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COBTH BY THE NUMBERS Employees 72,070 >> Indirect Employees 57,656 Total Employment Impact 129,726 Direct Economic Impact $13.48b >> Indirect Economic Impact $17.53b Total Economic Impact Community Benefit Funding Net Charity Care Provided* NIH, CDC, AHRQ, NSF and VA funding $31.02b $177.74m $160.29m $1.24b Licensed beds 5,501 Emergency Department Visits 692,116 Outpatient Visits 6,225,138 Discharges 266,523 Deliveries 23,373 Active Clinical Trials 2,679
TEACHING HOSPITALS AND THE FUTURE OF HEALTH CARE With their culture of innovation, their commitment to new knowledge and discovery, their state-of-the-art technology, and their strong investment in the communities they serve, teaching hospitals are leading change in our health care system. Teaching hospitals are where medical education, research, community service and patient care come together for the benefit of patients and our entire healthcare system. It is the resulting synergy the added value that comes when these missions are united that make teaching hospitals unique. As the nation and Massachusetts explore new ways of delivering and paying for healthcare and providing greater value for each healthcare dollar, the role that teaching hospitals play in our healthcare system has never been more important. With that renewed focus on providing greater value for each healthcare dollar teaching hospitals are uniquely positioned to provide the leadership and innovation needed to transform our healthcare system. New ways to care for patients with chronic illnesses, new models of care that put the patients at the center of their care, and more effective treatments are being developed and tested today that will transform patient care tomorrow. And the next generation of physicians and other healthcare professionals is being trained to work in teams and more closely with the patient to provide the high-quality, high value care to all. Teaching hospitals are also having a profound impact on the local and regional economy. Employing more than 72,000 people, driving more than $13b in direct economic impact and attracting more than $1.2b in federal research funding, Conference of Boston Teaching Hospitals (COBTH) hospitals are a driving force in the innovation economy that makes Massachusetts the envy of other states. 1
Healing Collaborating Empowering
DISCOVERING TOMORROW S CURES Massachusetts continues to rank second in overall National Institutes of Health (NIH) funding per state and first per capita, with the city of Boston leading all American cities in funding. In 2012, Greater Boston s teaching hospitals received more than $1.2b in research funding from federal sources, including NIH, National Science Foundation, and the Veterans Administration. While the federal research funding that COBTH hospitals attract is impressive, the impact on the entire life sciences cluster in Massachusetts is even more impressive. Massachusetts is now home to more than 400 biotechnology and 300 medical device companies with nearly half of the top 50 biopharmaceutical companies by revenue having a presence here. Massachusetts headquartered companies currently account for 11% of the U.S. drug development pipeline and 5% of the global pipeline. The strong partnership between teaching hospitals, NIH and industry has helped pioneer many of medicine s most remarkable advances, including life-saving vaccines; new and better treatments for cancer, diabetes, and heart disease; and advanced technology to improve quality of life, from artificial joints and hips, to minimally invasive techniques. FY13 NIH Funding to Independent Domestic Hospitals Rank (n=88) Hospital NIH Awards NIH FUNDING IMPACT 1 Massachusetts General Hospital $339,490,480 2 Brigham and Women s Hospital $315,919,592 3 Boston Children s Hospital $126,812,298 4 Beth Israel Deaconess Medical Center $118,785,811 5 Dana-Farber Cancer Institute $115,844,948 10 Boston Medical Center $34,357,978 12 Tufts Medical Center $30,823,441 18 Massachusetts Eye and Ear Infirmary $20,413,920 Source: National Institutes of Health Source: NIH s Role in Sustaining the US Economy, United for Medical Research 3
Educating Serving Transforming
TRAINING TOMORROW S HEALTHCARE WORKFORCE Medical education is at the core of the mission of each COBTH member hospital. Education programs at Greater Boston s teaching hospitals touch a wide cross section of people each day: their own workforce, medical residents, visiting researchers, student nurses, paramedics, community members entering the workforce and future generations of health care professionals. These programs mean that all hospitals and health centers throughout the Commonwealth and nation gain a ready supply of health care professionals; more 44% of those receiving their training in Massachusetts staying here to practice. Massachustets continues to lead the nation in the number of residents and fellows being trained per capita and ranks third for primary care training per capita. State RESIDENTS & FELLOWS IN ACGME PROGRAMS # per 100,000 population Rank RESIDENTS & FELLOWS IN ACGME PRIMARY CARE PROGRAMS # per 100,000 population Rank MA 84 1 26 3 However, based on demographic trends and current and expected medical school enrollment, the nation faces a significant physician shortage. As Massachusetts and the nation work to reform healthcare payment and delivery, the critical role that academic medical centers play in training health professionals will never be more important. PROJECTED SUPPLY AND DEMAND, PHYSICIANS, 2008-2020 NY 82 2 33 1 RI 74 3 30 2 CT 61 4 24 4 PA 60 5 21 5 Source: Association of American Medical Colleges, State Physician Workforce Data Book - 2013 Source: Association of American Medical Colleges 5
Supporting Listening Partnering
BUILDING HEALTHY COMMUNITIES By providing care for the uninsured and partnering with community based organizations and municipalities to address the unmet social and healthcare needs, teaching hospitals are helping to build healthier communities. Although Greater Boston s teaching hospitals have world-renowned reputations, their roots are grounded in public service to local communities in and around Boston. COBTH member hospitals partner with more than 400 local agencies and provide more than $177m to develop and support innovative programs aimed at serving those in need. Opening their doors to the uninsured, teaching hospitals provide more than two thirds of all the uncompensated care delivered in the Commonwealth. In FY12, Greater Boston teaching hospitals provided more than $160m in charity care as defined by the Commonwealth. In addition to the community benefits and charity calculated according to state guidelines, hospital also incur significant losses due to under-funding of Medicaid and Medicare as well as bad debt. Community Benefits Direct Expenditures $134,374,512 >> Determination of Need $4,219,580 >> Employee Volunteerism $1,889,296 >> Other Leveraged Resources $37,258,702 Total Community Benefit $177,742,090 Community Service Expenditures $1,934,756 Net Charity Care Provided $160,292,836 Total Resources $339,969,682 * Definitions and figures as reported by COBTH member hospitals in their Annual Report on Community Benefits (FY12) filed with the Office of the Attorney General. Does not include Boston Medical Center, Cambridge Health Alliance and Boston VA Healthcare. 7
Building Investing Leading
DRIVING THE LOCAL AND REGIONAL ECONOMY COBTH member hospitals provide access to healthcare services 24 hours a day, seven days a week, 365 days a year serving hundreds of thousands of people. But often less recognized is the impact that these hospitals have on the local economy and employment. The operations of Greater Boston s teaching hospitals generated more than $13b in direct economic activity for the Commonwealth of Massachusetts and more than $31b in indirect impact. This direct economic impact represents the salaries paid to hospital employees as well as the purchase of goods and services, construction and other activities necessary to operate a clinical and research enterprise. The indirect impact is initiated by the purchase of local resources; as hospitals buy goods and services from local businesses, these businesses must, in turn, spend more locally to meet this demand. Collectively, Greater Boston s Teaching Hospitals directly employ more than 72,000 people, but the total impact on statewide, regional, and local employment is far greater. Direct employment is only the beginning of a powerful story of how the operations of Greater Boston s teaching hospitals drive additional employment at hotels, restaurants, construction firms, laundry and cleaning services, and professional service companies. For every person directly employed at one of the COBTH member teaching hospitals, nearly one additional job is supported within the state s economy, resulting in nearly 130,000 direct and indirect employees in the Commonwealth. DIRECT AND INDIRECT IMPACT OF COBTH HOSPITALS 9
DRIVING THE LOCAL AND REGIONAL ECONOMY The critical role that healthcare plays in the Commonwealth s economy is clear when looking at the concentration of employment by industry in Massachusetts compared to the nation as a whole. MASSACHUSETTS MAJOR INDUSTRY EMPLOYMENT CONCENTRATION, SIZE AND % OF TOTAL PRIVATE EMPLOYMENT (2012) Jobs Location Quotient (employment concentration relative to US) How to read this chart: The size and location of the bubble relative to the Y (vertical) axis indicates employment size, with the % indicating % of total employment in MA. The location of the bubble relative to the X (horizontal) axis indicates the location quotient which is a measure of an industry s concentration relative to overall US concentration of employment in that industry. A location quotient greater than 1 indicates that employment in that sector is more concentrated in MA relative to the nation as a whole. 10
MASSACHUSETTS PRIVATE SECTOR EMPLOYMENT BY INDUSTRY (2012) As with most cities and towns throughout the Commonwealth, the largest employer is often the local hospital. The story is no different in Boston where five of the ten largest private employers are COBTH hospitals. 5 OF 10 TOP PRIVATE EMPLOYERS IN BOSTON ARE TEACHING HOSPITALS Massachusetts General Hospital Brigham and Women s Hospital Boston University Boston Children s Hospital State Street Bank & Trust Beth Israel Deaconess Medical Center Fidelity Harvard University Graduate Schools Northeastern University Source: US Dept. of Commerce, Bureau of Economic Analysis, SA25N, Total Full and Part-time Employment by NAICS Industry - 2012 Boston Medical Center Source: Boston Redevelopment Authority - November 2013 11
ABOUT COBTH The Conference of Boston Teaching Hospitals (COBTH) is coalition of fourteen Boston area teaching hospitals that works to advance policies critical to the core mission of academic medical centers; medical education, biomedical research, patient care and serving the under and uninsured. Through COBTH, member hospitals work with city, state and federal officials, members of the business community, consumer groups and other to effect needed change and to make the communities they serve healthier places to live. Beth Israel Deaconess Medical Center Boston Children s Hospital Boston Medical Center Brigham and Women s Hospital Brigham and Women s Faulkner Hospital Cambridge Health Alliance Carney Hospital Dana-Farber Cancer Institute Lahey Hospital and Medical Center Massachusetts Eye and Ear Infirmary Massachusetts General Hospital St. Elizabeth s Medical Center Tufts Medical Center VA Boston Healthcare System Chair John Fernandez President and Chief Executive Officer, Massachusetts Eye and Ear Infirmary Executive Director John Erwin Conference of Boston Teaching Hospitals 11 Beacon Street, #710 Boston, MA 02108 617-723-6100 www.cobth.org