A run for your money

Hospitals propose different funding, governance methods

By Emily Wolfe Explore Big Sky Managing Editor

GALLATIN COUNTY – Money and governance. Those are the two significant differences between the proposals Bozeman Deaconess Health Services and Billings Clinic have for Big Sky, according to independent health care consultant Howard Gershon.

Funded by $20,000 in resort tax dollars and hired by the self-appointed Big Sky and West Yellowstone Health Care Directions Committee, Gershon has reviewed the feasibility studies conducted by the hospitals this year, both of which propose building a hospital in Big Sky.

Otherwise, Gershon said, the hospitals have comparable patient ratings, financial capability and patient services, and are both on par with national levels.

Funding and governance

Bozeman Deaconess has proposed a $21 million facility, and has promised to secure and guarantee all initial funding. Its feasibility study, Gershon reported, stated that the facility would be a local nonprofit 501(c)3 owned and managed by BDHS, but with a local board of directors responsible for reviewing quality, service and performance.

Under BDHS, future funding could come from Big Sky Resort Tax, and also from a foundation formed in partnership with the Bozeman Deaconess Foundation.

Billings Clinic has proposed a $22 million facility, with $5 million in funding coming from within, $5 million from fundraising in Big Sky, and another $12 million from USDA or HUD grants. The facility would be a local nonprofit 501c3 managed by Billings Clinic. A 9-to-13-person local board of directors would govern the facility, with two of its positions appointed by Billings Clinic.

With Billings, Big Sky would be required to provide $300,000 annually to cover operations for the first three years, and West would provide $100,000. A local foundation would be established to help with future fundraising.

Health services

Both hospitals proposed building a hospital facility and then applying for critical access licensure, which receives federal funding. However, the services they’ve proposed to offer differ to a degree.

Bozeman has proposed a 35,000-square-foot primary care clinic with a patient-controlled medical home containing five inpatient beds, expandable to 10, with 24-7 emergency services, a helicopter pad, and space available for lease to other local providers.

Billings has proposed primary care physician clinics in Big Sky and West Yellowstone. The 30,000-square-foot facility in Big Sky would have four beds, expandable to eight, and 24-7 emergency and triage services and helipads in both towns.

Bozeman would expand the pharmacy it’s had in Big Sky since 2003, while Billings would use a telepharmacy, in which a technician prepares prescriptions by communicating with a pharmacist and patient through audio and video computer links. Billings would have an MRI available at all times, Bozeman’s would be a mobile unit.

Both would have CT scanning, laboratory and ultrasound capabilities under their proposed plans.

In the case of Billings Clinic, the Big Sky community would ostensibly have more local governance in terms of decision making and staffing, something local physician Dr. Jesse Coil, also a Health Care Directions Committee member, says has two sides.

“You’d have more say on how things are run,” Coil said. “But how much energy and time is going to take for a local board to run this facility?”

Population, timeline

Going forward