Eureka Springs Hospital launches hybrid emergency/urgent-care model; midyear report shows higher volume and lingering revenue-cycle problems

Tiffany, the hospital chief executive officer, told the Eureka Springs Hospital Commission on July 20 that leadership launched a hybrid emergency-department/urgent-care model on July 14 and has seen early operational gains while continuing to work on longstanding revenue-cycle problems.

"This model protects 24/7 emergency access while creating a more affordable pathway for patients whose conditions are clinically appropriate for urgent care after a medical screening examination," Tiffany said, describing the one-door model the hospital has implemented.

Why it matters: Hospital leaders said the service change is one piece of a broader stabilization effort that has produced higher patient volumes and improved throughput but remains constrained by billing and payer challenges that prevent management from fully validating operating forecasts.

Tiffany presented a midyear financial snapshot she described as part of a "working budget," saying the hospital’s revenue performance to date is $5,642,467.65, estimated operating expenses are $3,600,000 and the cash position is $3,514,149.74. She read a figure for gross accounts receivable that is unclear in the transcript; she emphasized that forecasts are still under active reconciliation while the finance team works through historical claims and contract issues.

Doug, the finance lead, told commissioners the finance department is prioritizing revenue-cycle stabilization, charge-master modernization and payer-contract optimization. "We're sitting at about 19 months now" of cash runway, he said, noting that the hospital’s burn rate has improved since earlier in the year after a partial settlement of disputed claims bolstered collections.

Operations update: Tiffany said the hospital has seen a 36.5% year-to-date increase in emergency-department volume (from 971 encounters in the first half of 2025 to 1,325 in the same period of 2026) and a roughly 105% increase in EMS arrivals (from 197 to 404). Transfers rose from 99 to 166, and average ED length of stay improved from 163 minutes last year to 148 minutes this year. Patient-satisfaction sampling for the month showed 49 of 57 respondents gave an overall care rating of 5.

Revenue-cycle actions: Tiffany outlined a recovery plan that includes daily revenue-cycle leadership huddles, denial management, charge-description master work (targeted for mid-August), payer outreach and contract renegotiation. She said the hospital has written four grants, has two additional grant applications near submission and is working with a rural-health researcher to identify funding opportunities beyond clinical grants, including facilities and emergency-management investments.

Staffing and credentialing: Commissioners asked whether credentialing or payer enrollment would be required for the urgent-care pathway. Tiffany said the hospital filed an "855" licensure application in January; the state and CMS approved the added service on the ED side and medical-screen evaluations determine which patients meet the urgent-care pathway. She also said an insurance-denials specialist (named in the discussion as Kate) is scheduled to start next month to help address claim denials.

What commissioners decided: The commission approved routine meeting business, including the minutes, and voted by voice to cancel the August 17 regular meeting because of vacations and planned workshops.

Looking ahead: Hospital leaders said work on charge-master modernization and payer-contract optimization will continue through late summer, and that further validation of 2025 and midyear 2026 financials remains ongoing. The commission adjourned after the regular meeting.