Dennis VonderfechtPresident and CEO
Johnson City (Tenn.) Mountain States Health Alliance
On capital constraints: We aren't cutting back but we have had to delay some of our purchases of some of the higher-end technology, and it's mainly because of capital constraints. We have had a number of replacement hospitals we have built over the past four years and so a lot of our capital budget has gone toward that.
On delays and reassessments: We have done a lot of analyses on robotics and the return on investment, and it's kind of a mixed bag. We have the da Vinci robot here—the first in the region. We had a good return on it, but there are other areas of robotics where the big question mark is the financial return on the investment. The fact that we have had to delay some of these purchases does give us a little bit more time to see what some other organizations are experiencing, maybe not being on the leading edge but being timely.
On investment in a time of uncertainty: I don't want to say the uncertainty is giving us pause, but it is one of those factors that we are taking into account a little more. Even though this equipment might be nice to have, if we have to, we can wait another year to see how it goes as far as the reimbursement picture on some of them. But we have a capital plan here that we stick to and it has served us well over the years and there is no reason to think that it won't in the future.