re: Economic Development for Winchester (Open Letter to Council via email from Robina Rich Bouffault)

From: robinarich5@gmail.com <robinarich5@gmail.com>


Sent: Friday, December 2, 2022 7:49 AM
To: Amy Simmons <Amy.Simmons@winchesterva.gov>; Corey Sullivan <corey.sullivan@winchesterva.com>; David Smith <david.smith@winchesterva.com>; Emily Deangelis <emily.deangelis@winchesterva.com>; John Hill <john.hill@winchesterva.com>; Kathy Tagnesi <kathy.tagnesi@winchesterva.com>; Kim Herbstritt <kim.herbstritt@winchesterva.com>; Les Veach <les.veach@winchesterva.com>; Phillip Milstead <phillip.milstead@winchesterva.com>; Richard Bell <richard.bell@winchesterva.gov>
Cc: Dan Hoffman <dan.hoffman@winchesterva.com>
Subject: Economic Development for Winchester


Open Letter to the Winchester City Council – via email


All -


I refer to City Manager Dan Hoffman’s Star Open Forum of November 21st “Recent Open Forum contained inaccuracies”.

Mr. Hoffman was hired in August 2020 and, as a “newbie” to Winchester, having come from Florida, he can be forgiven for not being totally familiar with the erratic meanderings of the city’s recent development attempts.

Stating that Mr. Youmans “has never proposed a new development” is disingenuous at best. Mr. Youmans is a long-term veteran of the city’s current confused economic development objectives, which have mutated depending on who was directing the conversation. He has learned to be flexible, trying to adapt city ordinances to the wishes of the EDA and/or Planning Commission members and/or City Council’s vagaries. It has become a dizzying job in the last few years.

In 2017 a new EDA Director was hired, (since departed), who used taxpayers’ funds to purchase two properties located on Piccadilly/Kent and Piccadilly/Cameron, initially called Piccadilly Street Investments LLC and Cameron Street Investments LLC. The first property cost taxpayers, including demolition, $1,449,000. The second property (Winchester Towers) cost $1,443,000.

Lets’ take the first property on Piccadilly/Kent as an example. Purchased by the EDA in 2017-2018, originally planned for a commercial/residential mixed-use, subsequently called Epicc Lofts, and now called Piccadilly Townes - under construction since April.

Early 2022, developers Aikens purchased the property from the EDA for $480,000. They will theoretically pay an additional “50% of the total profit” with payment due only after the LAST townhouse sells. (Question: who decides what the “total profit” will be?).

The original plans have morphed from a mixed-use project with self-contained parking in a five-story building, to the current 16 three-story residential townhouses under construction, with only 16 on-site parking spaces provided. As the townhouses are all 2 and 3-bedrooms, there will undoubtedly be quite a few cars with no parking spaces, left to park either on Kent or other streets close by. The 30% required green space was fudged by selling the small adjacent public park to Aikens as well.

In March, 2022, the EDA was suggesting that the sales prices of the townhouses would be in the “$250,000 to $300,000” range. They are currently being advertised between $399,000 and $429,000. Hardly “affordable housing”.

In 2019, the B.A.R. had a meeting clearly confirming that vinyl windows would not be allowed in the Old Town Winchester district. You wouldn’t know it by looking at the Aiken townhouses, which all have – you guessed it – vinyl windows. No mullions, of course.

Now the city is faced with a similar situation with the Cameron Square project undertaken by Richmond developers Lynx Ventures. Same problems – 100% residential, far too many apartments in a very small space, no green space, insufficient parking; all of which will only increase taxes and traffic congestion downtown.

Why is the City allowing this, or even promoting it against their own ordinances?

In the interest of the well-being of the city and its residents, it’s time for Council, the Planning Commission and the EDA to seriously reconsider their flawed “economic development” approach.

Thank you for taking the above into consideration when deliberating on future economic development in the City.



Robina Rich Bouffault

Biden’s Bounty on Your Life: Hospitals’ Incentive Payments for COVID-19

 

By Elizabeth Lee Vliet, M.D. and Ali Shultz, J.D. – https://www.truthforhealth.org/
November 17, 2021

Upon admission to a once-trusted hospital, American patients with COVID-19 become virtual prisoners, subjected to a rigid treatment protocol with roots in Ezekiel Emanuel’s “Complete Lives System” for rationing medical care in those over age 50. They have a shockingly high mortality rate. How and why is this happening, and what can be done about it?

As exposed in audio recordings, hospital executives in Arizona admitted meeting several times a week to lower standards of care, with coordinated restrictions on visitation rights. Most COVID-19 patients’ families are deliberately kept in the dark about what is really being done to their loved ones.

The combination that enables this tragic and avoidable loss of hundreds of thousands of lives includes (1) The CARES Act, which provides hospitals with bonus incentive payments for all things related to COVID-19 (testing, diagnosing, admitting to hospital, use of remdesivir and ventilators, reporting COVID-19 deaths, and vaccinations) and (2) waivers of customary and long-standing patient rights by the Centers for Medicare and Medicaid Services (CMS).

In 2020, the Texas Hospital Association submitted requests for waivers to CMS. According to Texas attorney Jerri Ward, “CMS has granted ‘waivers’ of federal law regarding patient rights. Specifically, CMS purports to allow hospitals to violate the rights of patients or their surrogates with regard to medical record access, to have patient visitation, and to be free from seclusion.” She notes that “rights do not come from the hospital or CMS and cannot be waived, as that is the antithesis of a ‘right.’ The purported waivers are meant to isolate and gain total control over the patient and to deny patient and patient’s decision-maker the ability to exercise informed consent.”

Creating a “National Pandemic Emergency” provided justification for such sweeping actions that override individual physician medical decision-making and patients’ rights. The CARES Act provides incentives for hospitals to use treatments dictated solely by the federal government under the auspices of the NIH. These “bounties” must be paid back if not “earned” by making the COVID-19 diagnosis and following the COVID-19 protocol.

The hospital payments include:A “free” required PCR test in the Emergency Room or upon admission for every patient, with government-paid fee to hospital.
Added bonus payment for each positive COVID-19 diagnosis.
Another bonus for a COVID-19 admission to the hospital.
A 20 percent “boost” bonus payment from Medicare on the entire hospital bill for use of remdesivir instead of medicines such as Ivermectin.
Another and larger bonus payment to the hospital if a COVID-19 patient is mechanically ventilated.
More money to the hospital if cause of death is listed as COVID-19, even if patient did not die directly of COVID-19.
A COVID-19 diagnosis also provides extra payments to coroners.

CMS implemented “value-based” payment programs that track data such as how many workers at a healthcare facility receive a COVID-19 vaccine. Now we see why many hospitals implemented COVID-19 vaccine mandates. They are paid more.

Outside hospitals, physician MIPS quality metrics link doctors’ income to performance-based pay for treating patients with COVID-19 EUA drugs. Failure to report information to CMS can cost the physician 4% of reimbursement.

Because of obfuscation with medical coding and legal jargon, we cannot be certain of the actual amount each hospital receives per COVID-19 patient. But Attorney Thomas Renz and CMS whistleblowers have calculated a total payment of at least $100,000 per patient.

What does this mean for your health and safety as a patient in the hospital?

There are deaths from the government-directed COVID treatments. For remdesivir, studies show that 71–75 percent of patients suffer an adverse effect, and the drug often had to be stopped after five to ten days because of these effects, such as kidney and liver damage, and death. Remdesivir trials during the 2018 West African Ebola outbreak had to be discontinued because death rate exceeded 50%. Yet, in 2020, Anthony Fauci directed that remdesivir was to be the drug hospitals use to treat COVID-19, even when the COVID clinical trials of remdesivir showed similar adverse effects.

In ventilated patients, the death toll is staggering. A National Library of Medicine January 2021 report of 69 studies involving more than 57,000 patients concluded that fatality rates were 45 percent in COVID-19 patients receiving invasive mechanical ventilation, increasing to 84 percent in older patients. Renz announced at a Truth for Health Foundation Press Conference that CMS data showed that in Texas hospitals, 84.9% percent of all patients died after more than 96 hours on a ventilator.

Then there are deaths from restrictions on effective treatments for hospitalized patients. Renz and a team of data analysts have estimated that more than 800,000 deaths in America’s hospitals, in COVID-19 and other patients, have been caused by approaches restricting fluids, nutrition, antibiotics, effective antivirals, anti-inflammatories, and therapeutic doses of anti-coagulants.

We now see government-dictated medical care at its worst in our history since the federal government mandated these ineffective and dangerous treatments for COVID-19, and then created financial incentives for hospitals and doctors to use only those “approved” (and paid for) approaches.

Our formerly trusted medical community of hospitals and hospital-employed medical staff have effectively become “bounty hunters” for your life. Patients need to now take unprecedented steps to avoid going into the hospital for COVID-19.

Patients need to take active steps to plan before getting sick to use early home-based treatment of COVID-19 that can help you save your life.

Why is "The National Forum for Heart Disease & Stroke Prevention" out soliciting mayors of cities to promote the COVID jabs that are proving to be worthless?

Are these mayors and individuals doing this voluntarily or are they getting paid to make such statements?

https://www.facebook.com/nationalforumforheartdiseaseandstrokeprevention

Wonder if Big Pharma has made any donations to this non-profit?

John M Clymer (Exec. Director) salary for years 2019 back to 2013 are the following that includes reportable compensation via W2 plus estimated amount of other compensation from the organization & related organizations.

2019 - $262,120

2018 - $247,689

2017 - $222,089

2016 - $222,963

2015 - $209,037

2014 - $209,037

2013 - $229,358

Meet the team:
https://www.nationalforum.org/about/team/

Meet the Advisory leadership council:
https://www.nationalforum.org/advisory-leadership-council/

Meet the Board of Directors:
https://www.nationalforum.org/about/board-of-directors/

Review the IRS990's at the following link:

https://projects.propublica.org/nonprofits/organizations/272257461

COVID vaccines, How it started vs. how it's going!

COVID vaccines, How it started vs. how it's going!

A quick 2min overview of all the news media headlines from the start of COVID to current times.


https://twitter.com/WallStreetSilv/status/1597834732209045505

Fauci Taps Wuhan Institute Of Virology’s ‘Longtime’ Gain-Of-Function Research Partner Advising People How To ‘Make Money’ Off Pandemics To Run Pandemic Drug Development Network.

Fauci Taps Wuhan Institute Of Virology’s ‘Longtime’ Gain-Of-Function Research Partner Advising People How To ‘Make Money’ Off Pandemics To Run Pandemic Drug Development Network.

BY: NATALIE WINTERS / WARROOM.ORG



https://warroom.org/2022/11/30/fauci-taps-wuhan-institute-of-virologys-longtime-gain-of-function-research-partner/

Finally, true physicians get a seat at the table, and speak truth loudly!

Finally, true physicians get a seat at the table, and speak truth loudly. 

We need more speaking out, like about the massive rise in strokes & cancers & excess mortality & miscarriages.

Never forget the near complete silence of the OB's, cardiologists, neurologists, & oncologists.

https://twitter.com/PierreKory/status/1597708474519289857

Who will foot the bill for the newly created positions within Central Admin Office of Winchester Public Schools?

What happens when the Redesigning Educator Pathways And Connecting HR systems (REACH) grant is exhausted?

The Winchester Public Schools Central Administration Office states all of these newly created positions in CAO are funded by the Redesigning Educator Pathways And Connecting HR systems (REACH) grant.

OK, but when the grant funds are exhausted, how will these salaries be funded or will all of these positions be eliminated?

Open Forum: Do the numbers justify a need for a WPS spokesperson?

Was there really a need for a spokesperson for the Winchester Public Schools?

I am very much aware it’s a combo deal where the majority of the individual’s time is spent working for WPS and less than half of their other time will be working in the Winchester Parks and Recreation Department.

No matter how you divide it up, $84,000 is all tax dollars being spent.

Were there any other critical needs within the system that need to be addressed?

Now, I totally agree that Loudoun County Public Schools would have a dire need of such a spokesperson with a budget of approximately $1.6 billion dollars. The numbers justify the need for such a position in Loudoun based on the following:

LCPS as of February 2020 had 94 schools, 83,936 students, 5,784 teachers and 6,121 staff. LCPS has two educational centers not included in that school total: Academies of Loudoun and The North Star School.

To make it current, LCPS has 95 schools now with the opening of another high school, Aldie’s Lightridge High School, which opened in the fall of 2021.

 

WPS has a total of six schools, including four elementary schools, one combo intermediate/middle school, one high school, plus the Emil & Grace Shihadeh Innovation Center.

WPS Superintendent Jason Van Heukelum said in an interview with The Winchester Star that the division has long wanted to hire a spokesperson and budgeted for it in 2020, but the pandemic postponed filling the position.

“I’ve never been a superintendent who tries to hide in my office and that will continue. I can and do speak for not only myself but the school division,” he told The Star. “But the volume of need for communicating is just something we need to do a better job at.”

 

To close: Do the numbers justify the need? Would the $84,000 annual expense be better suited for more critical needs within the city system?

Furthermore, do we need a new superintendent who can effectively communicate to the public and oversee 6 schools?

Quote of the day of COVID and the vaccines!

 “The vaccine was not brought in for COVID. COVID was brought in for the vaccine. Once you realize that, everything else makes sense.”
~ Dr. Reiner Fuellmich

Is PLANDEMIC 2 coming soon???

 FEMA WHISTLEBLOWER: PLANDEMIC 2 IS COMING SOON

SGT Report 
Published November 25, 2022

https://rumble.com/v1x5mpy-fema-whistleblower-plandemic-2-is-coming-soon.html

Are Valley Health Systems staff shortages self-inflicted? Why won't the Winchester Star and NVDaily "print" this?

For the record, I submitted this editorial to the Winchester Star during the week of November 14th and submitted on Sunday, November 20th and again Tuesday, November 22nd. I submitted to NVDaily on Sunday November 20th as well. Why is the following editorial not going to print???


The Winchester Star did a story back on October 6, 2022 headlined, "Valley Health feeling economic pinch from pandemic, inflation".

It was stated that Valley Health has about 800 job vacancies, whether full- or part-time, and most of them are in Winchester and the counties of Clarke, Frederick, Page, Shenandoah and Warren.

“Right now we’re making up for that shortfall by either asking people to work overtime, finding temporary agency [professionals] or combining units and services so that we can try to do more with less,” Valley Health Systems President/CEO Mark Nantz said.

"As of February 2020, Valley Health was averaging about $800,000 per month in premium pay", Nantz said. "Now it’s averaging $3 million a month."

Who made the decision that employees had to take the vaccines in order to keep their job or was it really about getting $126 million through the assistance programs such as the federal CARES Act, the Virginia Department of Medical Assistance Services and the Federal Emergency Management Agency?

Were Valley Health Systems and local doctors allowed to really practice medicine and treating patients utilizing all available information and protocols (such as FLCCC Alliance) or were they hamstrung to only follow NIH and FDA guidelines?

The FDA stated the only way an emergency order of any vaccine could get approval was that there could not be any known remedy/treatment on the market for COVID.

Does this explain why Ivermectin developed from a natural base plant, called the ‘Wonder drug’ due to its versatility, safety and impact from Japan that was discovered in 1978 and further developed for human treatment around 1987 and Hydroxychloroquine developed back in 1955 were quickly suppressed?

"Ivermectin proved to be even more of a ‘Wonder drug’ in human health, improving the nutrition, general health and wellbeing of billions of people worldwide ever since it was first used to treat Onchocerciasis in humans in 1988." In 1987, Merck indicated a price of $3 per tablet, meaning that a treatment dose would cost $6, well beyond an affordable amount for those most in need.

In 2015, Ivermectin was awarded the Nobel Prize for treatments of infectious diseases, a multifaceted drug deployed against some of the world's most devastating tropical diseases.

Readers are encouraged to read the medical white papers on Ivermectin:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3043740/

                    https://pubmed.ncbi.nlm.nih.gov/34466270/

https://covid19criticalcare.com/ivermectin/

Now one must ask, what drug would you feel more comfortable with, a vaccine that got an emergency order approved by the FDA and granted immunity to Big Pharma or drugs that have been on the market for human use since 1955 and 1988?

Furthermore, have you seen the video featuring Winchester’s mayor David Smith telling folks to get vaccinated?

https://fb.watch/gXzz2NQ1_5/

Does he have a medical degree that qualifies him to be in a position to be giving out medical advice to the local community? Maybe one would feel better about getting medical advice for the vaccine from the following world wide known doctors:

Dr. Robert Malone

 

Dr. Peter McCullough

 

Dr. Joseph Mercola

 

Something to ponder, Big Pharma was granted legal immunity but what about the employers, businesses and institutions that enforced the mandate? How would they be granted legal immunity?

To close, is it not all about dollars and cents and what makes the most sense? Within the last five years, what happened to common sense?

** End of Editorial submission **


More FYI on the next couple of pages.

Just released Nov. 21st, World Premiere …”Died Suddenly”, was shared with me Nov. 22nd in response to this editorial …

https://rumble.com/v1wac7i-world-premier-died-suddenly.html?mref=6zof&mrefc=2

Some facts about VHS:
Are you aware of Winchester Medical Center’s profits since Y2K? I emailed Mark Nantz back in February requesting profits/loss figures for 2013, 2014 and 2017. I just emailed his secretary this past week requesting the information and stating I believe they did not meet the deadline of 30 days to respond with the information.

2000 $11,917,127
2001 $ 4,262,944
2002 $25,868,766
2003 $35,113,921
2004 $46,711,931
2005 $54,346,679
2006 $57,422,789
2007 $66,617,961
2008 $ 9,500,911
2009 $53,757,390
2010 $53,104,420
2011 $62,029,246
2012 $50,522,325
2013
2014
2015 $71,439,119
2016 $58,416,060
2017
2018 $78,884,579
2019 $29,826,256
2020 $18,414,953

Valley Health System was not very discreet about becoming the monopoly of health care within our regional community in buying up all smaller regional hospitals and building approx $35 million dollar brand new buildings. This does not include the brand new $100 million Warren Memorial hospital that opened up in June of 2021. Side note, Valley Health purchased about 150 acres off Leach Run Parkway in 2008 for $2.6 million. Of that land, the hospital may cover about 25 acres. The land is currently zoned agriculture and open-space preservation and would have to be rezoned before construction.

Why was Valley Health against the birth of the Winchester Eye Surgery Clinic? I am perplexed with the following statement from the March 2006 Quad State Business Journal:

"Last year, the Winchester Eye Surgery Clinic applied to the Virginia Department of Health for a certificate of public need (COPN). Despite receiving a letter of opposition from Winchester Medical Center, which has its own Surgi-Center, at which cataract removals are performed, the state agency granted the COPN on December 22, 2006."

'We opposed it because it was a duplication of the services we provide,' said Larry Van Hoose, vice president for Valley Health. 'Duplication tends to drive health care costs up.'"

I always thought that competition drives prices lower and a monopoly drives the prices up. Now I ask you all, does Valley Health Systems have duplication of their services or not within the regional community? So are their rising costs self-inflicted too?


Other side notes:
I am hearing that VHS is hiring temp nurses (most likely traveling nurses) that are not required to be vaxxed but are paying them basically double the pay. VHS’s increase of premium pay went from approx $800,000 a month to $3 million, so that would be self-inflicted too, would it not?


“Deception and the Law” A look into the DOJ and FTC crimes. Someone involved in this group was a resident in Clarke County, VA for a period of time.

https://youtu.be/iPZ4wIO1FAM

 

Valley Health sues Anthem for $11.4 million in overdue payments (October 13, 2022)

Valley Health sues Anthem for $11.4 million in overdue payments
By JOSETTE KEELOR
The Winchester Star
Oct 13, 2022


WINCHESTER — Valley Health System is suing Anthem Blue Cross Blue Shield, now known as Elevance Health, for $11.4 million in past due payments, according to a news release.

The lawsuit was filed Thursday in Winchester Circuit Court. It includes two counts: breach of contract and violation of the Virginia Ethics and Fairness in Carrier Business Practices Act.

Mark Nantz, president and CEO of Winchester-based Valley Health, said the decision was “a last resort” and follows two years of attempts to resolve reimbursements that Valley Health says it is owed by Anthem, which is the largest health insurance carrier in Virginia.

“We’ve incurred the cost, we’ve performed the service, and we’ve not been paid,” he said on Thursday. “We had appealed to them. Some of these accounts are 2-plus years old.”

Valley Health, which operates six hospitals including Winchester Medical Center, has “worked in good faith to quietly resolve significant reimbursement issues with Anthem,” the release states, but “egregious delays in payment for healthcare services delivered to its members” has forced its hand.

“Anthem has left us no choice but to take legal action,” Nantz states in the release.

“We will not accept Anthem’s continued avoidance of the payments owed to our health system, which limits our resources to deliver the care our patients and their members pay for, expect, and deserve,” he adds.

Valley Health has tried for many years to work with Anthem on solving “its claims processing and payment deficiencies,” the suit reads, and has devoted “hundreds of hours of employee time” to meetings, calls, researching and “answering an endless stream of repetitive and unnecessary questions and data requests — but all to no avail.”

The suit goes on to say that this isn’t an isolated incident.

“In March 2022,” the suit states, “the Georgia Insurance Commissioner’s Office levied a multi-million dollar fine against Anthem’s Georgia affiliate for, among other failings, improper claims settlement practices and violations of the Georgia Prompt Pay Act requirements for paying healthcare providers.”

The Maine Insurance Department is also investigating and doing a market conduct examination of the payment practices of Anthem’s Maine affiliate.

Referencing media reports, the suit says Anthem owes more than $300 million in unpaid claims to VCU Health of Richmond and its Maine affiliate owes $70 million to a hospital system in Portland, Maine.

The suit was submitted by Kevin M. Rose, Michael W. Sharp and Mary Margaret Hawkins of BotkinRose PLC in Harrisonburg.

Valley Health recently announced concerns about its economic prospects following 2½ years of the COVID-19 pandemic, which has led to drastic staffing shortages, amid the country’s highest inflation rate since 1982.

The release also references “ongoing losses incurred from treating Medicare, Medicaid, and self-pay patients” while calling out Anthem for having recently announced record profits.

An information sheet provided by Valley Health on Thursday further explains why the health system has taken legal action, saying, “While the insurer continues to raise premiums and enjoys record profitability, every earned dollar Anthem/Elevance withholds from Valley Health jeopardizes access to sustainable, high-quality healthcare services available across the Shenandoah Valley.”

Anthem/Elevance made $6.1 billion in profits in 2021 alone, which Valley Health says is up 30% from 2020.

“Meanwhile, health systems are experiencing record losses,” Valley Health indicates.

According to Valley Health, its reimbursements from Anthem are overdue by $2.6 million in fiscal year 2019, $2.9 million in 2020 and $9.5 million in 2021. As of September 2022, $11.4 million is owed.

Meanwhile, it states, Anthem’s climbing profits amounted to $4.8 billion in 2019, $4.6 billion in 2020 and $6.1 billion in 2021. As of June 2022, it reached $3.5 billion in profits.

Furthermore, it states that Anthem/Elevance owns 43% of Virginia’s health insurance market, allowing it to “strong-arm health systems into accepting flagrant contract violations like this.”

Valley Health is far from alone in having to deal with failing to be reimbursed for services, Nantz said on Thursday. He explained that while Valley Health is making its judgments independently of what is happening elsewhere, he knows that other health systems around Virginia are experiencing the same types of problems.

Information provided by Valley Health also lists Indiana and Wisconsin as states with health systems or state regulators that have fined the insurance provider.

Conversely, Nantz said, Valley Health doesn’t have these issues with any other insurance provider.

“Every other payer we work with, we have nothing like this,” he said.

Valley Health renewed its three-year agreement with Anthem in January 2021 following lengthy contract negotiations. This enabled Valley Health to avoid terminating its relationship with Anthem, “which would have been highly disruptive to Anthem’s members,” the lawsuit states.

In a statement issued late Thursday, Anthem/Elevance called Valley Health’s claims overstated.

“We are aware of the lawsuit that was filed and are reviewing it,” the statement says. “We want to be clear that this action in no way impacts access to care, and Anthem Blue Cross Blue Shield members may continue to receive care at Valley Health. ...

“As to some of the specific claims being made, we believe they have been inflated based on inaccurate and incomplete data,” the statement continues. “It is a standard industry practice to review claims for medical services to ensure they are coded and billed appropriately. Anthem Blue Cross and Blue Shield in Virginia strives to process claims as quickly as possible and in accordance with our agreements, while also verifying billing accuracy, which requires the cooperation of our provider partners.”

The statement says the insurance provider will continue to work with Valley Health to resolve the issue as quickly as possible.

Valley Health, too, “will continue to do our part to serve our community and ensure patients have access to the providers and services of our health system,” Nantz states in the release.

“But we must hold Anthem — one of the nation’s largest health insurers and responsible for a large portion of Valley Health’s revenue — accountable for the harmful effects of their payment delays that ultimately impact our ability to sustain quality community healthcare services.”

Valley Health feeling economic pinch from pandemic, inflation (October 6, 2022)

Valley Health feeling economic pinch from pandemic, inflation
By JOSETTE KEELOR The Winchester Star
Oct 6, 2022

Faced with a vastly smaller staff, rising costs and the potential of cutting ties with insurance companies in the coming years, Valley Health is considering its options for how to weather the economic impact sparked by the COVID-19 pandemic.

Valley Health is not in danger of closing, said Mark Nantz, president and CEO of the not-for-profit healthcare company that serves more than 500,000 people and operates four hospitals in Virginia and two in West Virginia as well as more than 70 medical practices and urgent care centers, outpatient rehabilitation and fitness, medical transport, long-term care and home health.

However, he said they are cautious about the financial implications for them as health systems around the country struggle with many of the same issues.

“At some point, it would be difficult for any health system to keep the doors open,” he said.

For now, no essential services are in jeopardy, he said, but if inflation and job vacancies continue and they can’t get revenues to increase, they will have to look across their 15-county region to decide where they can reduce, consolidate or discontinue services.

Instead of six places for surgery, it might have to be four, he said. Instead of 150 doctor’s offices, it might be 100.

“We’re looking at every service we provide,” Nantz said. “How can we do that at a reasonable margin?”

Nantz credits federal funding over the last 2½ years with keeping the health system afloat.

In a news release earlier this week, he said that if Valley Health hadn’t received $126 million through assistance programs such as the federal CARES Act, the Virginia Department of Medical Assistance Services and the Federal Emergency Management Agency, then it would have lost $100 million over the last 2½ years.

But all of that funding is gone now, and he’s less sure about how the health system will remain in the black in the coming months and years.

“I would say that the biggest lasting impact is the cost of staffing,” Nantz said.

As with many other areas of business operations, he said the cost of salaries has gone up 20% from pre-pandemic rates.

Furthermore, Valley Health has about 800 job vacancies, whether full- or part-time, and most of them are in Winchester and the counties of Clarke, Frederick, Page, Shenandoah and Warren.

“Right now we’re making up for that shortfall by either asking people to work overtime, finding temporary agency [professionals] or combining units and services so that we can try to do more with less,” Nantz said.

Despite being short-handed, he said Valley Health is still providing necessary procedures and that the trauma centers are functioning at the capacity they must to provide that critical level of care.

“At all times during the pandemic, we’ve maintained a safe level of care and standard of care,” he said.

But asking staff to work more hours at premium rates while bringing in agency professionals to fulfill temporary assignments at higher rates has been costing a lot more than if Valley Health simply had a full staff, he said.

As of February 2020, Valley Health was averaging about $800,000 per month in premium pay, Nantz said. Now it’s averaging $3 million a month.

“It’s across the country. Everyone is feeling the same thing,” Nantz said.

“The labor has gone up significantly, and it doesn’t appear to be going back down.”

Another major problem, he said, is that most insurance providers are reimbursing health-care facilities based on pre-pandemic rates, not today’s rates, which are much higher because of the cost of labor and also the cost of doing business during a time of inflation with higher gas prices and various other products.

Historically, a health system looks to commercial insurance to make up the difference in the shortfall of Medicaid, Nantz said.

Valley Health has been negotiating higher rates with companies like Anthem, Aetna, Cigna and United, and since each insurance company’s contract period expires at a different time, he said this process could take until the end of 2024.

“In between contract periods we don’t really have the right … to cancel,” Nantz said. “As those negotiation rates come up for renewal, we’ve been requesting and receiving increases that are higher than normal.”

Also, regardless of what happens with the insurance companies, he said that Valley Health’s financial assistance program will remain.

Still, they’ll have to see if it’s all enough.

“We’re a long way from going out of network,” he said. But it is a possibility that they’re considering.

“Most health insurance companies have had record years in the last 2½ years,” Nantz said.

That’s at least in part because many patients have been avoiding going to the doctor, some even putting off necessary care. Insurance companies are still making money, Nantz explained, but they’re not having to pay out as many reimbursements as they would have done before the pandemic.

In the meantime, he said, hospitals are dealing with runaway inflation.

If the insurance companies refuse to give a rate of increase equal to Valley Health’s costs, he said, “Then we can’t afford to do business with that company.”

Whatever happens, though, Valley Health will “continue being the safety net for 15 counties," he said.

“Valley Health is strong; we’ve been here for a long time,” he said. “It’s important that the community know that we didn’t come through this without a mark.”

But, he’s proud of how they’ve responded throughout the pandemic.

“We’re gonna be here,” he said. “It’s not over for us yet.”