Health Board explores outsourcing radiology and outpatient services for cost savings

In a pivotal budget hearing held on May 5, 2025, the Guam Legislature delved into the intricacies of the Fiscal Year 2026 budget, focusing on innovative strategies to enhance financial efficiency within the Guam Memorial Hospital (GMH). The atmosphere was charged with urgency as officials explored various cost-saving measures aimed at addressing the hospital's ongoing financial challenges.

One of the key discussions centered around the hospital's radiology services. Currently, GMH pays radiologists on an hourly basis, regardless of whether they are actively reading diagnostic images. This model has led to inefficiencies, as radiologists may be on standby without any readings to perform. Hospital officials proposed a shift to a "per read" payment structure, which could significantly reduce costs by ensuring that payments are only made when services are rendered. This change echoes past practices where radiologists, such as those from Nighthawks, were compensated based on the actual number of readings completed.

The conversation then shifted to outpatient services, particularly in cardiology, gastroenterology, and pulmonary care. GMH is considering outsourcing these services to alleviate financial strain. By renting out clinic space to specialists, the hospital could generate revenue while allowing doctors to manage their own professional fees. This approach aims to optimize the use of hospital resources and improve cash flow, especially given the high costs associated with medical supplies in these fields.

Compensation adjustments were also on the table, particularly regarding on-call pay for staff. Currently set at $9.25 per hour, there is a proposal to reduce this rate to $5, aligning it with standards seen in other hospitals. This change could potentially halve the annual expenditure on on-call pay, which currently stands at approximately $300,000. Such adjustments are seen as necessary steps to ensure the hospital's financial sustainability.

Another significant topic was the upcoming opening of a new assisted living facility in Mooning, which is expected to relieve some of the bed space at GMH. While the facility is being retrofitted and prepared for operation, it was clarified that GMH would not be financially responsible for its funding or services. Instead, the Department of Public Health will oversee the facility, which is anticipated to help manage the overflow of patients, particularly those with social cases who often occupy hospital beds for extended periods.

As the hearing concluded, it was evident that the discussions held were not just about numbers but about the broader implications for healthcare delivery in Guam. The proposed changes aim to create a more efficient system that can better serve the community while navigating the financial realities faced by GMH. The decisions made in the coming months will be crucial in shaping the future of healthcare services on the island.