru would have less profit to pump back into the hospital, facility upgrades, new programs and the community.

Molmen said nonprofit hospitals tend to have a different focus than for-profit enterprises that are seeking a return for investors.

"It's very clear to you what your goal is," Molmen said of working for a nonprofit hospital. "It gets your priorities in the right order. We know our reason for being is to provide the best health outcome."

Altru's reach,

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future

Altru is one of the area's top employers with more than 3,700 employees, about 2,800 of them full-time, between the hospital, clinics and other facilities and services. The health system serves a population base of about 225,000 in northeastern North Dakota and northwestern Minnesota.

"Our footprint is close to what we would like it to be," Molmen said.

Altru has recently been named to national health care system top 100 lists for cardiovascular services, integration and technological advancement.

The community-owned company had a net operating revenue of $348 million at the end of 2006, an 8 percent increase from the previous year.

Altru is in the midst of a more than $100 million expansion project to build new facilities, renovate existing ones and invest in new technology.

"We want to have all the services so people don't have to go out of the area or out of the state to receive care," Molmen said.

The expansion and renovation project is expected to last for about five years and include adding clinic space, renovating some parts of clinics and the hospital, adding a new ambulatory surgical center, expanding its cancer center and investing in new technology.

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This fall Altru's cardiology department added a state-of-the-art new cardiac catheterization X-ray lab. The Allura Xper FD10 X-ray from Phillips Medical Systems is the first equipment of its kind to be used in the U.S. Altru officials said the new technology will allow staff to treat a wide range of ailments, including coronary artery disease, by using catheter-based procedures, reducing the health risks, hospital stays and recovery time of traditional surgical approaches.

The cancer center also recently acquired a next-generation scanner to help doctors detect disease in its early stages and better monitor patients' progress. The GE Discovery STE scanner combines two kinds of imaging to give doctors complete information about the patient's condition in a single exam with enhanced image quality. Previously, patients needed separate scans to obtain similar information.

Altru also is working to go to a paperless system, in which all medical records will be transferred to an electronic format by 2008, allowing a doctor or nurse at Altru or any other facility in the nation using the same system to immediately gain access to a patient's medical records.

Molmen estimated Altru has spent about $15 million on new technology this year.

But for Altru to continue to grow, reinvest in its own product and expand at its current rate, it will need to continue posting strong financial growth.

How a new competitor in its own backyard will affect Altru's balance sheet is unknown.

"In order to do all these things, you've got to stay healthy financially," Molmen said.

Schuster reports on business. Reach him by phone at (701) 780-1107 or (800) 477-6572, ext. 107; by e-mail at rschuster@gfherald.com or view his business blog at www.areavoices.com/bizbuzz .

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