FLORENCE — Economic growth and “Obamacare” may increase the demand for hospital services in the Shoals, an official with RegionalCare Hospital Partners testified Thursday.

Testimony during the fourth day of the contested case hearing for two proposed health-care facilities for Florence proceeded slowly, as financial data and hospital occupancy were examined.

Mike Browder, chief financial officer for RegionalCare, testified for approximately four hours about data and projections contained in the certificate of need applications filed by RegionalCare to build a 300-bed replacement hospital and a cancer treatment center.

The contested hearing is part of the Alabama Health Planning and Development Agency’s hospital certificate of need review process.

Under particular scrutiny were projected admissions and projected patient days for the proposed replacement hospital.

The certificate of need shows an increase from 10,978 admissions in 2011 to a projected 18,501 admissions in the second year of the proposed new facility.

It also shows an increase from 52,100 patient days in 2011 to a projected 79,556 patient days in the second year of operation for the proposed facility.

Browder, who was not employed by RegionalCare when the certificate of need applications were submitted, said those numbers were “conservative.” In fact he said approximately 7,000 additional patient days could have been projected.

Dennis Nabors, an attorney representing Helen Keller Hospital in the hearing, questioned that assertion, noting his belief that health care is trending toward more outpatient procedures and shorter lengths of stay.

Browder agreed increased outpatient service has been a trend, but said other factors will cause the projected increase.

He said there is an expected increase in admissions because the facility is new and because there will be increased access to health insurance under the federal Affordable Care Act. Browder also said that during the national recession, some patients delayed seeking health care but, as the economy improves, those people will seek treatment.

“I will tell you as a hospital operator the last three years have been the toughest three years in our careers in terms of impact on volumes,” Browder said. “We believe they are suppressed. Our hope frankly as operators is that as the economy improves ... that there is a big backlog (of) people that have been self-selecting to not receive non-urgent care”

An economic impact study conducted by Keith Malone, a professor of economics at the University of North Alabama, showed a more than $1 billion economic impact during a five-year period, assuming a new 300-bed hospital is built.

Malone was provided scenario data by RegionalCare that was used in the economic impact study.

It has been the contention of Helen Keller and its attorneys that they only opposed the proposed size of the hospital. In fact, during Thursday’s portion of the hearing, Nabors said, “we are willing to let them build a hospital today for 215 beds.”

Will Somerville, an attorney for Helen Keller Hospital, asked how the economic impact would change if RegionalCare were to build a smaller hospital now and add additional rooms later.

Malone said the impact would change as the factors surrounding the project changed.

Malone said the study did not take into account the impact relocating the hospital would have on the businesses and services near the existing hospital campus. Those services include Bethesda Regional Cancer Treatment Center, whose parent company, Alliance Oncology, has opposed the cancer treatment portion of the project.

Daniel McBrayer, an attorney representing Alliance, asked if Malone thought the move might negatively impact providers near ECM.

Malone said that could be a short-term impact of the move.

Jennifer Edwards can be reached at 256-740-5754 or jennifer.edwards@Times Daily.com.

“The last three years have been the toughest volume period in my experience in the business since I left public accounting in (1991). It was just a given frankly that in the mid ‘90s you’d see 3-, 4-, 5-, 6-percent growth depending on the market ...

The last three years, we believe as a company, primarily due to the economy, that patients are self selecting in droves to save their health-care dollars.”

Mike Browder, chief financial officer at RegionalCare Hospital Partners, concerning the health care climate

Thursday’s witnesses

Today’s planned witnesses