Vidant Health: An economic engine. David C. Herman, MD March 18, 2014

Transcription

1 Vidant Health: An economic engine David C. Herman, MD March 18, 2014

2 Our system of care 12,000+ employees 9 hospitals 69 physician practices Outpatient, home health and hospice services Critical care transport Serving 1.4 million people in 29 counties, 1/3 of NC 2

3 Our mission is to enhance the quality of life for the people and communities we serve, touch and support.

4 Service area 4

5 Fast Fact There are 184 admissions per day across Vidant Health 5

6 Fast Fact Top 1% Vidant Medical Center is in the top 1% in the country for admissions, more than any other hospital in NC 6

7 Fast Fact Vidant Medical Center is 3 rd in the US for hospital-to-hospital transfers 7

8 Fast Fact Vidant Medical Center has the only Level 1 Trauma Center east of I-95 from Norfolk to Charleston 8

9 Fast Fact Vidant Health includes an academic medical center for 300 medical students, 350 medical residents, and 1,100 nursing students from East Carolina University s Brody School of Medicine and College of Nursing 9

10 Fast Fact Vidant Medical Center is much more than a community hospital 50-bed NICU 120 ICU beds Heart Hospital Transplant Services 10

11 Fast Fact Our Emergency Departments see 748 patients each day 11

12 Fast Fact We treat 110 ICU patients each day 12

13 Fast Fact We perform 128 surgeries every day 13

14 Fast Fact Vidant Medical Transport helicopters transport 7 critically patients a day... That s 233 air nautical miles and 460 gallons of fuel each day 14

15 Fast Fact 16 babies are born across Vidant Health each day 15

16 Fast Fact Vidant Health $1.6 billion Operating Revenue 16

17 Healthcare expense $2.5 trillion in 2009 $8,100 per person 17.6% of GDP in % growth in expense Largest area of cost growth is not in utilization, but in unit cost of treatment delivered 17

18 Healthcare expense $8,100 $8,100 $8,100 $8,100 $8,100 $8,100 Who spends the money? 5% of population accounts for 50% of expenditures Concentrated in those over 55 and those with chronic disease 50% of population accounts for 3% of expenditures 18

19 Did you know annually, Vidant Health spends... Group health $82,000,000 Physician fees $49,000,000 Isolation gowns $1,000,000 19

20 Did you know annually, Vidant Health spends... Salaries $683,571,000 Benefits $189,577,000 Linen service and replacement $5,000,000 Service agreement on DaVinci robot $189,000 20

21 Did you know monthly, Vidant Health spends... Implants Utilities and telephone Blood Raw food $6,000,000 $2,000,000 $1,500,000 $750,000 21

22 Did you know daily, Vidant Health spends... Total operating expenses Salary and benefits Postage $4,500,000 $2,500,000 $4,500 22

23 Did you know the cost of.. Heart valves $5,000 - $12,500 Factor 7 (per avg. dose) $10,620 Cost of knee replacement implant $5,000 23

24 Did you know the cost of.. Vidant Medical Group (FY2014 budget) $160,000,000 FY2014 impact of ICD-10 implementation $9,600,000 Disposable instrument for DaVinci robot $12,000 Surgical screw (orthopedic) $300 - $1,000 24

25 Employee growth trend As of January 1 for each year 25

26 How do we compare? 26

27 Annual economic impact Vidant Health contributed $2.44 billion to the gross regional product of eastern NC $2.69 billion to NC gross state product $4.04 billion to the nation s gross domestic product (2010 data) 27

28 Annual economic impact For every full time employee at Vidant Health, an additional.86 jobs are created in the region For every dollar of labor at Vidant Health, an additional $.41 of labor income is created in the region (2010 data) 28

29 Who are our patients?

30 Who are our patients? Eastern NC is home to roughly 1.4 million people spread throughout 29 counties that represent a geographic area roughly the size of Maryland. 30

31 Who are our patients? Compared to other areas of the state, eastern NC as a whole: Largely consists of rural communities with a few mid-sized urban markets Has a higher concentration of people over the age of 65 (15.4% ENC vs. 14.3% NC) Has a significantly higher percent of the population without a high school diploma (18.3% vs. 16.0%) 31

32 Who are our patients? Has a higher percent of children and adults living at or below the poverty level (32.7% vs. 26.8%) Has a higher percentage of uninsured people Experiences significant access issues to primary care and specialists. Has average household incomes significantly below the state average ($49,932 vs. $58,413) Has a higher concentration of minorities (41.5% vs. 33.7%) 32

33 What are our challenges?

34 Challenges: Fulfilling our mission Last year, we provided more than $152 million in unreimbursed care (including charity care, bad debt and Medicare). 34

35 Challenges: Fulfilling our mission More than 70% of patients treated at Vidant Health hospitals and clinics are paid for by government programs with rates set below the cost of caring. 35

36 Challenges: Fulfilling our mission At Vidant Medical Center, only 34% of our work provides a positive margin, and that margin is used to cover the losses of other critical services such as trauma, graduate medical education and children s. 36

37 Challenges: Fulfilling our mission 10% can t afford healthcare at all 37

38 Challenges: Impacts of ACA Cumulative impact of ACA cuts, over the next 10 years, exceeds $580 million for Vidant Health. Other Vidant Health Entities $117.6 million Vidant Medical Center $465.3 million 38

39 Questions?