Lebanon — Seventeen employees of Alice Peck Day Memorial Hospital lost their jobs on Wednesday after the hospital closed its patient accounts department and outsourced the work to a Maryland company.
The Chappelle Group Corp. — a Greenbelt, Md.-based company that specializes in revenue cycle and cash collections — will take over responsibility for billing payers and patients, according to a Wednesday news release from the hospital.
While this isn’t the first outsourcing to take place at a Lebanon hospital — APD last year outsourced its medical coding functions, while Dartmouth-Hitchcock in 2015 decided to outsource its revenue management operations — Wednesday’s job losses came without warning to the affected employees, said Lisa Blodgett, a now former credit coordinator who had worked at APD for nearly nine years.
“I bent over backward for my patients,” Blodgett said of those she helped to navigate the often complex systems of health insurance and billing. “I’m going to miss them.”
Though she had nothing but praise for the quality of care she and other APD patients receive, Blodgett did fault administrators for the way they notified her and other employees that they were out of work.
“The way APD went about letting us know was so disrespectful,” she said.
About six months ago, Blodgett recalled, the Chappelle Group began consulting with APD to improve its billing services. Blodgett said the goal was “trying to get more money in the door because billing for hospitals is hard.”
But her understanding of the relationship between APD and Chappelle was that Chapelle was “supposed to help us.” It wasn’t until Wednesday morning, when APD’s Chief Financial Officer Timothy Graham showed up with two human resources employees and invited members of the department into a closed-door meeting, that she “knew something was up.”
Graham proceeded to inform the group that “as of today, your jobs have been terminated,” Blodgett said.
Now, she said, she feels “we’ve been lied to since the get-go.”
Employees will receive two weeks of paid notice and severance payments according to their years of service, the hospital’s release said.
One member of the department had worked at APD for 37 years, Blodgett said. That co-worker has spent her “whole entire life” at APD, Blodgett said.
Some of the employees who lost their jobs are the sole earners in their households, she said.
APD officials said their hands were tied in terms of when they notified employees.
“Because of the sensitive nature of this transition, we could not provide advance notice about this decision,” APD spokesman Peter Glenshaw said in an email on Wednesday.
APD, which employs 478 workers, has offered to help the laid-off employees transition to other jobs, including positions at the hospital, according to the release. The Chappelle Group also may offer positions to some of the former APD employees, the release said.
The move is not expected to result in any savings for the hospital, nor is it expected to cost additional money, Glenshaw said.
Instead, officials describe the move as part of an effort to improve the hospital’s “revenue cycle” and cash management. APD already has seen “significant improvement in its monthly cash collections as well as other components in the revenue cycle” since engaging the Chappelle Group, according to the release.
“I believe this is the right decision for APD because it ensures our finances remain strong and viable,” APD Chief Executive Sue Mooney said in the news release. “While we are sorry to lose these colleagues, we also know this initiative has improved our ability to make timely payments to vendors, some of whom are located in the Upper Valley.”
In addition to APD’s vendors, Mooney said, patients also will benefit from the change.
“Patients deserve to get information in a timely fashion regarding their bill, and this change will improve their satisfaction with this process at APD,” she said.
While Blodgett said she and the other members of the department will find other jobs, she’s concerned that outsourcing her department further distances APD from its mission as a community-based hospital.
“When patients found out we were affiliating with (Dartmouth-Hitchcock), they were scared,” Blodgett said of the formal agreement between the two organizations, which came into effect in 2016.
APD providers “really care about their patients,” Blodgett said. “Outsourcing ... it’s not in the patients’ best interest. ... Not in the community’s best interest. ... It’s sad.”
APD’s outsourcing of patient accounts comes on the heels of D-H’s outsourcing of 340 jobs related to revenue management to Conifer Health Solutions, a subsidiary of the Dallas-based Tenet Healthcare Corp., in 2015. However, that outsourcing was one of the factors that contributed to D-H’s $12.2 million deficit in 2016, according to James Weinstein, D-H’s chief executive at the time.
On Wednesday, D-H spokesman Rick Adams said he wasn’t sure what Weinstein was referring to regarding the hospital system’s losses due to the relationship with Conifer.
“To my knowledge the relationship is going well,” he said.
APD also outsourced eight jobs in the hospital’s medical coding department, which helps ensure that people and insurers are billed for the right diagnoses and procedures, to Conifer last year.
Conifer offered jobs to each of the eight employees that APD released, Glenshaw said in an email.
“We have been pleased with the results of this transition,” he said.
Adams put some distance between D-H and APD’s decision to outsource the patient accounts jobs by saying that decisions are left to leaders at the local level.
APD leaders echoed this sentiment in an email.
“APD made this decision,” Glenshaw said. “D-H is aware of this decision, but the decision was made by APD alone.”
He added that the decision to outsource was unrelated to the hospital’s affiliation with D-H.
At the moment, neither APD’s leaders nor Adams foresee further outsourcing.
Adams also said he was unaware of any other plans to outsource services at any of D-H’s other affiliates, which include New London Hospital, Mt. Ascutney Hospital and Health Center in Windsor, Cheshire Medical Center in Keene and Visiting Nurse and Hospice for Vermont and New Hampshire, which is based in White River Junction.
For her part, Blodgett on Wednesday said she is moving on.
“I’ll start looking (for work) tomorrow,” she said.
Nora Doyle-Burr can be reached at ndoyleburr@vnews.com or 603-727-3213.