Cutting costs at the most minute level and finding creative ways to build business will be Natchez Regional Medical Center’s keys to survival in the era of reimbursement cuts and managed care, as new chief executive officer Jack Houghton sees it.

He admits that, with little more than two weeks on the job, he still has much to learn, including finding out what measures interim CEO Karen Fiducia has already taken to make ends meet.

But with more than 25 years of hospital management experience behind him — most recently at Bossier Medical Center in Bossier City, La. — he knows there are some things all hospitals have in common.

&uot;All hospitals are struggling due to Medicare and Medicaid reimbursement cuts and lower reimbursement from managed care,&uot; Houghton said. &uot;And with declining revenues, we’re forced to deal with the expense side of the formula.

&uot;We have to manage smarter than we ever managed before.&uot;

Although he is not ruling any cost-cutting option out completely, Houghton said he does not see staffing cuts being made in the foreseeable future. Staffing cuts already made in recent years, he added, should suffice for now.

Instead, he believes the hospital needs to take a closer look at other expenses, such as the cost of supplies, in ways that will have the least effect on patient care. Being part of a purchasing consortium helps keep those costs down, he said.

He also believes the hospital should take a look at which services it provides are the least cost-effective and should consider paring them down or eliminating them altogether.

While he would not say whether outpatient surgery could face such cuts, Houghton did say that an outpatient surgical center planned for Vidalia &uot;will affect surgery at both hospitals.

&uot;To what extent, we don’t yet know. We may look at services we can no longer provide.&uot;

But Houghton also wants to take a closer look at which medical services people are seeking outside Natchez that could reasonably be provided here. One way to grow the local health care business, he said, is to attract new specialists, although he does not want to reveal details yet.

The bottom line is to make ends meet while still providing the highest quality of health care possible to the people of Adams County and surrounding areas, he added.

&uot;(Natchez Regional) is community-owned, so it has to serve the interests of the community,&uot; Houghton said. &uot;Its stockholders are the citizens of Adams County, so the hospital must be responsive to them.&uot;

But while his comments focused on NRMC, Houghton said there can be room for both hospitals – NRMC and the private Natchez Community Hospital — in Adams County &uot;if both hospitals are well-managed. They’ve both survived so far.&uot;

Houghton has had more than 25 years of management experience at hospitals from south Texas to northeastern Wyoming — not counting the three years he spent in the U.S. Army, managing an Army hospital during the Vietnam War.

One thing that brought him to Natchez from his job as chief executive officer of Bossier Medical Center was the chance to work again with Quorum Health Resources, which manages the county-owned hospital.

He already knew he didn’t want to move to a hospital up north — five 70-below-zero winters in Wyoming convinced him of that.

And upon visiting Natchez, he loved what he calls the &uot;personality&uot; of the community itself.

&uot;It doesn’t hurt that Natchez has so much history to it, either,&uot; said Houghton, a Civil War buff.