The ur­gency to keep our hos­pi­tals healthy

The News-Times (Sunday) - - Opinion -

Amer­i­cans love fic­tional hos­pi­tals. From “Ben Casey” to “M*A*S*H” to “St. Else­where” to “ER” to “Grey’s Anatomy,” hos­pi­tal shows have re­mained as re­li­able on net­work tele­vi­sion as a win­ter cold. Non­fic­tion hos­pi­tals? Not so pop­u­lar.

Why would they be? Even the best ex­pe­ri­ences at hos­pi­tals (birth) come with an as­so­ci­a­tion to pain and time away from home.

That, along with the pro­hib­i­tive cost of care, leaves the pub­lic in­dif­fer­ent to the plight of hos­pi­tals’ eco­nomic chal­lenges.

But ig­nor­ing ail­ments risks fu­ture surgery. Some hos­pi­tals are carv­ing up their bud­gets as they cope with ex­ist­ing and threat­ened state taxes, along with Pres­i­dent Don­ald Trump’s shaky un­der­stand­ing of health poli­cies, in­clud­ing his own.

The state Of­fice of Health Strat­egy re­ports that nine of Con­necti­cut’s 16 health sys­tems fin­ished 2017 in the black. That still leaves seven sys­tems in the red by as much as -5.49 per­cent (the Uni­ver­sity of Con­necti­cut Health Cen­ter). UConn rose from a pre­vi­ous re­ported loss of -50.65 per­cent but got help from $322 mil­lion in state and cap­i­tal ap­pro­pri­a­tions.

Yale New Haven Health Ser­vices, which in­cludes Bridge­port and Green­wich hos­pi­tals, posted a healthy to­tal mar­gin of 6.94 per­cent, while Western Con­necti­cut Health Net­work, which over­sees Nor­walk and Dan­bury hos­pi­tals, was 3.89 per­cent.

Stam­ford Health im­proved from -3.56 per­cent to -1.67 per­cent in 2017, which saw the doors open on its new $450 mil­lion com­plex. Brian Grissler, who over­saw the ex­pan­sion, re­cently re­tired as Stam­ford’s CEO with no fan­fare af­ter earn­ing $2.9 mil­lion in salary and ben­e­fits in 2017. Gov. Dan­nel P. Mal­loy rea­soned a few years ago that such com­pen­sa­tions jus­ti­fied a re­struc­tured hos­pi­tal tax.

In terms of cold cash, the sys­tems col­lec­tively pulled in about $580 mil­lion.

What caught the at­ten­tion of hos­pi­tal book­keep­ers was that the op­er­at­ing mar­gin for the sys­tems fell from 0.9 per­cent in 2016 to -1.7 per­cent. David White­head, ex­ec­u­tive vice pres­i­dent at Hart­ford Health­Care, said the in­dus­try stan­dard should be around 4.

You’re prob­a­bly do­ing the math and com­ing up with the an­swer that this means more ex­pen­sive med­i­cal bills.

Hos­pi­tal ad­min­is­tra­tors are jug­gling the num­bers as well. St Vin­cent’s Med­i­cal Cen­ter in Bridge­port pulled it­self a lit­tle closer from the red, ris­ing from a -1.35 per­cent deficit to -0.47 per­cent, and is be­ing ac­quired by Hart­ford Health­Care, which had a 5.95 per­cent mar­gin.

The data can be over­whelm­ing but will hope­fully prove valu­able. Vicki Vel­tri, ex­ec­u­tive di­rec­tor of the Of­fice of Health Strat­egy, ac­knowl­edges that they have yet to lever­age the in­for­ma­tion to di­ag­nose what “all of you might see in your pre­mium and in your out-of-pocket costs.” Hos­pi­tal CFOs are at the mercy of ever-shift­ing state and fed­eral po­lices, in­sur­ance pay­ments, and un­ceas­ingly high salaries for its top po­si­tions. They should wel­come the anal­y­sis of the Of­fice of Health Strat­egy, and law­mak­ers should take the time to un­der­stand the is­sue, one of the few that af­fects every Amer­i­can.

This isn’t any­one’s fa­vorite med­i­cal drama, but every­one should tune in.

Hos­pi­tal CFOs are at the mercy of ever-shift­ing state and fed­eral po­lices, in­sur­ance pay­ments, and un­ceas­ingly high salaries for its top po­si­tions.

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