An influx of millions of patients into the health care system under health reform will necessitate a fundamental shift in how medical care is delivered in the U.S. toward greater collaboration among providers and new payment methods, a local hospital executive said Monday.
“For the medical community it’s a real challenge because (reform) is not built with increased (payment) fees or an expansion of physician manpower, so 32 million more Americans … have to seek their care,” Erlanger CEO Jim Brexler said at the hospital’s monthly budget committee meeting. “The traditional model of a medical practice probably cannot accommodate that.”
Mr. Brexler discussed the U.S. House’s approval Sunday of the Senate’s version of health care reform with committee members, noting after the meeting that the delivery system will probably have to start incorporating more collaboration between providers caring for a patient, including coordination between hospitals and physician practices. He pointed out a provision in the still-pending reconciliation bill that would guarantee Tennessee almost $100 million in disproportionate share payments for the upcoming years. The funds benefit hospitals like Erlanger that treat a disproportionate share of poor and uninsured patients.
Year-to-date the hospital has provided $53 million in uncompensated care, according to monthly financial records.
In February Erlanger had a net income of about $81,000, and year-to-date the hospital has lost $2.6 million, compared to a loss of $2.7 million last year, said Chief Financial Officer Britt Tabor in his financial presentation to the committee.
He noted that last year’s budget figures included about $3.4 million in disproportionate share payments and trauma fund payments, which the hospital expects to receive again this year.
Admissions were considerably lower than budgeted at T.C. Thompson Children’s Hospital, in part because of the low incidence of respiratory illness like influenza, officials said.
Also at the meeting:
* Committee members gave preliminary approval to the purchase of new defibrillators as part of a scheduled upgrade at a cost of $200,450.
* The committee also gave its approval to the emergency purchase of nine new fetal heart monitors that have been recalled by the manufacturer, at a cost of $162,225.
ERLANGER FINANCIAL REPORT
* February net income: $81,000
* Year-to-date: Loss of $2.6 million
* Highlight: Orthopedic inpatient surgeries 29.4 percent over budget
* Concern: Emergency room visits 11 percent under budget
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