From Y2K to BBA, it has certainly been a year of change in health care.  In
fact, the only constant factor for hospitals and healthcare providers has
been that there are no constant factors.  Expansions, cutbacks, new
technology, new physicians, more services, less reimbursement, new owners,
less reimbursement, new just about everything, less reimbursement-this sums
up the year in review.
Looking first at the highpoints of the year, many hospitals have undergone
expansions in both their facilities and their services.
John Faulker is CEO of the Northwest Mississippi Regional Medical Center in
Clarskdale.  His hospital has recently completed an expansion project.
"The opening of our new 44,000 square foot professional building was one of
the highpoints of our year.  This new facility is attached to our existing
hospital building and will house doctor's offices and our outpatient
physical therapy program," he says.
At Greenwood-LeFlore Hospital, construction has begun on a hospital
expansion project.
"We have had a wonderful start with our major construction project that is
in progress," stated hospital Executive Director Bob Barrett.  "The project
is almost five weeks ahead of schedule and so far it has gone very
smoothly."
The King's Daughters Hospital (TKDH) in Greenville has experienced both an
expansion of services and has begun an expansion of facilities. In May 2000
TKDH reopened their emergency room. At the end of December, construction
began on a 6,800 square foot expansion of that emergency room.
Delta Regional Medical Center, also in Greenville, has seen the birth of
many new services in the past year.
Bart Hove, Delta Regional's Chief Executive Officer, explained, "Delta
Regional Medical Center is proud to have brought many new services to the
Delta in the year 2000.  Our Wound Healing Center, Solutions Psychiatric
Center, and most recently our inpatient Rehabilitation Center are just three
examples of services that are now available right here in Greenville.  Our
Emergency Department was designated as the only Level II Trauma Center in
Northwest Mississippi, and we are integrally involved in the statewide
trauma system working to improve the delivery of emergency care not only
within our county but within our state, as well.  Our mission is to provide
the most comprehensive list of services to the residents of Washington
County, and we are quickly moving towards that goal."
Another positive aspect of the past year has been the arrival of new
physicians at some facilities.
"The arrival of Drs. Hayek and Sultani to the Delta medical community has
been a definite highpoint for Bethesda Cancer Center," says Dr. Roderick
Givens.  "Their additions to our staff allow us to provide comprehensive
cancer care in that they perform chemotherapy and I perform radiation."
Faulkner at Northwest Mississippi Regional Medical Center says, "We have
brought in several new quality specialists who enhance and expand the care
we give to the citizens in our service area.  These people are not only good
physicians but will also be good additions to our community as well."
CEO of King's Daughters Hospital in Yazoo City, Noel Hart, was also happy to
report that his hospital now has a prospect for a surgeon to practice in the
south Delta city.
At least two Delta hospitals have welcomed new corporations to the
administrative helms of their facilities. The King's Daughters Hospital in
Greenville was bought by Community Health Systems in 1999 and the Bolivar
Medical Center in Cleveland was leased to Province Health Care in April of
this year.  Both corporations are based in Brentwood, Tennessee.
"In April our hospital was leased to Province Health Care and we went from
being a county hospital to part of a publicly traded company at that time,"
explained Barbara Levingston, marketing director for Bolivar Medical Center.
"Province has put a great deal of money into the hospital in the updating of
computers and medical technology and already has plans to recruit needed
physicians and medical staff."
The purchase of TKDH in Greenville has been a positive development for that
hospital. "Our involvement with Community Health Systems has been a great
benefit to the King's Daughters Hospital in Greenville," stated TDKH CEO Don
Fisher.  "It has been a win, win, win situation for the hospital, Community
Health Systems and the community."
Fisher went on to say that Community Health Systems was an essential
component in the reopening of the hospital's emergency room. "Once we were
purchased, it was not a difficult decision to reopen our ER and Community
Health Systems had the capital to get the equipment in order to open the
doors," he says.
Also positive for the health care of the Delta are those physicians who are
willing to look at new methods of treatment for their patients.
Tom Tappy, administrative director of the North Central Mississippi Regional
Cancer Center in Greenwood, explained, "One of the primary focuses of Dr.
Arnold Smith at our clinic is the use of complimentary medicine such as use
of herbs, vitamins, hormone replacement therapy, and the use of other
pharmaceuticals that are not used in a traditional cancer treatment routine.
These are used as an adjunct to conventional therapies to stimulate the
patient's immune system and improve their quality of life.  We are seeing
national leaders in cancer treatment such as the Mayo Clinic and M.D.
Anderson using complimentary medicine in a similar manner.  With many
cancers, we can attribute this to our treatment outcomes that are higher
than the national average."
All of these issues bode well not only for the healthcare climate, but also
for the economic climate in the communities in which these facilities are
located.
In Cleveland, Province Health Care is interested in not only making Bolivar
Medical Center successful, but is interested in the community as well.
"Province is committed to being a good member of the community by supporting
Delta State University and local business and industry," says Levingston.
Unfortunately, the reverse is also true-when hospitals are hit hard
economically, the community suffers as well.
Debra Griffin is Hospital Administrator at Humphreys County Memorial
Hospital in Belzoni.  She explained, "The hospital is a valuable economic
component in communities.  When hit by cuts from the federal government, you
have not only weakened a county's treasured asset, but you have weakened the
county overall.  Hospitals bring new dollars into the community and employ
people who in turn spend dollars in the community-that money turns over many
times."
"Communities realize that in many of these small towns, the hospital is
absolutely vital to the social and economic fabric of the community," says
Brent Alexander, senior vice president for the Mississippi Hospital
Association (MHA).  In most of these places, the hospitals are the largest
employers and the place of the most highly-skilled workers.  They are also
essential in providing the safety net that these communities depend on for
healthcare services.  Unless you have adequate healthcare, people will not
locate a business in your community." As Griffin pointed out, in a time of
national economic prosperity, small rural hospitals are suffering greatly.
Noel Hart of King's Daughters Hospital in Yazoo City says, "Our biggest
challenge in the year 2000 has been the Balanced Budget Act of 1997 (BBA)
that cut Medicare reimbursements.  This hurts small hospitals in that it
makes it difficult to provide needed services.  It also makes it difficult
to keep necessary nurses and technical personnel because we are unable to
provide necessary pay increases.  Overall, health care in the Delta is
adversely affected."
Debra Griffin added, "We are expected to provide services regardless of our
reimbursement, but we are prohibited from providing those services due to
cash flow problems.  Most small hospitals were not in a strong financial
position before BBA and that position has been weakened.  There are larger
financial reserves at larger hospitals, but smaller hospitals have no
reserves to fall back on."
The MHA also knows the plight of some Delta hospitals.  Alexander says,
"When you add on top of the Delta's other healthcare problems a billion
dollars in federal budget cuts over the past five years it is no mystery
that the year 2000 saw hospitals and other healthcare providers working
under enormous strain.  These hospitals, especially small rural hospitals,
are still under enormous stress. The BBA and its ramifications have probably
been the most difficult thing with which to deal," Bob Barrett of
Greenwood-LeFlore says.  "We are being hit hard and we need some relief."
John Faulkner of Clarksdale also added, "There are continued expectations by
federal and state governments and insurance companies that we do more and
more for our patients and receive less and less reimbursements. We willingly
provide healthcare services without regard to a patient's ability to pay,
but we do expect to be fairly compensated by the federal government and
insurance companies for these services."
"We are hoping that the President and Congress will immediately pass
legislation to give relief.  This has greatly injured the small hospitals
who count on the government for much of our reimbursement," says Barbara
Levingston.
Hospitals are not the only healthcare facilities affected by these cuts.
"There has been a great deal of concern on government regulation,
particularly the BBA," says Tappy of the North Central Mississippi Regional
Cancer Center.  "Though we are a private center, what happens in one arena
trickles down to the others.  There was a strong desire on the parts of the
Clinton administration in a sense to socialize medicine and that would have
a serious affect on any area with an underserved population."
The year 2000 was the best of times and the worst of times, to paraphrase
Dickens, in health care. Brent Alexander of MHA summed it up this way,
"These hospitals, especially small rural hospitals are still under enormous
stress.  But like they've done throughout their history, they are proving to
be resilient."