Where there’s growth in people, there is growth in demand for service. Saskatoon Health Region has been seeing the effects of an unprecedented provincial population boom.

Dan Florizone speaks with media about the financial situation of the Region on November 25, 2015.

Dan Florizone speaks with media about the financial situation of the Region on November 25, 2015.

Saskatoon Health Region has worked to be innovative in the face of a demanding population. In the past five years alone, even though experiencing a 15 per cent population increase, the Region has managed to keep a correlating increase in expenses to just six per cent (net of inflation).

Since 1995, the Region has grown by 27 per cent growth in population – a total of 74,000 more people seeking health services. This accounts for 50 per cent of the total provincial population growth in that same time period. In addition to the increase in the number of newcomers that are in the 20 to 40 age group, there has been a significant shift in population in the birth-to-five years and over-65 age groupings. Both of these groups come with substantial health care costs. These added pressures of increased population and changed demographics, along with inflation, could cost the Region approximately $20 million in 2015-16 alone.

“We have been able to bend what should have been a much higher rate of expenses relative to the rate of growth. We call this the cost curve. And through system improvements, we have been able to bend that cost curve by nine per cent,” said Dan Florizone, President and CEO of Saskatoon Health Region. “It hasn’t been easy. A lot of hard work has gone into maintaining services, finding efficiencies while trying to balance expenses with revenue.”

 

Dan Florizone, President and CEO of Saskatoon Health Region, answers questions from media about budget on November 26, 2015.

 

Staff and physicians continue to work diligently to keep expenses down. Over 94 per cent of the paid hours in the Region are for regularly scheduled time. Sick time hours amount to just four per cent with overtime or premium hours at 1.99 per cent. These numbers show Saskatoon is doing better than the provincial average when it comes to overtime hours worked per full time position.

“And it is getting better,” says Florizone. “Overtime hours have decreased over three consecutive months this fall compared to 2014.”

Over 200 managers, directors and vice presidents have been involved in implementing more effective schedules which match staffing to demand, vacation level loading and overtime reduction strategies. The Region has also been reviewing every vacant position.

A number of strategies have been implemented this year to improve care to patients, clients, residents and families. And the Region has seen a correlating benefit with expenses.

 

Nilesh Kavia, Vice President of Finance and Corporate Services for Saskatoon Health Region, speaks about the Region’s financial situation during the Saskatoon Regional Health Authority meeting November 25, 2015.

For example, the Region’s Community Paramedicine pilot in Saskatoon has resulted in a reduction of Emergency Department visits by providing care to patients in their long term care or personal care home setting. Expanding direct client funding has meant that more people are able to continue to live at home, instead of being admitted into long term care. Also, a total of 34 patients deemed as needing an alternate level of care have been pulled into less costly and more appropriate settings.

Overall, Saskatoon Health Region has seen a decrease of approximately 900 visits to the emergency department to October 31, 2015. This translates into reduced costs in the long-term, and shows strategies to get people the care they need in the community, where and when they need it, instead of having them seek service at the emergency department, are also working.

“We are doing all the right things and are on the right track. Our aim is to improve every day, and work together to support each other in providing exceptional and safe care to our patients, clients and residents and their families,” says Florizone.

However, the improvements that have been made are not resulting in financial gains quickly enough to stop the bleeding. The Region is running a gap between revenue and expenses of about 4.5 per cent or $4 million per month, which is projected to result in a $45 million deficit by year’s end, if nothing is done to check it.

“We take our responsibility to provide quality care within our funding seriously,” said Florizone. “We know it’s not sustainable nor acceptable to spend more than the funding allocated to us, and we’re working to eliminate our monthly gap between revenue and expenses by the end of the fiscal year.”

The Region is now in an intensive budget planning process and there will be some tough decisions ahead.

“We are leaving no stone unturned,” said Florizone. “What’s not changing is that we must continue our journey to become the best place for care, the best place to work, and the most innovative place in creating optimal health for the people of Saskatchewan.”