A SWOT Analysis for Hospitals Bill Pully, President
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Alamance Regional Medical Center • Albemarle Health • Alleghany Memorial Hospital • Angel Medical Center • Annie Penn Hospital • Anson Community Hospital • Ashe Memorial Hospital, Inc. • Betsy Johnson Regional Hospital • Blowing Rock Hospital • Blue Ridge Regional Hospital • Broughton Hospital • Brunswick Community Hospital • Caldwell Memorial Hospital, Inc. • Cape Fear Valley - Bladen County Hospital • Cape Fear Valley Health System • CarePartners Rehabilitation Hospital • CarolinaEast Health System • Carolinas Medical Center • Carolinas Medical Center - Lincoln • Carolinas Medical Center - Mercy • Carolinas Medical Center - Northeast • Carolinas Medical Center - Pineville • Carolinas Medical Center - Union • Carolinas Medical Center - University • Carolinas Rehabilitation • Carteret County General Hospital • CaroMont Health, Inc. • Catawba Valley Medical Center • Central Carolina Hospital • Central Regional Hospital • Charles A Cannon, Jr. Memorial Hospital • Chatham Hospital • Cherokee Indian Hospital • Cherry Hospital • Cleveland Regional Medical Center • Coastal Plain Hospital • Columbus Regional Healthcare System • Cone Health Behavioral Health • Davie County Hospital • Davis Regional Medical Center • Department of Veterans Affairs Medical Center Asheville • Department of Veterans Affairs Medical Center Durham • Duke Raleigh Hospital • Duke University Hospital • Durham Regional Hospital • FirstHealth Montgomery Memorial Hospital • FirstHealth Moore Regional Hospital • FirstHealth Richmond Memorial Hospital • Forsyth Medical Center • Franklin Regional Medical Center • Frye Regional Medical Center • Grace Hospital • Granville Health System • Halifax Regional Medical Center • High Point Regional Health System • Highland-Cashiers Hospital • Highsmith-Rainey Specialty Hospital • Holly Hill Hospital • Hugh Chatham Memorial Hospital • Iredell Health System • J. Arthur Dosher Memorial Hospital • Johnston Medical Center - Smithfield • Kindred Hospital • Kings Mountain Hospital, Inc. • Lake Norman Regional Medical Center • Lenoir Memorial Hospital, Inc. • Lexington Memorial Hospital, Inc. • LifeCare Hospitals of North Carolina • Margaret R. Pardee Memorial Hospital • Maria Parham Medical Center • Martin General Hospital • The McDowell Hospital • Medical Park Hospital • MedWest - Harris • MedWest - Haywood • MedWest - Swain • Mission Health System • Morehead Memorial Hospital • Murphy Medical Center, Inc. • Nash Health Care Systems • New Hanover Regional Medical Center • North Carolina Specialty Hospital • Northern Hospital of Surry County • Onslow Memorial Hospital • Our Community Hospital • The Outer Banks Hospital • Park Ridge Health • Pender Memorial Hospital • Person Memorial Hospital • Presbyterian Healthcare • Presbyterian Hospital Huntersville • Presbyterian Hospital Matthews • Presbyterian Orthopaedic Hospital • Randolph Hospital • Rex Healthcare • Rowan Regional Medical Center • Rutherford Regional Medical Center• Sampson Regional Medical Center • Sandhills Regional Medical Center • Scotland Health Care System • Select Specialty Hospital-Durham • Select Specialty Hospital-Winston-Salem • Southeastern Regional Medical Center • St. Luke’s Hospital • Stanly Regional Medical Center • Stokes-Reynolds Memorial Hospital, Inc. • The Moses H. Cone Memorial Hospital • Thomasville Medical Center • Transylvania Regional Hospital • UNC Hospitals • Valdese Hospital • Vidant Beaufort Hospital • Vidant Bertie Hospital • Vidant Chowan Hospital • Vidant Duplin Hospital • Vidant Edgecombe Hospital • Wake Forest Baptist Medical Center • Vidant Medical Center • Vidant Pungo Hospital • Vidant Roanoke-Chowan Hospital • Wake Forest Baptist Health – Davie Hospital • Wake Forest Baptist Health – Lexington Medical Center • WakeMed • WakeMed Cary Hospital • WakeMed Fuquay-Varina • WakeMed Zebulon/Wendell SNF and Outpatient Diagnostic Center • Washington County Hospital • Watauga Medical Center • Wayne Memorial Hospital • Wesley Long Community Hospital • Wilkes Regional Medical Center • Wilson Medical Center • Women’s Hospital of Greensboro • Yadkin Valley Community Hospital A SWOT Analysis for Hospitals Bill Pully, President North Carolina Hospital Association
A Different Order for Difficult Times Threats Weaknesses Opportunities Strengths
Threats Governor’s budget Drops outpatient payments to 70% of costs from 80% $80 million minus MRI offset Increases MRI/GAP retention to $43 million plus 29% Impact estimated at $137 million annually Can’t be recouped through MRI/GAP Medicaid expansion $4.4 billion / 10 years Certificate of Need $400 million/year for orthopedics plus ENT procedures
Threats Tax reform $250 million/year for sales tax exemption Mental Health Community services, inpatient beds needed Medicaid HMO $943 million/year, plus payment cuts, plus administrative hassles
Cuts Coming in Next 10 Years Sources: American Hospital Association, DataGen. Value-Based Purchasing cannot be projected on a ten-year basis. Period of this table, 2012 - 2021
Weaknesses We’re Addressing Now Healthcare Affordability Erosion of Public Trust Federal politics Partisan Gridlock State politics Majority of legislators have two years or less of experience
State Representatives w/ a Term or Less 72 Freshmen and Sophomores among 120 Representatives
State Senators w/ a Term or Less 31 Freshmen and Sophomores among 50 Senators
Opportunities Strengthen Community Care of North Carolina Take more ownership in the system Develop a more politically active workforce
Strengths Hospitals’ Missions Care for everyone, every hour, every day without regard to ability to pay Provide good jobs that don’t leave the community Act as an incentive for economic development Quality Improvements Unified Hospital Field
HOSPAC Helping hospitals’ friends in the legislature
NCHA Supports Our Members North Carolina Hospital Association Core Services Transformation Mission: Improve delivery of quality, affordable healthcare in North Carolina through leadership, advocacy, information, & education Principles: Transparency, Collaboration, Innovation, Evidence-Based, Patient-Centered Community Health Improvement Collaborative Education Financial Services Communication & Public Relations Advocacy & Representation NC Center for Rural Health NC Quality Center NC Center for Affordable Health Care Policy Development Payment Systems
Quality Efforts Reducing Mortality
Optimal Care Improvements
NCHA Supports Our Members North Carolina Hospital Association Core Services Transformation Mission: Improve delivery of quality, affordable healthcare in North Carolina through leadership, advocacy, information, & education Principles: Transparency, Collaboration, Innovation, Evidence-Based, Patient-Centered Community Health Improvement Collaborative Education Financial Services Communication & Public Relations Advocacy & Representation NC Center for Rural Health NC Quality Center NC Center for Affordable Health Care Policy Development Payment Systems
A LEAN Success Story FY 12: 8.7 FY 09: 7.7 FY 11: 4.2 FY 10: 8.2
Eastern NC Collaborative Success Third quarter 2012 Activity Summary
NCHA Supports Our Members North Carolina Hospital Association Core Services Transformation Mission: Improve delivery of quality, affordable healthcare in North Carolina through leadership, advocacy, information, & education Principles: Transparency, Collaboration, Innovation, Evidence-Based, Patient-Centered Community Health Improvement Collaborative Education Financial Services Communication & Public Relations Advocacy & Representation NC Center for Rural Health NC Quality Center NC Center for Affordable Health Care Policy Development Payment Systems
VA Who’s Healthy, Who’s Not ND WA MT MN ME WI ID SD VT OR MI NH MA WY NY IA NE CT IL PA RI OH IN NV UT NJ CO MD KS MO WV DE CA KY OK TN 33th NC AR NM AZ SC MS AL GA LA TX FL Alaska #28 Hawaii #2 Source: www.americashealthrankings.org, 2012
Why 33th? Where NC was 2 years ago Children in Poverty 39nd42rd Violent Crime 27th 30rd Prevalence of Obesity 34th 39th Prevalence of Smoking 27th 36rd Premature Deaths 37th 37th Infant Mortality 46th 44th Lack of Health Insurance 34th 38st Since 1990, the U.S. uninsured rate has increased by 46% Source: www.americashealthrankings.org, 2010, U.S. Census Bureau
NCHA Supports Our Members North Carolina Hospital Association Core Services Transformation Mission: Improve delivery of quality, affordable healthcare in North Carolina through leadership, advocacy, information, & education Principles: Transparency, Collaboration, Innovation, Evidence-Based, Patient-Centered Community Health Improvement Collaborative Education Financial Services Communication & Public Relations Advocacy & Representation NC Center for Rural Health NC Quality Center NC Center for Affordable Health Care Policy Development Payment Systems
The Path to Medicaid Cost-Saving Decrease avoidable ED utilization Reduce avoidable Medicaid admissions Maximize Medicaid’s Preferred Drug List Improve collaboration with CCNC Enroll all eligible Medicaid patients in CCNC
Color Changes Show Improvement
Alamance Regional Medical Center • Albemarle Health • Alleghany Memorial Hospital • Angel Medical Center • Annie Penn Hospital • Anson Community Hospital • Ashe Memorial Hospital, Inc. • Betsy Johnson Regional Hospital • Blowing Rock Hospital • Blue Ridge Regional Hospital • Broughton Hospital • Brunswick Community Hospital • Caldwell Memorial Hospital, Inc. • Cape Fear Valley - Bladen County Hospital • Cape Fear Valley Health System • CarePartners Rehabilitation Hospital • CarolinaEast Health System • Carolinas Medical Center • Carolinas Medical Center - Lincoln • Carolinas Medical Center - Mercy • Carolinas Medical Center - Northeast • Carolinas Medical Center - Pineville • Carolinas Medical Center - Union • Carolinas Medical Center - University • Carolinas Rehabilitation • Carteret County General Hospital • CaroMont Health, Inc. • Catawba Valley Medical Center • Central Carolina Hospital • Central Regional Hospital • Charles A Cannon, Jr. Memorial Hospital • Chatham Hospital • Cherokee Indian Hospital • Cherry Hospital • Cleveland Regional Medical Center • Coastal Plain Hospital • Columbus Regional Healthcare System • Cone Health Behavioral Health • Davie County Hospital • Davis Regional Medical Center • Department of Veterans Affairs Medical Center Asheville • Department of Veterans Affairs Medical Center Durham • Duke Raleigh Hospital • Duke University Hospital • Durham Regional Hospital • FirstHealth Montgomery Memorial Hospital • FirstHealth Moore Regional Hospital • FirstHealth Richmond Memorial Hospital • Forsyth Medical Center • Franklin Regional Medical Center • Frye Regional Medical Center • Grace Hospital • Granville Health System • Halifax Regional Medical Center • High Point Regional Health System • Highland-Cashiers Hospital • Highsmith-Rainey Specialty Hospital • Holly Hill Hospital • Hugh Chatham Memorial Hospital • Iredell Health System • J. Arthur Dosher Memorial Hospital • Johnston Medical Center - Smithfield • Kings Mountain Hospital, Inc. • Lake Norman Regional Medical Center • Lenoir Memorial Hospital, Inc. • Lexington Memorial Hospital, Inc. • LifeCare Hospitals of North Carolina • Margaret R. Pardee Memorial Hospital • Maria Parham Medical Center • Martin General Hospital • The McDowell Hospital • Medical Park Hospital • MedWest - Harris • MedWest - Haywood • MedWest - Swain • Mission Health System • Morehead Memorial Hospital • Murphy Medical Center, Inc. • Nash Health Care Systems • New Hanover Regional Medical Center • North Carolina Specialty Hospital • Northern Hospital of Surry County • Onslow Memorial Hospital • Our Community Hospital • The Outer Banks Hospital • Park Ridge Health • Pender Memorial Hospital • Person Memorial Hospital • Presbyterian Healthcare • Presbyterian Hospital Huntersville • Presbyterian Hospital Matthews • Presbyterian Orthopaedic Hospital • Randolph Hospital • Rex Healthcare • Rowan Regional Medical Center • Rutherford Regional Medical Center• Sampson Regional Medical Center • Sandhills Regional Medical Center • Scotland Health Care System • Select Specialty Hospital-Durham • Select Specialty Hospital-Winston-Salem • Southeastern Regional Medical Center • St. Luke’s Hospital • Stanly Regional Medical Center • Stokes-Reynolds Memorial Hospital, Inc. • The Moses H. Cone Memorial Hospital • Thomasville Medical Center • Transylvania Regional Hospital • UNC Hospitals • Valdese Hospital • Vidant Beaufort Hospital • Vidant Bertie Hospital • Vidant Chowan Hospital • Vidant Duplin Hospital • Vidant Edgecombe Hospital • Wake Forest Baptist Medical Center • Vidant Medical Center • Vidant Pungo Hospital • Vidant Roanoke-Chowan Hospital • Wake Forest Baptist Health – Davie Hospital • Wake Forest Baptist Health – Lexington Medical Center • WakeMed • WakeMed Cary Hospital • WakeMed Fuquay-Varina • WakeMed Zebulon/Wendell SNF and Outpatient Diagnostic Center • Washington County Hospital • Watauga Medical Center • Wayne Memorial Hospital • Wesley Long Community Hospital • Wilkes Regional Medical Center • Wilson Medical Center • Women’s Hospital of Greensboro • Yadkin Valley Community Hospital North Carolina Hospital Association Questions?
