hospitalThe Governor Juan F. Luis Hospital on St. Croix, U.S. Virgin Islands has been hoping to secure a vendor agreement that would help the medical center sort out its revenue cycle. However, due to inadequate paperwork and a lack of quorum at the Territorial Hospital Board meeting on April 4, the Board found itself no closer to coming to an agreement.

The meeting was scheduled as a follow-up to the Board’s regularly scheduled Wednesday meeting, and was planned to ease Board members’ concerns about the hospital’s upcoming “revenue cycle optimization project.” Once initiated, the project will involve hiring an outside company called Advisory Board to improve the hospital’s revenue stream, in addition to teaching hospital staff about the best practices used to generate and improve revenue.

The initial contract with Advisory Board would be $250,000 for the first four months, with a bill totaling $1.27 million for the year. While the estimated savings resulting from Advisory Board’s services hover around $6 million (or $62,000 in monthly invoices), some Board members have expressed doubts about the project, saying that the hospital may be setting itself up to overpay for the service. As evidence of this, they point out that the Schneider Regional Medical Center on St. Thomas is currently receiving a similar service from Advisory Board, but is paying only $300,000 for eight months.

Due to the Board’s lack of quorum, it was unable to make any official decisions on the contract. However, the meeting did end with Chief Executive Officer Kendall Griffith being directed to contact Advisory Board to inquire about the possibility of pursuing a shorter four-month contract, with the option to extend to a one-year contract if the initial outcomes are positive.

Concerns have also been expressed regarding Advisory Board’s nonexistent contract draft, according to Board Chairwoman Lynn Millin-Maduro. Although the company has sent over two versions of its proposal, the document is said to contain no specific provisions or guarantees that might help Board members make an informed decision. If the Board does vote to approve the terms of the agreement, past practice would also require the contract to be reviewed by Board Counsel and the Chair before it could be signed, significantly slowing down the approval process.

In response, hospital officials have reassured the Territorial Hospital Board that while it understands the need to follow strict procedures, they are also feeling the pressure of overwhelming financial concerns that they strongly believe would be alleviated with Advisory Board’s help.

This story highlights the complexities that can come with working with government agencies, especially those that have an appointed Board. Many in the private sector become frustrated with the slow progress associated with many of these types of transactions, but the key is to remain patient and allow the Board to conduct its due diligence.

BoltNagi is a well-established and widely respected government relations law firm serving businesses and organizations throughout the U.S. Virgin Islands.