DAYTON-When the Hospital Board of Commissioners met in December, Columbia County Health System (CCHS) CEO Shane McGuire took the opportunity to thank them for their show of support since he has been at the helm of the organization.

"You have been great visionaries and you have been very supportive with this community. It has been challenging, but it has been impressive. There are a lot of elements you have allowed me to invest in to enhance services," said McGuire. "We are growing programs, making investments, and bringing on staff."

McGuire said CCHS is heavily focused on providing better value and better health outcomes for the whole population.

"It isn't just what we're doing inside the walls of the hospital, it's also what we're doing outside the walls of the hospital," he said.

CCHS is partnering with other agencies to bring programs into the community, as well.

Programs like Stay Active and Independent for Life (SAIL), the dementia Memory Café, and nursing services for students in the Dayton School District are just a few examples.

CCHS has participated in Washington State and Centers for Medicare and Medicaid population health initiatives such as the Accountable Community Organizations and Accountable Communities of Health, McGuire said.

"We are not only leading in the community, we are leading in the state, in many ways," said McGuire.

Recently Stephanie Carpenter, Director of Nursing Services at the Booker Rest Home, testified before the state legislature about the new Palliative Care Program.

McGuire said that while in Olympia testifying about issues important to rural health care, he saw a KING Channel 5 news report featuring one of the University of Washington psychiatrists and CCHS LICSW Wayne Pollard, discussing the Integrated Behavioral Health Model currently in practice at the CCHS clinics.

In December, state representative Skyler Rude toured the CCHS facilities with him, and he hopes to work with Rude on important initiatives, such a providing dental services to Medicaid patients, which will fulfill the CCHS strategic goal of serving all patient needs.

McGuire told the commissioners about state funds that are available for capital improvements and/or construction of dental facilities for Medicaid patients.

He explained that reimbursement rates for dental services are better for rural clinics than they are for dentists in private practice. While local dentists want to serve that population, it isn't financially feasible for them to do so.

He also talked about the state's mandate that fourteen hospitals in the Washington Rural Health Access Preservation Group come up with new payment models, which is concerning because rural hospitals are not currently reimbursed for their true operating costs.

Finally, McGuire produced a three-year look back at finances for the commissioners.

McGuire said there has been a 48% increase in the Gross Operating Revenue Budget, over Year 2016, and he is predicting a 42% increase in Net Revenue, before expenses.

He said growing programs and services, and reliance on expensive contract labor has contributed to the slower growth of Net Revenue, after expenses.

He said collections for Accounts Receivable, and older AR, continues to improve.

Currently, the "un-audited bottom line" is in the red, but a clearer picture of 2018's finances will emerge as the financial team begins working with the hospital auditors over the course of the next few months, McGuire said.