Harrison stands to lose lots of money to Franciscan Home Health

By Rachel Pritchett
BREMERTON — More information has come to light about why Harrison Medical Center is so strenuously opposing Franciscan Health System's attempt to bring its version of home health to Kitsap County.
Harrison will lose even more money with the new competition than it is now with its own Harrison Home Health, according to a letter Harrison strategist Bob Cross sent in August to the state Department of Health and obtained Tuesday by the Kitsap Sun through a public-documents request.
Harrison Home Health already is losing $284,330 a year as it provides services such as help in dressing and eating to discharged hospital patients now at home, according to the letter. If the department allows Franciscan Home Health to come in, Harrison will lose an additional $108,170 a years for a grand total annual loss of $392,500.
Harrison Home Health by far is the biggest provider of home health in Kitsap, and estimates it will make 2,436 fewer home visits after three year to Franciscan.
"We already lose money on home health," Cross said Wednesday. Both Harrison and Franciscan provide in-home follow-up for patients because it's the right thing to do, and because under health care reform "hospitals will be financially penalized by Medicare" if discharged patients return to hospitals too soon, according to Franciscan spokesman Gale Robinette.
Harrison also is accusing the department of using an outdated and capricious formula to decide whether to allow a new agency to set up shop in new territory. Currently, if there's capacity for a new agency to make 10,000 home-health visits in a specific area, then there's probably room for it to move in, according to the rule.
"Say who? Says who why?" asked Cross, adding the rule made in 1987 is not in state law. Harrison Home Health currently makes 21,864 visits annually, and without too much trouble, could increase that to 30,500 visits, according to the letter of objection to Franciscan's certificate-of-need application.
Bigger is better, Cross said. Overhead costs are spread across more patients, making delivery of services cheaper.
But Franciscan's application states it believes more agencies are needed. There are four certified providers in Kitsap now: Harrison, Group Health Home Health and Hospice, Gentiva Health Services and Signature Home Health. Franciscan believes more than six will be needed by 2015, based on the department's 10,000 rule.
Franciscan's application states the hospital system already is experiencing delays placing its patients in home-health situations.
"(Franciscan Health System) has increasingly experienced delays and problems in discharging certain patient types to home health," it stated.
Franciscan's application also suggests it wants to keep its home-health patients in the Franciscan system. They're easier to track and for a longer period of time. It expects 95 percent of its home-health business will be for patients exiting its hospitals or who have received services from its clinics.
Cross responded that Harrison Home Health never has turned down Franciscan patients, and that it's working to improve its home-health electronic patient records so that they can more easily be shared with other providers.
"The whole idea is you want different systems to be able to talk to each other," Cross said.
A decision from the department is expected in about three weeks. If granted, Franciscan could begin offering its own brand of home-health services in Kitsap County within months.