COREROTARY  PRESENTATION

Michael Curtin

 

Eroding Community Access to Quality Health Care

THE CASE AGAINST “BOUTIQUE” HOSPITALS

 

DRAFT:  November 3, 2002

 

Introductory Comments

 

Thank you, Ann.

And thank you, members of the Rotary Club of Columbus, for this opportunity  for that generous introduction … and thank you for the opportunity to share with you some thoughts about how our health care landscape is changing … and about what these changes mean today for both the consumers and providers of health care services.speak with you  on an issue that is vitally important to our community’s quality of life.

 

I am the board chairman of Mt. Carmel Health System. I am a strong advocate  for our full-service, nonprofit community hospitals hospitals that have serve this area, our state and most of the nation very well for over a century.  And I have no need to balance hats here because The Dispatch and the Wolfe family – for many decades – have been strong advocates along with many of the institutions and families represented in this room in building this excellent system we enjoy.

 

In central Ohio, these hospitals include on behalf of all of our local non-profit full-service community hospitals – Children’s Hospital; Mount Carmel East, West and St. Ann’s; the local OhioHealth hospitals – Doctors Hospital, Grant Medical Center and Riverside Methodist Hospitals; and The Ohio State University Health System OSU Medical Center, OSU East, and The Arthur G. James Cancer Hospital & Richard J. Solove Research Institute.

 

 I am here to sound the alarm before it’s too late about an emerging trend in health care that threatens  great  and lasting harm -- by has the potential to erodinge our  the community’s access to the full range of healthcare services we need.

 

[I’D PREFER TO GET RIGHT TO THE POINT OF THE ISSUE]At the dawn of the 21st century … many of the most deadly diseases of 100 years ago are being routinely cured … or at least managed. In contrast to the norm in 1902 … cancer, kidney disease, cirrhosis, pneumonia, cholera tuberculosis, the flu and even heart disease are no longer relentless killers.  And the hospital is no longer a place where people go to die.

 

There are many explanations for these changes.  In part, they reflect our success in dramatically cutting the number of vaccine preventable diseases.  They point to the fact that our drugs today are smarter … our surgical tools are more powerful … and our diagnostic tests are amazingly precise.

 

To be sure … we are winning over sickness.  But we also are discovering that it is far more important … and possible … to avoid sickness and disease. 

 

These changes are reshaping healthcare … the things we do and the results we try to achieve. 

 

But they are NOT the only important changes that are transforming health care today … because those changes extend to the organizations through which health care services are being provided.

 

One of the most important changes in the delivery of health care services is reflected inI’m referring to the emergence of for-profit, limited-service hospitals  in which  specialty doctors have an ownership interest – often referred to as “specialty” or “boutique” hospitals.  Approximately 30 orthopedic surgeons have begun construction on are building an orthopedic boutique hospital in New Albany and there are reportedly other boutique hospitals such facilities being planned or discussed in our area.

 

Most often, the rationale given for these so-called “boutique hospitals is found in the competitive forces of a free market … with claims of[I DON’T THINK WE SHOULD BRING UP THE FREE MARKET ISSUE UNLESS WE’RE WILLING TO ADDRESS IT IN DETAIL…JUST BE PREPARED FOR SUCH QUESTIONS IN THE Q&A SESSION AFTERWARD] that they will provide better services and higher quality care. 

 

But Tthe evidence suggests that most of these claims are bogus exaggerated if not untrue altogether They are smokescreens for investors’ belief that , in a new and unregulated environment for hospital facilities, they have health care offers tremendous opportunities to create wealth for creating wealth themselves by referring the best-insured, best-paying patients to hospitals they own, steering those patients away from our nonprofit, community hospitals.for a few at the expense of patients.

 

And mMost of these claims ignore the fact that for-profit hospitals can erode community access to quality health care … particularly for “unprofitableThey would leave for the nonprofit, community hospitals the care of the sick . . . the poor . . .the under-insured. . . the uninsured . . . .those people with limited ability to pay for needed health-care services.

” populations such as the sick … the poor … the under-insured … and people with limited ability to pay for needed health care services .

 

This is the issue we are here to consider today.  And I want to begin my remarks with a brief story.

 

It is told that when There’s a story about the the great late JJustice Oliver Wendell Holmes, as he was  was approaching his 90th birthday. He was on , he was on a train one day and couldn’t find his ticket.  The conductor recognized the distinguished jurist and told him not to worry … and if he found his ticket later, he could mail it to the railroad.

 

“You don’t understand,” the worried Justice said.  “The problem isn’t where my ticket is. The problem is where am I going?”

 

Justice Holmes’ question is the one I want to pose today … and it’s the question all of us need to educate ourselves on, and finally answer.

 

Our primary concern todayThe centralurgent questions for our community are is not … w”What are for-profit, limited-serviceboutique hospitals?” … and wWhy are they emerging in Central Ohio?”


Rather, the most important questions isarewWhere are will these so-called “boutique” hospitals takeing us?” … and dDo we want our community to go in that direction?”…and, if we do,  “What will the ultimate impact be on our community?”

 

I believe that the answer is clear … At the conclusion of my remarks, I bhope elieve thathat you’ll agree that this issue is worth more of your time and study. I hope you will agree that it’s an issue that is too important not to investigate further.

 

If you do, I am confident that a great majority of you will come to conclude that is NOT the road that we want to travel the boutique hospital road is one we don’t want to follow.  That  instead of improving health care, and tThat boutique hospitals offer few if any benefits for our community.…And that boutique hospitals they will do lasting damage to our community’s access to the full range of needed – instead of improving healthcare -- may actually hinder our community’s access to needed healthcare services.

services.

 

Let me tell you why.

 

What’s the Issue?

 

For more than 50 years many decades, , Ggreater Columbus has been served well by a system of non-profitnot-for-profit hospitals – hospitals with a charitable, community mission – providing that offers a single high-quality standard of affordable care for ALL citizens … regardless of their ability to pay.

 

In this respect, Columbus stands  as a model  . . . being one of the largest communites in the nation that provides this alone as the largest community in the nation that provides this kind of high-quality care – a single, high-quality standard of affordable care for all citizens – without local tax support.  Without a hospital levy. This is a record we should be very proud of.

 

This is This is not an insignificant achievement. 

 

It stands in sharp contrast, for example, to the situation in Cincinnati, where local tax levies generate $30 million a year for care that is provided in “charity” hospitals that serve medically indigent patients. In Cleveland, local tax levies generate $26 million a year.  In Dayton, the number is $4 million a year for charity care.  And the This story is repeated in scores of many communities across the nation.

 

But not in Columbus … largely because our community hospitals are sharing the responsibility for charity care. Last year, Children’s Hospital, Mount Carmel, OhioHealth and The Ohio State University Health System provided more than $21600 million in uncompensated care for the community.

 

This is why the decision of about 30 orthopedic surgeons to construct a 30-bed, for-profit orthopedic hospital in New Albany has generated so much attention.  It is why the actions of these physicians … who will own a 60 percent interest in this so-called “boutique” hospital … have raised so many concerns … and produced so much opposition.

 

The New Albany hospital project has been given a lot of labels … everything from a “knife fight” to a 21st century battle between David and Goliath.

 

I prefer to call it something else. 

 

Non-profitNot-for-profit full-service hospitals take the long view in planning for, and preparing to meet, the community’s healthcare needs -- not only for today but well into the future.  Our community hospitals ask themselves, “How will what we do today affect what we do in the future – 5 years from now…10 years from now…20 years from now…And beyond?”  The oldest hospitals in the Columbus area have been serving the community for more than 100 years, and we have the fine healthcare system we have today because their forefathers our predecessors asked these kinds of questions in their day.

 

Our system of full-service, nonprofit, community hospitals did not develop by accident.  This system was the result of much hard work, much deliberation, much consensus-building, much philanthropy, voted bond issues by your parents and grandparents, and careful public policymaking in the General Assembly.

 

Many members of this Rotary Club were instrumental in building the system we enjoy today. This community collaborative included civic leaders named Huntington, Lazarus, McCoy, Ready, Sayre, Vorys and Wolfe.

 

The result of their efforts was a system of community hospitals – first-rate community hospitals. Community, in every sense of the word. Hospitals founded with a charitable, nonprofit mission.

 

It is the tip of an iceberg … the surfacing ofBut for-profit boutique hospitals represent a new kind of hospital … one that is investor-driven … defined by doing what’s necessary to meet the next quarter’s profitability targets.

 

The Center for Studying Health System Change recently stated this about the physician ventures popping up all over the country: “This is really about docs not being happy with their income, and the fact that they’re feeling squeezed.’’

trapped by “next quarter-it is” … and focused on “making our numbersa certain level profit” this quarter and every quarter by doing whatever it takes.

 

This new for-profit hospital rejects the view of our traditional non-profit community hospital system, which makes community health and customer service Priority Number 1 … even for “unprofitable” populations, including those who are sick and in need … even though they may not have the ability to pay for quality care.

 

To be sure, New Albany is a single hospital.  Yet, there are reports that additional for-profit, boutique hospitals are either in development or in the planning stages … here in Central Ohio. 

 

This is NOT an isolated situation … and Columbus is NOT alone in facing it.  Besides Ohio, boutique hospitals are emerging Boutique hospitals are emerging in increasing numbers in such many states -- as Arkansas, California, Florida, Idaho, Louisiana, Indiana, Kansas, North Dakota, Oklahoma, Wisconsin, to name a few.

 

In just the last two years, approximately 120 speciality hospitals were built in the U.S., at a combined cost of $7 billion. The number of physician-owned specialty hospitals is expected to double in the next 2 to 5 years.

 

 and elsewhere.…And those communities are grappling with this issue just as we are.On March 20, the chairman of the U.S. House Ways and Means Committee, Bill Thomas, a Republican from California, said that boutique hospitals should be called cash-cow hospitals because they focus only on medical services designed to maximize their profits. The goal of the owners of boutique hospitals is to strip away the few profit margins that currently exist in community hospitals. Like strip-mining. And when you strip-mine hospitals, you will change the health-care landscape forever.

 

 


So the question is … what can be done to preserve the special balance that our community has achieved?  What can we do to ensure that for-profit hospitals don’t come in and divert millions of dollars in revenues from our community hospitals?

 

 

Why Are Boutique Hospitals a Bad Idea for Central Ohio?

 

First, we We should not allow Ohio to be taken in this direction. need understand why for-profit, limited-service hospitals are taking us in a direction that our community should not allow itself to go.  I believe there are THREE REASONS.

 

REASON ONE.  Certainly we shouldn’t without a full debate, full consideration, a full exploration of where this ride would take us.

 

Boutique hospitals can will undermine this a community’s access to high-quality, affordable health, which is essential to the well-being of all of our citizens and the community as a whole.

 

How?  It’s fairly simple.

 

 

For-profit, limited-service hospitals begin by “cherry-picking” the most profitable patients, leaving community hospitals with those patients who need the most complicated and costly care.

 

It is no wonder why the majority of boutique hospitals specialize in cardiac care and orthopedics. Those two specialities typically account for about 30 to 40 percent of hospital revenues.

 

Cardiac care is a $150 billion a year revenue stream in this country. Orthopedics is a $100 billion a year revenue stream. Some specialty doctors increasingly want to divert those streams from our nonprofit, community hospitals to themselves.

 

But those are the very revenue streams that support a comprehensive, full-service hospital in which most services barely support themselves or don’t support themselves at all. It is those few profitable streams that enable, full-service, nonprofit community hospitals to operate emergency rooms, trauma units, burn units, poison centers, community outreach, programs, charity care and the like.

 

 

TThese new hospitals don’t offer these services.  They may pay lip service to them, but  with them it’s really only about the bottom line.

 

If the specialty docs are successful with their boutique hospitals, our current model for providing these important community services simply cannot stand.

many of the services that are available at non-profitnot-for-profit, full-service community hospitals. Typically, they don’t have emergency rooms, burn units and poison centers – and they don’t provide the level of charity care for the poor and underserved populations that our non-profit full-service community hospitals do.

 


What this means is that for-profit, limited serviceboutique hospitals siphon off millions of dollars from full-service community hospitals by concentrating on the most profitable services. And that leaves the full-service community hospitals without the dollars they now use to help pay for such things as poison centers, free health screenings for children and pregnant women, trauma care, child abuse prevention programs and charity care for the poor.

 

This also means that these unprofitable, yet essential, services will be jeopardized. The job security of health professionals employed at many of Central Ohio’s non-profit hospitals will be threatened. And boutique hospitals will drain talented specialists from our community hospitals … making referrals difficult for other physicians … and jeopardizing many citizens’ access to high-quality care. 

 

It’s at this point that the Ssupporters of boutique hospitals – including the New Albany facility – like to argue that community hospitals are exaggerating the threat.  We typically hear from these doctors and their investor friends that this is nothing more than a battle between David and Goliath, and that they are in the underdog role.  And these folks quickly grab the mantle of David … and announce their willingness to defend themselves with a measly slingshot.

 

You don’t need to fear for the friends of for-profit hospitals … and don’t need to buy into the supposed benefits of boutique providers.

 

A quick look at the experiences of other communities provides clear evidence that this is not a fight between David and Goliath.  Far from it!

 

Take Indianapolis, just next door, for example.

 

.

 

As a result of the opening of four for-profit heart hospitals, several non-profitnot-for-profit, community hospitals are in financial crisis. teetering today on the edge of serious financial crisis. Clarian Health Partners, which includes Methodist, Indiana University and Riley hospitals, had a 52% drop in revenue in 2001. St. Francis Hospital and Health Centers saw its net income fall 26%.


A bit further to the west, in Wichita, Kansas, the proliferation of cardiac and other for-profit, boutique hospitals chopped into Via Christi Regional Medical Center’s revenues – reducing its net operating income by 60% in 2001.

 

Via Christi in the city’s seventh largest employer, so we are not talking about a minor inconvenience.  Instead, we are talking about a major impact on the community’s physical and financial health.

 

In Idaho, the non-profitnot-for-profit Logan Regional Medical Center saw its revenues decrease by 10 percent immediately after the Cache Valley boutique hospital opened in 2000.

 

And In in Louisiana,  four in ten  today, 38 percent of the state’s non-profitnot-for-profit community hospitals now are losing money to for-profit boutique hospitals.  For example In Rushton, Louisiana, a , in Ruston … a town where a group of 35 physicians have announced plans to construct a for-profit surgical hospital … representatives at the town's only community hospital, Lincoln General, say they expect to lose $1.6 million in surgical and imaging revenue this year – that ‘s $300,000 more than the hospital’s entire profit margin of . The hospital ended last year with a $1.3 million.

 margin

 

These are not isolated situations.  Similar examples can be found in Texas, Arizona, North Dakota, Oklahoma, Wisconsin, Utah and elsewhere.

 across the country.

 

 

In fact, the Health Care Advisory Board … a research organization serving health executives of more than 2,000 leading health systems and medical centers … has estimated that 35% to 45% of hospital revenues could be are jeopardized by for-profit, limited-service hospitals. 

 

Revenue loss of this scale . . And this kind of revenue loss … rresulting from the cherry-picking of the most profitable and lowest-risk patients by boutique hospitals and the doctors who own them … jeopardizes the ability of community hospitals to offer the full scope of health care services that their communities need. 


 

We cannot allow this to happen, for three fundamental reasons.