Muskoka Algonquin Health Care CEO Natalie Bubela said while MAHC is delighted to have received just in excess of an additional $1 million to its annual base funding starting this year, the organization is still projecting a deficit of about $2.3 to $2.4 million this fiscal year, ending March 31, 2017.
“We’re appreciative but it didn’t go all the way. We would’ve hoped it could’ve,” she said, following the announcement made on December 7 by the North Simcoe Muskoka Local Health Integration Network. NSM LHIN is the provincial agency responsible for funding and coordinating public health care services in this area on behalf of the Ontario Ministry of Health and Long-Term Care.
Before the additional funding announcement Bubela said MAHC was anticipating an estimated $3.4 million deficit for this year. “With this announcement, that brings it down to $2.3 to $2.4 million. That carries on into next year and then all the other inflationary costs that will come forward – people moving through their salary grid, etc. – will come to play and our deficit will be even larger next year,” she warned. According to Bubela, those inflationary costs also include things like the cost of utilities such as heat and hydro as well as increases to the cost of medicine and food.
Bubela explained that part of MAHC’s deficit is based on inflationary costs that have historically not been covered by Ministry funding. She also said the latest funding model came into effect in 2013, and it does not work well for medium-sized organizations, particularly those with two hospital sites. The Ministry did help mitigate shortfalls the first couple of years after the formula was implemented, but that has since stopped, making it that much harder for MAHC to balance its books.
MAHC Chief Financial Officer Tim Smith also noted that hospital funding has not increased for four years.
The Ministry didn’t include any increases in revenue available to hospitals for four years, so each year we had to absorb more and more cost increases and it finally got to the point where we couldn’t absorb anymore and we ended up in a deficit position last year.
Smith, referring to a $1.5 million deficit in MAHC’s 2015-2016 fiscal year
“So that was our first deficit year after five years of balanced positions and this will be our second deficit year if we don’t receive additional funding,” added Bubela.
MAHC has an annual budget of roughly $78 million. It gets about $56 million from the Ministry. Other sources of revenue include semi-private accommodations, parking revenue, revenue generated through diagnostic testing and money it receives for leasing space at both hospital sites to a private physiotherapy company – all normal streams of revenue for hospitals in Ontario, explained Bubela.
MAHC CFO, Tim Smith
Yet unlike larger hospitals, the Huntsville and Bracebridge hospitals don’t have the traffic larger areas have, according to Smith.
“If you go to larger hospitals you will find that they have a food court. They almost have mini malls in some of those new modern hospitals. But we just don’t get the traffic going through either site in Muskoka to make it profitable for anybody to set up.”
On the spending side, Bubela said MAHC has brought in an energy savings program as a way of reducing costs. “We’re about half way through our retrofits and an energy program to reduce our costs,” she said. “Even if it doesn’t reduce our costs and maintains them, we’ll still be ahead because we would not have the inflationary pressures related to energy costs. We’ve tried strategically to look ahead and see how we can reduce our costs so we don’t have them into the future, which would mitigate some of the variance.”
Natalie Bubela
In the interim, the Muskoka and Area Health System Transformation (MAHST) initiative, which aims to redesign the way health care services are delivered in the community (including that of hospitals), continues. Bubela is one of the MAHST council members who’ll be bringing her knowledge of acute care services to the table. She’s not sure what impact, if any, MAHC’s deficit position will have on decision-making related to the MAHST initiative at this time.
She did say the premise some people have discussed related to the MAHST initiative is that there may be some savings that can be generated by integrating services in Muskoka and area and that those savings could then be applied towards the hospitals’ operating costs.
In terms of speculations that MAHST may also look at ways that hospitals can generate more revenue outside of the Ministry funding envelope, she said she had not heard of that but welcomed it. “Any opportunity to increase our revenue, any idea that might come forward, we would welcome looking at,” she said.
In the meantime, MAHC is hopeful that the Ministry will step up with additional funding to help it address its deficit position this year and reconsider its funding formula into the future.
You can find the local LHIN’s December 7, 2016 funding announcement here.
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