Benefis Health System
Encyclopedia
Benefis Health System is a nonprofit
independent health care system
based in the city of Great Falls
in the state of Montana
in the United States
. The system owns 516-bed Benefis Hospital, Sletten Cancer Institute, Benefis Mercy Flight (a fixed-wing and helicopter emergency medical evacuation service), 146-bed Benefis Extended Care Center (for both rehabilitation and long-term nursing care), 12-bed Peace Hospice of Montana, Benefis Quick Care (an ambulatory care
facility), and Benefis Physician Associates. As of March 2011, it was Montana's largest hospital.
) merged in July 1996. The two hospitals first considered merging in 1994, but a traditional merger was held up by prolonged disagreements (which lasted 20 months) with state and federal antitrust officials over the legality of the merger.
The hospitals finally merged in July 1996 under a so-called "certificate of public advantage" (COPA), a provision in Montana state antitrust
law which permitted hospitals to merge prior to examination of the merger under state antitrust laws, provided that the state issued a certification that the merger met public need (the COPA) and further provided that the merging hospitals agreed to certain conditions imposed by the state. The U.S. Federal Trade Commission
dropped its objections to the merger after the COPA was signed. Columbus and Deaconess hospitals were the first hospitals in the United States to merge under a state COPA statute. The name "Benefis" was chosen because, although it was not a word found in any dictionary, it sounded similar to words such as beneficence, beneficial, and benefit.
A number of conditions on the merger were required by both state and federal governments. These included a limit on excess revenues ("profits"), that $86 million in cost savings be passed on to consumers, and a prohibition on certain anti-competitive behaviors. Another restriction prohibited Benefis from entering into any joint ventures which would permit existing services to be transferred to the joint venture (thus enabling Benefis to skirt the COPA agreement).
The merged entity was originally named Benefis Healthcare.
centers in the city. The Clinic had explored building its center as a joint venture with Benefis, but the COPA agreement prohibited it. Both companies sought a certificate of need
(CON) for their surgery centers, but Benefis challenged these filings. Both companies then altered their plans, saying they would build specialty surgical centers instead (as permission was not needed under the state's CON law). The state subsequently approved both plans. Benefis filed suit in state district court as well as filed a protest with the state over the decision not to seek a certificate of need for either proposed facility.
In late December 1997, Benefis, Central Montana Surgery Center, and the Great Falls Clinic agreed to settle their differences out of court and to drop their administrative dispute with the state of Montana. Central Montana Surgery Center and the Great Falls Clinic agreed to abandon plans to build surgical hospitals and to build outpatient surgery centers instead. Benefis agreed to close its own outpatient surgery center, and become a 49 percent owner in the Clinic's center. The Montana State Attorney General's office, which approved the settlement, said Benefis would be permitted to charge the costs of closing its center to the $86 million in cost savings owed to the community.
Benefis reported excess revenues of $7 million on income of $140 million in 1997. In early 1999, Benefis announced it was suffering serious financial losses that were imperiling its ability to provide health care. In January 1999, the company reported a loss of $3 million on revenues of $128 million in 1998, and projected a doubling of that loss in 1999 with no appreciable growth in revenues. Benefis claimed its COPA agreement did not account for the costs of consummating the merger of Columbus and Deaconess hospitals, and did not provide for adjustments to the agreement in the event competition forced changes to its business plan. The company cut costs by $17 million, saw construction costs increase by $17 million, and had not yet implemented any staff reductions. Benefis predicted losses totaling $25.7 million by 2003 unless changes to the COPA were made. After two months of negotiations, the state amended the COPA to allow Benefis to raise prices faster than originally permitted (generating $12 million in revenues), and reduce cost savings returned to the community by $39.5 million. The term of the COPA (its initial terms were to end in 2006) was not changed.
In January 2000, Benefis reported that it had generated $9.1 million in excess revenues in 1999 because of the changes. The company also doubled its charity care expenditures from $2 million to $4.8 million, inpatient prices were 6 percent lower than pre-merger prices, and outpatient prices were 15 percent lower than pre-merger prices. That same year, Benefis received a $7 million gift from a group of anonymous donors, permitting it to build a 25000 square feet (2,322.6 m²) hospice
(now known as Peace Hospice) near its east campus. In August 2000, Benefis signed an agreement with Treasure State Healthcare Network, an independent practice association
(IPA) representing about 30 percent of the physicians practicing in Great Falls. The agreement created a 50-50 for-profit partnership which marketed Benefis and the IPA to large employers and health care trusts.
Despite these changes, Benefis faced continuing financial pressures. The company had excess revenues of $3.3 million in 2000, but said it would only break even in 2001. It sought a second revision to the COPA agreement, but the state refused to reopen the terms.
In 2001, Benefis again sought state permission to revise the terms of the COPA. That year, Harold Poulsen, owner of Central Montana Surgery Center, announced he would build a 20-bed, 24000 square feet (2,229.7 m²), $5.3 million inpatient specialty surgical hospital (to be called Central Montana Surgical Hospital). (Instead, Poulsen ended up transforming his existing outpatient center into a hospital.) Benefis sought to reopen the COPA before Poulsen's announcement, but its pleas became more urgent after the competitor's plans were announced. But once more the state turned down the request.
In October 2005, Benefis sought to disaffiliate from Providence Services. A dispute between the local health system and its parent organization first arose in 2003, when Providence Services asked Benefis to change its corporate constitution and bylaws to permit the parent organization to veto any joint venture that the local system might enter into, review and veto capital spending plans, and power to reject any chief executive officer the system might attempt to hire. Benefis refused, and in 2004 Providence Services declined to issue a corporate bond
that would have financed construction of a new cancer center in Great Falls. According to Standard & Poor's
, a bond rating agency, Benefis contributed 16 percent of Providence Services' total assets, 17 percent of its operating revenues, and 30 percent of its net operating income. In the last week of December 2005, Benefis opened its $20 million Sletten Cancer Institute.
In early 2006, Benefis sought to stop the Great Falls Clinic from purchasing 20-bed Central Montana Surgical Hospital. The clinic had partnered with Essentia Health, a non-profit healthcare system based in Minnesota
and North Dakota
, to purchase Harold Poulsen's outstanding stock in Central Montana Surgical Hospital and gain a controlling interest in the surgical hospital. Benefis sued to prevent the transaction, arguing that the new owners intended to run the facility as a specialty hospital in contravention of a 2005 state law banning further construction of these types of facilities and that the Clinic and Essentia did not apply for the required health care facility license. The health system won a temporary restraining order. Benefis also said it stood to lose $4 million a year in revenues if Central Montana Surgical Hospital was licensed as a general hospital.The company said it would likely close its renal dialysis unit, suspend Mercy Flights, shutter its nursing home, and end outpatient psychiatric and chemical dependency services. Benefis also said it would lose several million dollars a year in federal payments as well. On March 24, the injunction was lifted. Benefis filed an emergency motion with the Montana Supreme Court three days later, appealing the district court's ruling. The state of Montana then issued a six-month provisional license to Central Montana to operate as a general hospital. But on October 4, 2006, the Montana Supreme Court
ruled 4-to-3 to uphold the district court's dismissal of the temporary injunction. However, the state supreme court declined to rule on other issues raised by Benefis' lawsuit, and left open the door for the company to continue litigation in the district courts. On November 6, 2006, Benefis declined to appeal the high court's ruling and said it would not bring the other issues back to the district court. In February 2007, the Clinic sued Benefis to recover its legal fees. A state judge ruled in September 2007 that Benefis must pay these fees.
Also in 2006, the Clinic bought out Benefis' 49 percent ownership in the Great Falls Clinic Surgery Center.
Benefis also began a number of construction projects in 2006. It began work on an 80000 square feet (7,432.2 m²), three-story, $14 million medical office building and 22 private rooms in the old Deaconess building at a cost of $4 million. Benefis also consolidated its rehabilitation and physical therapy units into one space at its east campus, and moved its skilled nursing unit
to its west campus. It moved the Montana Orthopedic, Neurologic and Rehabilitative Care Center (MONARC) sports injury center and its behavioral health unit into the old nursing home space, expanded its emergency room waiting area, and remodeled its pediatric unit. In January 2006, Benefis partnered with Diversified Clinical Services to open the Benefis Wound Care and Hyperbaric Medicine Center, the only like it in the state of Montana at the time. In August 2006, Benefis' Sletten Cancer Institute added a CyberKnife
nuclear radiosurgery
system for treating tumors and other medical conditions (at the time, making Benefis the only hospital to own a cyberknife in the Idaho
, Montana, Oregon
, Washington, and Wyoming
areas).
Benefis' separation from Providence Services was finalized on September 30, 2006. Benefis was forced to make a donation of $10 million to cover goodwill
, and repay loans made to the company by Providence Services. Both the Vatican
and the Montana Attorney General's Office approved the disaffiliation. The company said it saved $100,000 a month in corporate overhead costs, although it incurred an equal amount of cost because it now had higher interest payments on its debt. The same year, Benefis founded the Northcentral Montana Healthcare Alliance, a consortium of 14 hospitals and long-term care facilities whose goal was to promote the general economic well-being of its member institutions. Benefis also gave Cascade County
3.5 acres (1.4 ha) near on Benefis Court in exchange for 2.6 acres (1.1 ha) of land near 15th Avenue South and 25th Street in September 2006. A month later, the United States Department of Agriculture
's Rural Development grant program awarded $380,000 to Northcentral Montana Healthcare Alliance to expand telehealth
throughout the area, a grant which was matched by a $700,000 grant from Benefis.
On February 7, 2007, a Benefis Mercy Flight Beechcraft Super King Air 200 twin-engine fixed-wing aircraft crashed a short distance from Gallatin Field Airport
(near Bozeman, Montana
) around 9 p.m., killing the pilot, a registered nurse
, and a paramedic
. Members of the victims' families contended the contractor which operated the flight, Metro Aviation, failed to adhere to safety and training procedures. In June 2007, Metro Aviation reached a confidential, out-of-court settlement with the family of paramedic Paul Erickson. In April 2009, the family of nurse Darcy Dengel also reached an out-of-court settlement with Metro Aviation.
In March 2007, Benefis and the Great Falls Clinic began exploring ways to collaborate in cardiac care. These talks continued for two years, and expanded to include discussions that included Benefis buying the Clinic outright. But although the talks continued into February 2010, the Clinic eventually rejected the confidential purchase price and terms offered by Benefis.
2008 saw Benefis expand even further. It opened its new Hi-Line Sletten Cancer Center in Havre
in August. The same month, it partnered with the 10-physician Great Falls Orthopedic Associates to break ground on the $17 million, 72000 square feet (6,689 m²) Orthopedic Center of Montana, an ambulatory and outpatient surgical center offering physical therapy
, sports medicine
, and urgent care
services. The new building permitted Benefis Quick Care, an existing urgent care center, to move into larger quarters on the health system's west campus. In December, Benefis began construction, cost, and marketing studies aimed at building a continuous-case retirement community on 60 acres (24.3 ha) south of its east campus. The first phase of the project (which would replace its traditional nursing home, built in the early 1980s) would construct several seven-to-10 person cottages over a four-year period to provide long-term nursing care, dining facilities, and recreation. The company said it intended to build an independent
and assisted living
facilities as well. Ground was broken on the first phase of this project in November 2010.
In 2009, Republican
Congressman Denny Rehberg
secured federal spending earmarks
for Benefis that included $300,000 to subsidize construction of the pediatric care areas, $900,000 for the cardiac care suites in the new tower, and $143,000 for electronic medical recordkeeping and telehealth.
Benefis began construction of a $17 million, four-story, 79000 square feet (7,339.3 m²) medical office building next to the Orthopedic Center of Montana on its east campus in August 2010. The building was intended to house Benefis Medical Group (formerly called Benefis Physician Associates), a group of 53 physicians and 18 other healthcare providers the health system created in late 2007. In September of that year, it also outsourced its medical records functions to Precyse, a medical records transcription, coding, and filing company in Pennsylvania
.
In April 2011, Benefis announced it would build a $5.5 million, 40-unit low-income housing project for senior citizens. The health care company sought housing tax credits from the Montana Board of Housing for the project (only the third time since 1996 that such credits had been sought for a project in Great Falls). Benefis said Mountain Plains Equity Group of Billings would invest in the project as well, which would be built on 3 acres (1.2 ha) next to its existing 66 acres (26.7 ha) senior campus (under construction at the time). The project, to be called The Grandview at Benefis, would break ground in fall 2011. Benefis also said that the cost of its long-term care cottages and assisted living housing, which began construction in November 2010, would be about $21.5 million. The cost of the independent living housing had not yet been determined, but would break ground in 2012. This second phase, Benefis said, would now include 33 stand-alone homes as well.
Benefis also said in April 2011 that it would spend $3.5 million to expand and renovate its Peak Health & Wellness facility, a for-profit joint venture with private investors.
, and founded by the Sisters of Providence. A local board of directors provided leadership and oversight for Benefis, although the Providence Services maintained some corporate control.
In July 2008, a holding company known as Benefis Health System was created to hold title to the growing variety of services offered.
behaviors.
In October 2006, Montana Attorney General Mike McGrath
ruled that although some competition for certain services had emerged, not enough competition existed in enough areas to justify releasing Benefis from its obligations under the COPA. On December 3, citing internal studies which showed Benefis could lose $2.4 million a year due to competition, Benefis asked McGrath to reconsider his decision. McGrath declined to do so and said he would neither affirm or overturn his decision until the upcoming legislative session ended.
A legislative effort to repeal the COPA agreement began in January 2007.
State Senator Jesse Laslovich, a Democrat
from Anaconda
, sponsored a bill that would limit COPA agreements to 10 years and which would make this limitation retroactive (so it would apply to the Benefis agreement). Benefis focused its lobbying efforts on prices, and pledged to keep its prices in the lower 50th percentile for large Montana hospitals. At legislative hearings in the state senate, more than 20 individuals testified for three and a half hours about the merits of the bill. The bill passed the state senate by a vote of 39-to-11. The state house passed the bill 93-to-6 on March 20.
On April 2, 2007, Montana Governor Brian Schweitzer
signed the legislation ending state oversight of Benefis through the COPA process.
Benefis said in 2008 that it saved $300,000 to $600,000 a year in interest rate payments on its bonds after being freed from the COPA requirements. It also saw another $120,000 a year in savings by no longer having to engage in COPA reporting and oversight, or for reimbursing the state for COPA oversight.
However, in early 2011, representatives from school employee health care trust funds, nursing associations, community health clinics, and others accused Benefis of raising prices 16 percent in 2010 and 30 percent overall since removal of the COPA agreement. But Benefis also said its costs fell 2 percent in the 2008-2009 period, and another 8 percent in 2010. Benefis denied the accusation, saying the 16 percent figure was overstated because much of that number came from a discontinuation of health care price breaks the health system used to provide. Benefis officials also said their charges for inpatient care were still 2.6 percent below those of its peers, while charges for outpatient service were 29.2 percent lower. Benefis also said it would implement no price increase in 2011, and hoped to reduce costs another 5.2 percent.
, with the remainder coming from the remaining counties in north-central Montana. The region is five times the size of the state of New Jersey
.
Benefis has more of an economic impact on the city of Great Falls than any other industry or employer. In 2008, it was the north-central Montana region's largest private employer.
As of 2008, Benefis was considered the "sole community provider" by the Centers for Medicare and Medicaid Services
, which resulted in a $1.5 million annual federal payment to the health system. If total hospital admissions at any other healthcare facility in the community rises above 8 percent, Benefis would be required to share that payment equally with the other provider(s). The same year, Benefis said Medicare patients accounted for 48 percent of the health system's admissions, but contributed only 40 percent of its revenues. Patients with private insurance represented 26 percent of admissions but accounted for 40 percent of revenues. Benefis said that it lost money on its dialysis, emergency room, and inpatient mental health services.
In November 2010, a study conducted by the University of Montana Bureau of Business and Economic Research found that health care was now the largest sector of the Cascade County economy. Although the military (represented primarily by Malmstrom Air Force Base
) had long been assumed to be the city's economic driver, health care now accounted for 16 percent of the county's non-agricultural earnings, compared to 14 percent for military activities. Benefis, the researchers found, not only employed 10 percent of the county's entire workforce, but also accounted for 10 percent of its earnings. Health care represented more of Cascade County's total economy (14 percent) than in other large Montana cities such as Billings
(12 percent) or Missoula
(12 percent), or in Montana as a whole (9 percent). Health care also appeared to be the primary driver of economic growth and employment in the county, with health care employment rising 4.2 percent from 2008 to 2009 (while construction, finance, and transportation saw major drops).
Benefis Health System was the largest hospital in Montana as of March 2011.
to construct an $11 million cardiac hospital on its east campus. MedCath owned 49 percent of the cardiac hospital, and had the option to invest in the physical property as well.
The tower was originally expected to cost $50 million, but by mid 2006 the cost had risen to a "staggering" $75.2 million. Construction on the now seven-story medical tower began in September 2006. Although only a year had passed since announcement of the MedCath deal, the tower's purpose had radically changed. Benefis said the tower, which would have 88 private rooms and connect with the operating room tower and medical building via an existing skyway
, would provide space for obstetrics, neonatal intensive care, and pediatrics in addition to cardiology. The new medical tower opened on August 25, 2009, at a final cost of $85 million. Private donations paid for $3.5 million of the cost, while federal earmarks contributed another $1.2 million.
but that the hospital actually lost $3.2 million on providing the service. If the correct figure were used, Benefis officials said, the health system would have ranked fifth.
The following year, the Attorney General's office reported that Benefis received $5.7 million in tax exemptions in 2007. Although Benefis gave charity care to more people (4,082) in 2007 compared to 2006 (3,493), it donated $4.68 million in charity care (a decrease of $11,000 from the previous year).
By 2008, charity care constituted 2.95 percent of Benefis' operating budget (up from 1.5 percent in 2006). Based on the ratio of charity care to operating budget, Benefis ranked fourth-highest among nonprofit hospitals in the state.
(a company which ranks quality of care) listed Benefis as among the top 5 percent of hospitals in the nation for the quality of its care. In 2006, HealthGrades listed Benefis' cardiology and gastrointestinal
services "number one" in Montana. HealthGrades also listed Benefis among the top 5 percent of hospitals in the country for the quality of its orthopedic services, and in the top 10 percent nationally for joint-replacement surgery and treatment of stroke. Benefis also won a Specialty Excellence Award recipient for its orthopedic, joint replacement, and stroke care. It also gave the hospital five-star ratings (for above-average patient outcomes) in the areas of bowel obstruction, pneumonia, respiratory failure, sepsis, and stroke. In 2006 and again in 2007, Benefis was once again listed in the top 5 percent of hospitals delivering high-quality health care.
In 2006, the American Society for Bariatric Surgery gave Benefis its Bariatric Surgery Center of Excellence designation, recognizing it for the quality of its care and the high percentage of positive patient outcomes.
The Sletten Cancer Institute received the Outstanding Achievement Award from the American College of Surgeons
for the quality of its cancer care. It won the accolade a second time in 2008, one o only 66 cancer centers in the entire United States to achieve the honor.
Nonprofit organization
Nonprofit organization is neither a legal nor technical definition but generally refers to an organization that uses surplus revenues to achieve its goals, rather than distributing them as profit or dividends...
independent health care system
Health care system
A health care system is the organization of people, institutions, and resources to deliver health care services to meet the health needs of target populations....
based in the city of Great Falls
Great Falls, Montana
Great Falls is a city in and the county seat of Cascade County, Montana, United States. The population was 58,505 at the 2010 census. It is the principal city of the Great Falls, Montana Metropolitan Statistical Area, which encompasses all of Cascade County...
in the state of Montana
Montana
Montana is a state in the Western United States. The western third of Montana contains numerous mountain ranges. Smaller, "island ranges" are found in the central third of the state, for a total of 77 named ranges of the Rocky Mountains. This geographical fact is reflected in the state's name,...
in the United States
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...
. The system owns 516-bed Benefis Hospital, Sletten Cancer Institute, Benefis Mercy Flight (a fixed-wing and helicopter emergency medical evacuation service), 146-bed Benefis Extended Care Center (for both rehabilitation and long-term nursing care), 12-bed Peace Hospice of Montana, Benefis Quick Care (an ambulatory care
Ambulatory care
Ambulatory care is a personal health care consultation, treatment or intervention using advanced medical technology or procedures delivered on an outpatient basis Ambulatory care is a personal health care consultation, treatment or intervention using advanced medical technology or procedures...
facility), and Benefis Physician Associates. As of March 2011, it was Montana's largest hospital.
Formation
The forerunner of Benefis Health System was Benefis Healthcare. Benefis Healthcare was formed when 145-bed Columbus Hospital (a Catholic Church-owned hospital founded in 1892) and 339-bed Montana Deaconess Medical Center (a hospital founded in 1898 by the Methodist Episcopal ChurchMethodist Episcopal Church
The Methodist Episcopal Church, sometimes referred to as the M.E. Church, was a development of the first expression of Methodism in the United States. It officially began at the Baltimore Christmas Conference in 1784, with Francis Asbury and Thomas Coke as the first bishops. Through a series of...
) merged in July 1996. The two hospitals first considered merging in 1994, but a traditional merger was held up by prolonged disagreements (which lasted 20 months) with state and federal antitrust officials over the legality of the merger.
The hospitals finally merged in July 1996 under a so-called "certificate of public advantage" (COPA), a provision in Montana state antitrust
Competition law
Competition law, known in the United States as antitrust law, is law that promotes or maintains market competition by regulating anti-competitive conduct by companies....
law which permitted hospitals to merge prior to examination of the merger under state antitrust laws, provided that the state issued a certification that the merger met public need (the COPA) and further provided that the merging hospitals agreed to certain conditions imposed by the state. The U.S. Federal Trade Commission
Federal Trade Commission
The Federal Trade Commission is an independent agency of the United States government, established in 1914 by the Federal Trade Commission Act...
dropped its objections to the merger after the COPA was signed. Columbus and Deaconess hospitals were the first hospitals in the United States to merge under a state COPA statute. The name "Benefis" was chosen because, although it was not a word found in any dictionary, it sounded similar to words such as beneficence, beneficial, and benefit.
A number of conditions on the merger were required by both state and federal governments. These included a limit on excess revenues ("profits"), that $86 million in cost savings be passed on to consumers, and a prohibition on certain anti-competitive behaviors. Another restriction prohibited Benefis from entering into any joint ventures which would permit existing services to be transferred to the joint venture (thus enabling Benefis to skirt the COPA agreement).
The merged entity was originally named Benefis Healthcare.
Corporate history
Just a year after its formation, Benefis challenged the construction of specialty surgical centers in Great Falls. Both the Central Montana Surgery Center (an ambulatory care facility founded in 1996 by local Great Falls businessman Harold Poulsen) and the Great Falls Clinic (a physician-owned group practice founded in 1917) announced they intended to build outpatient surgeryOutpatient surgery
Outpatient surgery, also known as ambulatory surgery, same-day surgery or day surgery, is surgery that does not require an overnight hospital stay. The term “outpatient” arises from the fact that surgery patients may go home and do not need an overnight hospital bed...
centers in the city. The Clinic had explored building its center as a joint venture with Benefis, but the COPA agreement prohibited it. Both companies sought a certificate of need
Certificate of Need
A Certificate of Need , in the United States, is a legal document required in many state and some federal jurisdictions before proposed acquisitions, expansions, or creations of facilities are allowed. CONs are issued by a federal or state regulatory agency with authority over an area to affirm...
(CON) for their surgery centers, but Benefis challenged these filings. Both companies then altered their plans, saying they would build specialty surgical centers instead (as permission was not needed under the state's CON law). The state subsequently approved both plans. Benefis filed suit in state district court as well as filed a protest with the state over the decision not to seek a certificate of need for either proposed facility.
In late December 1997, Benefis, Central Montana Surgery Center, and the Great Falls Clinic agreed to settle their differences out of court and to drop their administrative dispute with the state of Montana. Central Montana Surgery Center and the Great Falls Clinic agreed to abandon plans to build surgical hospitals and to build outpatient surgery centers instead. Benefis agreed to close its own outpatient surgery center, and become a 49 percent owner in the Clinic's center. The Montana State Attorney General's office, which approved the settlement, said Benefis would be permitted to charge the costs of closing its center to the $86 million in cost savings owed to the community.
Benefis reported excess revenues of $7 million on income of $140 million in 1997. In early 1999, Benefis announced it was suffering serious financial losses that were imperiling its ability to provide health care. In January 1999, the company reported a loss of $3 million on revenues of $128 million in 1998, and projected a doubling of that loss in 1999 with no appreciable growth in revenues. Benefis claimed its COPA agreement did not account for the costs of consummating the merger of Columbus and Deaconess hospitals, and did not provide for adjustments to the agreement in the event competition forced changes to its business plan. The company cut costs by $17 million, saw construction costs increase by $17 million, and had not yet implemented any staff reductions. Benefis predicted losses totaling $25.7 million by 2003 unless changes to the COPA were made. After two months of negotiations, the state amended the COPA to allow Benefis to raise prices faster than originally permitted (generating $12 million in revenues), and reduce cost savings returned to the community by $39.5 million. The term of the COPA (its initial terms were to end in 2006) was not changed.
In January 2000, Benefis reported that it had generated $9.1 million in excess revenues in 1999 because of the changes. The company also doubled its charity care expenditures from $2 million to $4.8 million, inpatient prices were 6 percent lower than pre-merger prices, and outpatient prices were 15 percent lower than pre-merger prices. That same year, Benefis received a $7 million gift from a group of anonymous donors, permitting it to build a 25000 square feet (2,322.6 m²) hospice
Hospice
Hospice is a type of care and a philosophy of care which focuses on the palliation of a terminally ill patient's symptoms.In the United States and Canada:*Gentiva Health Services, national provider of hospice and home health services...
(now known as Peace Hospice) near its east campus. In August 2000, Benefis signed an agreement with Treasure State Healthcare Network, an independent practice association
Independent practice association
An independent practice association is an association of independent physicians, or other organization that contracts with independent physicians, and provides services to managed care organizations on a negotiated per capita rate, flat retainer fee, or negotiated fee-for-service basis...
(IPA) representing about 30 percent of the physicians practicing in Great Falls. The agreement created a 50-50 for-profit partnership which marketed Benefis and the IPA to large employers and health care trusts.
Despite these changes, Benefis faced continuing financial pressures. The company had excess revenues of $3.3 million in 2000, but said it would only break even in 2001. It sought a second revision to the COPA agreement, but the state refused to reopen the terms.
In 2001, Benefis again sought state permission to revise the terms of the COPA. That year, Harold Poulsen, owner of Central Montana Surgery Center, announced he would build a 20-bed, 24000 square feet (2,229.7 m²), $5.3 million inpatient specialty surgical hospital (to be called Central Montana Surgical Hospital). (Instead, Poulsen ended up transforming his existing outpatient center into a hospital.) Benefis sought to reopen the COPA before Poulsen's announcement, but its pleas became more urgent after the competitor's plans were announced. But once more the state turned down the request.
In October 2005, Benefis sought to disaffiliate from Providence Services. A dispute between the local health system and its parent organization first arose in 2003, when Providence Services asked Benefis to change its corporate constitution and bylaws to permit the parent organization to veto any joint venture that the local system might enter into, review and veto capital spending plans, and power to reject any chief executive officer the system might attempt to hire. Benefis refused, and in 2004 Providence Services declined to issue a corporate bond
Corporate bond
A corporate bond is a bond issued by a corporation. It is a bond that a corporation issues to raise money in order to expand its business. The term is usually applied to longer-term debt instruments, generally with a maturity date falling at least a year after their issue date...
that would have financed construction of a new cancer center in Great Falls. According to Standard & Poor's
Standard & Poor's
Standard & Poor's is a United States-based financial services company. It is a division of The McGraw-Hill Companies that publishes financial research and analysis on stocks and bonds. It is well known for its stock-market indices, the US-based S&P 500, the Australian S&P/ASX 200, the Canadian...
, a bond rating agency, Benefis contributed 16 percent of Providence Services' total assets, 17 percent of its operating revenues, and 30 percent of its net operating income. In the last week of December 2005, Benefis opened its $20 million Sletten Cancer Institute.
In early 2006, Benefis sought to stop the Great Falls Clinic from purchasing 20-bed Central Montana Surgical Hospital. The clinic had partnered with Essentia Health, a non-profit healthcare system based in Minnesota
Minnesota
Minnesota is a U.S. state located in the Midwestern United States. The twelfth largest state of the U.S., it is the twenty-first most populous, with 5.3 million residents. Minnesota was carved out of the eastern half of the Minnesota Territory and admitted to the Union as the thirty-second state...
and North Dakota
North Dakota
North Dakota is a state located in the Midwestern region of the United States of America, along the Canadian border. The state is bordered by Canada to the north, Minnesota to the east, South Dakota to the south and Montana to the west. North Dakota is the 19th-largest state by area in the U.S....
, to purchase Harold Poulsen's outstanding stock in Central Montana Surgical Hospital and gain a controlling interest in the surgical hospital. Benefis sued to prevent the transaction, arguing that the new owners intended to run the facility as a specialty hospital in contravention of a 2005 state law banning further construction of these types of facilities and that the Clinic and Essentia did not apply for the required health care facility license. The health system won a temporary restraining order. Benefis also said it stood to lose $4 million a year in revenues if Central Montana Surgical Hospital was licensed as a general hospital.The company said it would likely close its renal dialysis unit, suspend Mercy Flights, shutter its nursing home, and end outpatient psychiatric and chemical dependency services. Benefis also said it would lose several million dollars a year in federal payments as well. On March 24, the injunction was lifted. Benefis filed an emergency motion with the Montana Supreme Court three days later, appealing the district court's ruling. The state of Montana then issued a six-month provisional license to Central Montana to operate as a general hospital. But on October 4, 2006, the Montana Supreme Court
Montana Supreme Court
The Montana Supreme Court is the highest court of the Montana state court system in the U.S. state of Montana. It is established and its powers defined by Article VII of the 1972 Montana Constitution...
ruled 4-to-3 to uphold the district court's dismissal of the temporary injunction. However, the state supreme court declined to rule on other issues raised by Benefis' lawsuit, and left open the door for the company to continue litigation in the district courts. On November 6, 2006, Benefis declined to appeal the high court's ruling and said it would not bring the other issues back to the district court. In February 2007, the Clinic sued Benefis to recover its legal fees. A state judge ruled in September 2007 that Benefis must pay these fees.
Also in 2006, the Clinic bought out Benefis' 49 percent ownership in the Great Falls Clinic Surgery Center.
Benefis also began a number of construction projects in 2006. It began work on an 80000 square feet (7,432.2 m²), three-story, $14 million medical office building and 22 private rooms in the old Deaconess building at a cost of $4 million. Benefis also consolidated its rehabilitation and physical therapy units into one space at its east campus, and moved its skilled nursing unit
Nursing home
A nursing home, convalescent home, skilled nursing unit , care home, rest home, or old people's home provides a type of care of residents: it is a place of residence for people who require constant nursing care and have significant deficiencies with activities of daily living...
to its west campus. It moved the Montana Orthopedic, Neurologic and Rehabilitative Care Center (MONARC) sports injury center and its behavioral health unit into the old nursing home space, expanded its emergency room waiting area, and remodeled its pediatric unit. In January 2006, Benefis partnered with Diversified Clinical Services to open the Benefis Wound Care and Hyperbaric Medicine Center, the only like it in the state of Montana at the time. In August 2006, Benefis' Sletten Cancer Institute added a CyberKnife
Cyberknife
The CyberKnife is a frameless robotic radiosurgery system used for treating benign tumors, malignant tumors and other medical conditions. The system was invented by John R. Adler, a Stanford University Professor of Neurosurgery and Radiation Oncology, and Peter and Russell Schonberg of Schonberg...
nuclear radiosurgery
Radiosurgery
Radiosurgery is a medical procedure that allows non-invasive treatment of benign and malignant tumors. It is also known as stereotactic radiotherapy, when used to target lesions in the brain, and stereotactic body radiotherapy when used to target lesions in the body...
system for treating tumors and other medical conditions (at the time, making Benefis the only hospital to own a cyberknife in the Idaho
Idaho
Idaho is a state in the Rocky Mountain area of the United States. The state's largest city and capital is Boise. Residents are called "Idahoans". Idaho was admitted to the Union on July 3, 1890, as the 43rd state....
, Montana, Oregon
Oregon
Oregon is a state in the Pacific Northwest region of the United States. It is located on the Pacific coast, with Washington to the north, California to the south, Nevada on the southeast and Idaho to the east. The Columbia and Snake rivers delineate much of Oregon's northern and eastern...
, Washington, and Wyoming
Wyoming
Wyoming is a state in the mountain region of the Western United States. The western two thirds of the state is covered mostly with the mountain ranges and rangelands in the foothills of the Eastern Rocky Mountains, while the eastern third of the state is high elevation prairie known as the High...
areas).
Benefis' separation from Providence Services was finalized on September 30, 2006. Benefis was forced to make a donation of $10 million to cover goodwill
Goodwill (accounting)
Goodwill is an accounting concept meaning the value of an entity over and above the value of its assets. The term was originally used in accounting to express the intangible but quantifiable "prudent value" of an ongoing business beyond its assets, resulting perhaps because the reputation the firm...
, and repay loans made to the company by Providence Services. Both the Vatican
Holy See
The Holy See is the episcopal jurisdiction of the Catholic Church in Rome, in which its Bishop is commonly known as the Pope. It is the preeminent episcopal see of the Catholic Church, forming the central government of the Church. As such, diplomatically, and in other spheres the Holy See acts and...
and the Montana Attorney General's Office approved the disaffiliation. The company said it saved $100,000 a month in corporate overhead costs, although it incurred an equal amount of cost because it now had higher interest payments on its debt. The same year, Benefis founded the Northcentral Montana Healthcare Alliance, a consortium of 14 hospitals and long-term care facilities whose goal was to promote the general economic well-being of its member institutions. Benefis also gave Cascade County
Cascade County, Montana
-National protected areas:*Benton Lake National Wildlife Refuge*Lewis and Clark National Forest -Economy:Malmstrom Air Force Base is a driving force in the regional economy...
3.5 acres (1.4 ha) near on Benefis Court in exchange for 2.6 acres (1.1 ha) of land near 15th Avenue South and 25th Street in September 2006. A month later, the United States Department of Agriculture
United States Department of Agriculture
The United States Department of Agriculture is the United States federal executive department responsible for developing and executing U.S. federal government policy on farming, agriculture, and food...
's Rural Development grant program awarded $380,000 to Northcentral Montana Healthcare Alliance to expand telehealth
Telehealth
Telehealth is the delivery of health-related services and information via telecommunications technologies. Telehealth could be as simple as two health professionals discussing a case over the telephone or as sophisticated as doing robotic surgery between facilities at different ends of the...
throughout the area, a grant which was matched by a $700,000 grant from Benefis.
On February 7, 2007, a Benefis Mercy Flight Beechcraft Super King Air 200 twin-engine fixed-wing aircraft crashed a short distance from Gallatin Field Airport
Gallatin Field Airport
Gallatin Field Airport , also known as Gallatin Field, is a public-use airport located seven nautical miles northwest of the central business district of Bozeman, a city in Gallatin County, Montana, United States. It is owned by the Gallatin Airport Authority...
(near Bozeman, Montana
Bozeman, Montana
Bozeman is a city in and the county seat of Gallatin County, Montana, United States, in the southwestern part of the state. The 2010 census put Bozeman's population at 37,280 making it the fourth largest city in the state. It is the principal city of the Bozeman micropolitan area, which consists...
) around 9 p.m., killing the pilot, a registered nurse
Registered nurse
A registered nurse is a nurse who has graduated from a nursing program at a university or college and has passed a national licensing exam. A registered nurse helps individuals, families, and groups to achieve health and prevent disease...
, and a paramedic
Paramedic
A paramedic is a healthcare professional that works in emergency medical situations. Paramedics provide advanced levels of care for medical emergencies and trauma. The majority of paramedics are based in the field in ambulances, emergency response vehicles, or in specialist mobile units such as...
. Members of the victims' families contended the contractor which operated the flight, Metro Aviation, failed to adhere to safety and training procedures. In June 2007, Metro Aviation reached a confidential, out-of-court settlement with the family of paramedic Paul Erickson. In April 2009, the family of nurse Darcy Dengel also reached an out-of-court settlement with Metro Aviation.
In March 2007, Benefis and the Great Falls Clinic began exploring ways to collaborate in cardiac care. These talks continued for two years, and expanded to include discussions that included Benefis buying the Clinic outright. But although the talks continued into February 2010, the Clinic eventually rejected the confidential purchase price and terms offered by Benefis.
2008 saw Benefis expand even further. It opened its new Hi-Line Sletten Cancer Center in Havre
Havre, Montana
Havre is a city in, and the county seat of, Hill County, Montana, United States. It is said to be named after the city of Le Havre in France. The population was 9,621 at the 2000 census.-History:...
in August. The same month, it partnered with the 10-physician Great Falls Orthopedic Associates to break ground on the $17 million, 72000 square feet (6,689 m²) Orthopedic Center of Montana, an ambulatory and outpatient surgical center offering physical therapy
Physical therapy
Physical therapy , often abbreviated PT, is a health care profession. Physical therapy is concerned with identifying and maximizing quality of life and movement potential within the spheres of promotion, prevention, diagnosis, treatment/intervention,and rehabilitation...
, sports medicine
Sports medicine
Sports medicine is a branch of medicine that deals with physical fitness, treatment and prevention of injuries related to sports and exercise...
, and urgent care
Urgent care
Urgent care is the delivery of ambulatory care in a facility dedicated to the delivery of medical care outside of a hospital emergency department, usually on an unscheduled, walk-in basis. Urgent care centers are primarily used to treat patients who have an injury or illness that requires immediate...
services. The new building permitted Benefis Quick Care, an existing urgent care center, to move into larger quarters on the health system's west campus. In December, Benefis began construction, cost, and marketing studies aimed at building a continuous-case retirement community on 60 acres (24.3 ha) south of its east campus. The first phase of the project (which would replace its traditional nursing home, built in the early 1980s) would construct several seven-to-10 person cottages over a four-year period to provide long-term nursing care, dining facilities, and recreation. The company said it intended to build an independent
Independent living
Independent living, as seen by its advocates, is a philosophy, a way of looking at disability and society, and a worldwide movement of people with disabilities working for self-determination, self-respect and equal opportunities...
and assisted living
Assisted living
Assisted living residences or assisted living facilities provide supervision or assistance with activities of daily living ; coordination of services by outside health care providers; and monitoring of resident activities to help to ensure their health, safety, and well-being.Assistance may...
facilities as well. Ground was broken on the first phase of this project in November 2010.
In 2009, Republican
Republican Party (United States)
The Republican Party is one of the two major contemporary political parties in the United States, along with the Democratic Party. Founded by anti-slavery expansion activists in 1854, it is often called the GOP . The party's platform generally reflects American conservatism in the U.S...
Congressman Denny Rehberg
Denny Rehberg
Dennis R. "Denny" Rehberg is the U.S. Representative for , serving since 2001. He is a member of the Republican Party.-Early life, education and career:...
secured federal spending earmarks
Earmark (politics)
In United States politics, an earmark is a legislative provision that directs approved funds to be spent on specific projects, or that directs specific exemptions from taxes or mandated fees...
for Benefis that included $300,000 to subsidize construction of the pediatric care areas, $900,000 for the cardiac care suites in the new tower, and $143,000 for electronic medical recordkeeping and telehealth.
Benefis began construction of a $17 million, four-story, 79000 square feet (7,339.3 m²) medical office building next to the Orthopedic Center of Montana on its east campus in August 2010. The building was intended to house Benefis Medical Group (formerly called Benefis Physician Associates), a group of 53 physicians and 18 other healthcare providers the health system created in late 2007. In September of that year, it also outsourced its medical records functions to Precyse, a medical records transcription, coding, and filing company in Pennsylvania
Pennsylvania
The Commonwealth of Pennsylvania is a U.S. state that is located in the Northeastern and Mid-Atlantic regions of the United States. The state borders Delaware and Maryland to the south, West Virginia to the southwest, Ohio to the west, New York and Ontario, Canada, to the north, and New Jersey to...
.
In April 2011, Benefis announced it would build a $5.5 million, 40-unit low-income housing project for senior citizens. The health care company sought housing tax credits from the Montana Board of Housing for the project (only the third time since 1996 that such credits had been sought for a project in Great Falls). Benefis said Mountain Plains Equity Group of Billings would invest in the project as well, which would be built on 3 acres (1.2 ha) next to its existing 66 acres (26.7 ha) senior campus (under construction at the time). The project, to be called The Grandview at Benefis, would break ground in fall 2011. Benefis also said that the cost of its long-term care cottages and assisted living housing, which began construction in November 2010, would be about $21.5 million. The cost of the independent living housing had not yet been determined, but would break ground in 2012. This second phase, Benefis said, would now include 33 stand-alone homes as well.
Benefis also said in April 2011 that it would spend $3.5 million to expand and renovate its Peak Health & Wellness facility, a for-profit joint venture with private investors.
Ownership changes
Under the terms of the merger, Benefis affiliated with Providence Services, a Catholic-owned health care system based in Spokane, WashingtonSpokane, Washington
Spokane is a city located in the Northwestern United States in the state of Washington. It is the largest city of Spokane County of which it is also the county seat, and the metropolitan center of the Inland Northwest region...
, and founded by the Sisters of Providence. A local board of directors provided leadership and oversight for Benefis, although the Providence Services maintained some corporate control.
In July 2008, a holding company known as Benefis Health System was created to hold title to the growing variety of services offered.
Deregulation battle
The COPA permitting the merger of Columbus and Deaconess hospitals in 1996 was due to expire in 2006. However, the state had the option of renewing the agreement at that time, if the state believed not enough strong competition had emerged to keep Benefis from engaging in monopolisticMonopoly
A monopoly exists when a specific person or enterprise is the only supplier of a particular commodity...
behaviors.
In October 2006, Montana Attorney General Mike McGrath
Mike McGrath
Michael McGrath currently serves as the Chief Justice of the Montana Supreme Court. He was elected in 2008. He also served as Montana's Attorney General from 2000-2008. He was elected in November 2000, and was unopposed for his second term in 2004. He was a member of the Montana Democratic Party...
ruled that although some competition for certain services had emerged, not enough competition existed in enough areas to justify releasing Benefis from its obligations under the COPA. On December 3, citing internal studies which showed Benefis could lose $2.4 million a year due to competition, Benefis asked McGrath to reconsider his decision. McGrath declined to do so and said he would neither affirm or overturn his decision until the upcoming legislative session ended.
A legislative effort to repeal the COPA agreement began in January 2007.
State Senator Jesse Laslovich, a Democrat
Democratic Party (United States)
The Democratic Party is one of two major contemporary political parties in the United States, along with the Republican Party. The party's socially liberal and progressive platform is largely considered center-left in the U.S. political spectrum. The party has the lengthiest record of continuous...
from Anaconda
Anaconda, Montana
Anaconda, county seat of Anaconda City/Deer Lodge County, is located in mountainous southwestern Montana. The Continental Divide passes within 8 miles of the community with the local Pintler Mountain range reaching 10,379 feet...
, sponsored a bill that would limit COPA agreements to 10 years and which would make this limitation retroactive (so it would apply to the Benefis agreement). Benefis focused its lobbying efforts on prices, and pledged to keep its prices in the lower 50th percentile for large Montana hospitals. At legislative hearings in the state senate, more than 20 individuals testified for three and a half hours about the merits of the bill. The bill passed the state senate by a vote of 39-to-11. The state house passed the bill 93-to-6 on March 20.
On April 2, 2007, Montana Governor Brian Schweitzer
Brian Schweitzer
Brian David Schweitzer is an American politician from the U.S. state of Montana. Schweitzer is its 23rd and current governor, serving since January 2005. Schweitzer currently has one of the highest approval ratings among governors in the nation, with polls regularly showing a rating of above 60...
signed the legislation ending state oversight of Benefis through the COPA process.
Benefis said in 2008 that it saved $300,000 to $600,000 a year in interest rate payments on its bonds after being freed from the COPA requirements. It also saw another $120,000 a year in savings by no longer having to engage in COPA reporting and oversight, or for reimbursing the state for COPA oversight.
However, in early 2011, representatives from school employee health care trust funds, nursing associations, community health clinics, and others accused Benefis of raising prices 16 percent in 2010 and 30 percent overall since removal of the COPA agreement. But Benefis also said its costs fell 2 percent in the 2008-2009 period, and another 8 percent in 2010. Benefis denied the accusation, saying the 16 percent figure was overstated because much of that number came from a discontinuation of health care price breaks the health system used to provide. Benefis officials also said their charges for inpatient care were still 2.6 percent below those of its peers, while charges for outpatient service were 29.2 percent lower. Benefis also said it would implement no price increase in 2011, and hoped to reduce costs another 5.2 percent.
Market size and economic impact
In 2006, two-thirds of all Benefis patients came from Cascade County, MontanaCascade County, Montana
-National protected areas:*Benton Lake National Wildlife Refuge*Lewis and Clark National Forest -Economy:Malmstrom Air Force Base is a driving force in the regional economy...
, with the remainder coming from the remaining counties in north-central Montana. The region is five times the size of the state of New Jersey
New Jersey
New Jersey is a state in the Northeastern and Middle Atlantic regions of the United States. , its population was 8,791,894. It is bordered on the north and east by the state of New York, on the southeast and south by the Atlantic Ocean, on the west by Pennsylvania and on the southwest by Delaware...
.
Benefis has more of an economic impact on the city of Great Falls than any other industry or employer. In 2008, it was the north-central Montana region's largest private employer.
As of 2008, Benefis was considered the "sole community provider" by the Centers for Medicare and Medicaid Services
Centers for Medicare and Medicaid Services
The Centers for Medicare & Medicaid Services , previously known as the Health Care Financing Administration , is a federal agency within the United States Department of Health and Human Services that administers the Medicare program and works in partnership with state governments to administer...
, which resulted in a $1.5 million annual federal payment to the health system. If total hospital admissions at any other healthcare facility in the community rises above 8 percent, Benefis would be required to share that payment equally with the other provider(s). The same year, Benefis said Medicare patients accounted for 48 percent of the health system's admissions, but contributed only 40 percent of its revenues. Patients with private insurance represented 26 percent of admissions but accounted for 40 percent of revenues. Benefis said that it lost money on its dialysis, emergency room, and inpatient mental health services.
In November 2010, a study conducted by the University of Montana Bureau of Business and Economic Research found that health care was now the largest sector of the Cascade County economy. Although the military (represented primarily by Malmstrom Air Force Base
Malmstrom Air Force Base
Malmstrom Air Force Base is a United States Air Force base and census-designated place in Cascade County, Montana, United States. It was named in honor of World War II POW Colonel Einar Axel Malmstrom...
) had long been assumed to be the city's economic driver, health care now accounted for 16 percent of the county's non-agricultural earnings, compared to 14 percent for military activities. Benefis, the researchers found, not only employed 10 percent of the county's entire workforce, but also accounted for 10 percent of its earnings. Health care represented more of Cascade County's total economy (14 percent) than in other large Montana cities such as Billings
Billings, Montana
Billings is the largest city in the U.S. state of Montana, and is the principal city of the Billings Metropolitan Area, the largest metropolitan area in over...
(12 percent) or Missoula
Missoula, Montana
Missoula is a city located in western Montana and is the county seat of Missoula County. The 2010 Census put the population of Missoula at 66,788 and the population of Missoula County at 109,299. Missoula is the principal city of the Missoula Metropolitan Area...
(12 percent), or in Montana as a whole (9 percent). Health care also appeared to be the primary driver of economic growth and employment in the county, with health care employment rising 4.2 percent from 2008 to 2009 (while construction, finance, and transportation saw major drops).
Benefis Health System was the largest hospital in Montana as of March 2011.
Cardiac services
In July 2005, Benefis announced it was partnering with MedCath Corp.MedCath Corp.
MedCath Corporation is an American public company which provides cardiac health care. The company was founded in 1988 as MedCath Partners, a for-profit corporation which offered cath lab, nuclear cardiology, and sleep medicine services...
to construct an $11 million cardiac hospital on its east campus. MedCath owned 49 percent of the cardiac hospital, and had the option to invest in the physical property as well.
The tower was originally expected to cost $50 million, but by mid 2006 the cost had risen to a "staggering" $75.2 million. Construction on the now seven-story medical tower began in September 2006. Although only a year had passed since announcement of the MedCath deal, the tower's purpose had radically changed. Benefis said the tower, which would have 88 private rooms and connect with the operating room tower and medical building via an existing skyway
Skyway
In an urban setting, a skyway, catwalk, sky bridge, or skywalk is a type of pedway consisting of an enclosed or covered bridge between two buildings. This protects pedestrians from the weather. These skyways are usually owned by businesses, and are therefore not public spaces...
, would provide space for obstetrics, neonatal intensive care, and pediatrics in addition to cardiology. The new medical tower opened on August 25, 2009, at a final cost of $85 million. Private donations paid for $3.5 million of the cost, while federal earmarks contributed another $1.2 million.
Charity care
In 2008, a report on the amount of public benefit hospitals returned to the community, released by the Montana Attorney General's office, said that Benefis ranked eighth out of 11 hospitals in the state. The report said Benefis received $7.5 million in tax breaks in 2006, but donated less than $4.7 million in charity care. Benefis disagreed with the report, noting that the document says the company broke even on MedicaidMedicaid
Medicaid is the United States health program for certain people and families with low incomes and resources. It is a means-tested program that is jointly funded by the state and federal governments, and is managed by the states. People served by Medicaid are U.S. citizens or legal permanent...
but that the hospital actually lost $3.2 million on providing the service. If the correct figure were used, Benefis officials said, the health system would have ranked fifth.
The following year, the Attorney General's office reported that Benefis received $5.7 million in tax exemptions in 2007. Although Benefis gave charity care to more people (4,082) in 2007 compared to 2006 (3,493), it donated $4.68 million in charity care (a decrease of $11,000 from the previous year).
By 2008, charity care constituted 2.95 percent of Benefis' operating budget (up from 1.5 percent in 2006). Based on the ratio of charity care to operating budget, Benefis ranked fourth-highest among nonprofit hospitals in the state.
Awards
Benefis has received numerous awards for its provision of health care. In 2005, HealthGradesHealthGrades
HealthGrades Inc. is a U.S. company that develops and markets quality and safety ratings of health care providers, including hospitals, nursing homes, physicians and dentists. Quality ratings are devised from publicly available patient safety data and analyzed with proprietary technology developed...
(a company which ranks quality of care) listed Benefis as among the top 5 percent of hospitals in the nation for the quality of its care. In 2006, HealthGrades listed Benefis' cardiology and gastrointestinal
Gastroenterology
Gastroenterology is the branch of medicine whereby the digestive system and its disorders are studied. The name is a combination of three Ancient Greek words gaster , enteron , and logos...
services "number one" in Montana. HealthGrades also listed Benefis among the top 5 percent of hospitals in the country for the quality of its orthopedic services, and in the top 10 percent nationally for joint-replacement surgery and treatment of stroke. Benefis also won a Specialty Excellence Award recipient for its orthopedic, joint replacement, and stroke care. It also gave the hospital five-star ratings (for above-average patient outcomes) in the areas of bowel obstruction, pneumonia, respiratory failure, sepsis, and stroke. In 2006 and again in 2007, Benefis was once again listed in the top 5 percent of hospitals delivering high-quality health care.
In 2006, the American Society for Bariatric Surgery gave Benefis its Bariatric Surgery Center of Excellence designation, recognizing it for the quality of its care and the high percentage of positive patient outcomes.
The Sletten Cancer Institute received the Outstanding Achievement Award from the American College of Surgeons
American College of Surgeons
The American College of Surgeons is an educational association of surgeons created in 1913 to improve the quality of care for the surgical patient by setting high standards for surgical education and practice.-Membership:...
for the quality of its cancer care. It won the accolade a second time in 2008, one o only 66 cancer centers in the entire United States to achieve the honor.