Memorial Healthcare System: A Financial Overview
What are the greatest challenges facing Memorial Healthcare System?
We are in an extremely competitive market serving one-third of Broward County. Because we are a Safety Net hospital, we attract a very high percentage of uncompensated indigent care, partially due to transient and undocumented patients. It is very important that we maintain a fiscal environment that enables us to continue to provide them with high quality care and this, of course, is a challenge.
What are some of the ways Memorial has approached the financial challenges of this environment?
It is critical to determine patient coverage or eligibility on every self-pay patient that presents to our facilities. We work diligently to assist patients who may be potentially covered by any number of assistance programs. This is key to minimizing the effects of serving such a large portion of the disadvantaged in our community. We are committed to bringing patients into the mainstream for coverage and prevention.
Speaking of prevention, are there and special programs Memorial has initiated?
Absolutely! We took over primary care from the county. We believe that we would have seen many more uninsured patients in our emergency rooms if we did not operate primary care centers. We have three sites, two mobile vans (one adult and one pediatric), and we also have a presence in some of the area public schools. Access to routine primary care services and preventive care is key for effective healthcare management. Some of the areas on which we have focused are hypertension, diabetes, asthma and obstetrics. For example, a high risk OB patient can see a physician within 24 hours, a low risk patient within three weeks. This is much faster than the national average. But prevention and early examination translate to better care and better care delivered in a more cost-effective manner because of the reduced risk of complications.
We have also started a Disease Management Program for the chronically ill. Critical care can be extremely costly and this program helps to reduce acute stays, and the patients dont tend to “crash” as often if they are managed and monitored. We have found this extremely effective in diabetes, asthma, high blood pressure and Sickle Cell anemia management, for example.
Who “manages” and monitors these patients?
We have implemented a Hospitalist Program comprised of internal medicine physicians. The best thing is that it provides consistency the same physicians seeing the same patients who are able to provide a unique perspective to the “shared commonalities” of the diseases and treat their patients more efficiently and effectively. This program is managed through our hospitals and reflects and addresses the unique socio-economic anatomy of the communities we serve and their healthcare needs.
In addition to prevention and “front end qualification,” what other initiatives have helped Memorials “bottom line”?
More attention to managed care collections, renegotiated contracts with managed care companies and an implementation of “best practices.” Unlike some hospitals, we determined that we needed to increase our investment in human resources in the business office to stay on top of the complexities of collections from the various payers.
Any final thoughts on a “financial forecast” for hospitals?
Health Care goes through cycles of favorable and challenging financial times. It is likely the industry as a whole, will experience some turbulence over the next few years. Declining Medicare and Medicaid reimbursement levels, growth in uncompensated care and demand for capital expenditures are ongoing challenges. Memorial is positioned well to address the challenges of this industry and with some of our in-place initiatives, vision and prudence, Memorial will continue to maintain a strong balance sheet
and meet our mission.
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