The latest news from Natividad Medical Center seems to be cause for celebration — actual strike-up-the-band and shoot-off-some-fireworks celebration. But the consultants running the county-owned hospital didn't get the grateful reaction they were hoping for when they announced they have almost stopped the flow of red ink.

In recent years, the county's responsibility to provide medical care for its neediest residents has cost county taxpayers on the order of $20 million annually. By quickly coming close to eliminating that expense this year, Huron Consulting Inc. makes a strong case that it deserves its eyebrow-raising fees. The consultants seem to have done the impossible. For now, though, the response remains cautious and reserved. There are several reasons.

We've heard it before, from previous consultants or other new teams of administrators, about how Natividad's books could be balanced if only it could fix chronic problems with billing/expenses/reimbursement rates, etc., etc.

Second, as Huron officials freely admit, it's not likely they'll be able to increase revenues as dramatically in future years. As one county official put it, Huron has "picked some low-hanging fruit."

Much of the turnaround is the result of Huron's ability to find additional funding from other levels of government, sources that previous administrations either didn't know about or couldn't tap because they were so busy just keeping the hospital afloat.

Another large chunk of new money resulted from some simple revisions to one of Natividad's most stubborn deficiencies: outdated and sloppy billing procedures. Simply by ensuring that incoming patients were accurately identified for billing and reimbursement reasons, Huron improved the bottom line by several million dollars. The potential for more improvement in that area appears substantial.

To continue the momentum, Huron will need to find more costs to cut, a difficult assignment. With Natividad operating in crisis mode for several years, county officials have already closed clinics and deferred capital expenditures and maintenance expenses. To make the hospital budget leaner will require more than simple belt-tightening. It will require sophisticated measures to improve efficiency, productivity and accountability.

The challenge now will be for county officials to learn from these visiting experts. The county and other stakeholders need to use this respite from crisis management to regroup and work with the consultants to create a solid strategic plan. It would be a short-sighted mistake for officialdom to divert its attention elsewhere just because the worst seems to be over. Inattention was a leading cause of many of the hospital's ailments.

Just three years ago, amid a leadership vacuum and a failed tax measure, Natividad looked to be in the last stages of terminal bureaucratitis. Today, for the first time in this century, the vital signs are improving at this critically important institution, and there is reason to believe it may someday walk on its own.