1

Securing the Future of the State’s Public Academic Health Center

Supporting Data

Higher Education and Employment Advancement Committee

March 8, 2007 Revised June 2007

Pages 11 & 12

2

John Dempsey Hospital

Comparative Data, Medicaid Inpatient Patient Days as a Percentage of Total Patient Days.

Total Medicaid Hospital Patient Days Patient Days Percent

John Dempsey Hospital 59,860 13,367 22.3%Saint Francis Hospital 162,182 36,919 22.8%Hartford Hospital 215,223 40,720 18.9%New Britain Hospital 76,470 14,871 19.4%Bristol Hospital 34,335 4,874 14.2%Charlotte Hungerford Hospital 27,117 4,355 16.1%Waterbury Hospital 72,317 11,923 16.5%St Mary's Hospital 59,899 11,180 18.7%

Statewide Average 2,039,739 366,131 17.9%

Top 5 Hospitals in StateConnecticut Children's Medical Center 46.8%Yale-New Haven Hospital 28.3%Bridgeport Hospital 23.6%St. Francis Hospital 22.8%John Dempsey Hospital 22.3%

Notes:Source: CHIME Database Connecticut Hospital Association FY 2006. Data reflects a fiscal year from October 1 through September 30.

The Legislative Program Review and Investigations Committee report "The Funding of Hospital Care" datedDecember 18, 2006 identifies three hospitals statewide that qualify for the Medicaid DSH Adjustment (John Dempsey, Yale-New Haven and Bridgeport). John Dempsey Hospital qualifies both as a Medicaid and Medicare Disproportionate Share Hospital.

3

JOHN DEMPSEY HOSPITALMEDICAID INPATIENT DAYS

11,364

10,924

12,397

13,339

9,876

12,996

12,21713.48%

15.07%

-3.87%

-1.45%

6.38%

2.64%

7,000

8,000

9,000

10,000

11,000

12,000

13,000

14,000

FY 2000 FY 2001 FY 2002 FY 2003 FY 2004 FY 2005 FY 2006

Pati

en

t D

ays

JOHN DEMPSEY HOSPITAL% OF MEDICAID INPATIENT DAYS AS A % OF TOTAL INPATIENT DAYS

20.0%

22.0%

20.3%

22.1%

21.0% 21.4%

22.5%

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

FY 2000 FY 2001 FY 2002 FY 2003 FY 2004 FY 2005 FY 2006

Percen

t

3

4

JOHN DEMPSEY HOSPITALMEDICAID INPATIENT DISCHARGES BY PROGRAM

480

420

486 489

600

489514

359

415

535

684662

683736

94144

182

250299

330294

0100200300400500600700800900

FY 2000 FY 2001 FY 2002 FY 2003 FY 2004 FY 2005 FY 2006

Dis

ch

arg

es

JOHN DEMPSEY HOSPITALMEDICAID OUTPATIENT VISITS BY PROGRAM

8,357

7,3427,827

8,8899,389

10,185

11,574

4,9684,495

7,767

11,567

12,84413,483

14,178

1,0921,769

2,536

4,0854,878

6,012

6,964

0

5,000

10,000

15,000

FY 2000 FY 2001 FY 2002 FY 2003 FY 2004 FY 2005 FY 2006

Ou

tpati

en

t V

isit

s

Husky B Husky A SAGA

5

John Dempsey HospitalFY2006 Medicaid, Medicaid Managed Care, SAGA Profit and Loss StatementDischarges 7/1/05 to 6/30/2006FY06 Costs Based on GL Expenses YTD Dec. Annualized

InpatientCases LOS ALOS Total Charges Expected Pay Total Cost Direct Cost Indirect Cost Est Profit

Financial Class Cases LOS ALOS Total Charges Expected Pay Total Cost Direct Cost Indirect Cost Est ProfitMEDICAID 860 - CONNECTICUT MEDICAID 510 4,304 8.44 11,122,472$ 5,954,002$ 7,731,631$ 5,147,525$ 2,584,107$ (1,777,629)$ MEDICAID 864 - OTHER STATE MEDICAID 3 16 5.33 41,178$ 13,589$ 25,047$ 15,765$ 9,282$ (11,458)$

Subtotal Medicaid 513 4,320 8.42 11,163,649$ 5,967,590$ 7,756,678$ 5,163,290$ 2,593,389$ (1,789,088)$

SAGA 867 - OTHER CT CITY GENERAL ASSISTAN 296 1,753 5.92 4,728,929$ 1,521,794$ 3,689,688$ 2,489,716$ 1,199,971$ (2,167,895)$

736 7,219 9.81 18,662,667$ 8,548,993$ 12,538,884$ 8,887,589$ 3,651,295$ (3,989,891)$ Financial Class Cases LOS ALOS Total Charges Expected Pay Total Cost Direct Cost Indirect Cost Est Profit

725 - BHP-HUSKY COMMUNITY HEALTH 2 6 3.00 7,788$ 4,260$ 8,595$ 5,665$ 2,930$ (4,335)$ 729 - BHP-HUSKY FIRST CHOICE PREF ON 1 6 6.00 5,001$ 4,260$ 7,015$ 4,506$ 2,509$ (2,755)$ 760 - MEDICAID BLUE CARE FAMILY-PART 398 3,345 8.40 8,642,991$ 3,746,570$ 5,833,628$ 4,105,162$ 1,728,465$ (2,087,058)$ 764 - MEDICAID COMMUNITY NTWK OF CT 118 1,641 13.91 4,202,242$ 1,734,537$ 2,803,141$ 2,003,406$ 799,735$ (1,068,604)$ 768 - BHP-HUSKY BLUECARE FAMILY PLAN 15 52 3.47 56,009$ 36,920$ 68,264$ 44,358$ 23,906$ (31,344)$ 772 - BHP-HUSKY HEALTH NET 5 17 3.40 18,537$ 12,070$ 24,282$ 15,658$ 8,624$ (12,212)$ 784 - MEDICAID HEALTH NET PARTICIPAT 155 1,375 8.87 3,641,603$ 1,935,621$ 2,443,288$ 1,722,196$ 721,093$ (507,667)$ 792 - MEDICAID FIRST CHOICE PREF ONE 42 777 18.50 2,088,497$ 1,074,755$ 1,350,671$ 986,637$ 364,033$ (275,916)$

Subtotal Medicaid Managed Care 736 7,219 9.81 18,662,667$ 8,548,993$ 12,538,884$ 8,887,589$ 3,651,295$ (3,989,891)$

Total Inpatient Medicaid 1,545 13,292 8.60 34,555,245$ 16,038,377$ 23,985,250$ 16,540,595$ 7,444,656$ (7,946,873)$

OutpatientCases Total Charges Expected Pay Total Cost Direct Cost Indirect Cost Est Profit

Financial Class Cases Total Charges Expected Pay Total Cost Direct Cost Indirect Cost Est ProfitMEDICAID 860 - CONNECTICUT MEDICAID 11,600 7,231,292$ 2,649,926$ 3,237,564$ 2,328,369$ 904,053$ (587,638)$ MEDICAID 862 - MASSACHUSETTS MEDICAID 17 5,995$ 1,939$ 5,577$ 3,765$ 1,811$ (3,638)$ MEDICAID 863 - NEW YORK MEDICAID 14 7,494$ 1,948$ 4,332$ 2,890$ 1,442$ (2,384)$ MEDICAID 864 - OTHER STATE MEDICAID 26 15,842$ 5,070$ 9,829$ 6,803$ 3,026$ (4,759)$

Subtotal Medicaid 11,657 7,260,623$ 2,658,883$ 3,257,302$ 2,341,828$ 910,332$ (598,419)$

SAGA 866 - (HDSS) HARTFORD CITY GENERAL A 1 4,553$ 1,362$ 3,201$ 1,995$ 1,205$ (1,839)$ SAGA 867 - OTHER CT CITY GENERAL ASSISTAN 7,018 4,029,345$ 1,083,590$ 1,944,755$ 1,315,587$ 628,292$ (861,165)$

Subtotal SAGA 7,019 4,033,898$ 1,084,952$ 1,947,956$ 1,317,583$ 629,497$ (863,004)$

14,025 6,031,924$ 2,775,411$ 3,709,740$ 2,489,713$ 1,213,356$ (934,329)$ Financial Class Cases Total Charges Expected Pay Total Cost Direct Cost Indirect Cost Est Profit

725 - BHP-HUSKY COMMUNITY HEALTH 100 40,536$ 26,904$ 35,500$ 16,496$ 19,004$ (8,595)$ 729 - BHP-HUSKY FIRST CHOICE PREF ON 2 640$ 457$ 631$ 502$ 129$ (174)$ 760 - MEDICAID BLUE CARE FAMILY-PART 8,350 3,431,228$ 1,615,958$ 1,890,535$ 1,258,397$ 628,268$ (274,577)$ 764 - MEDICAID COMMUNITY NTWK OF CT 1,584 830,607$ 360,700$ 497,801$ 325,394$ 172,219$ (137,101)$ 768 - BHP-HUSKY BLUECARE FAMILY PLAN 435 81,493$ 50,417$ 64,368$ 39,603$ 24,637$ (13,950)$ 772 - BHP-HUSKY HEALTH NET 130 20,262$ 9,243$ 14,536$ 10,304$ 4,160$ (5,293)$ 784 - MEDICAID HEALTH NET PARTICIPAT 3,015 1,440,411$ 623,785$ 1,022,685$ 713,799$ 307,587$ (398,900)$ 788 - MEDICAID BLUECARE FAMILY SECON 7 5,315$ 2,265$ 2,954$ 2,069$ 885$ (689)$ 792 - MEDICAID FIRST CHOICE PREF ONE 402 181,433$ 85,681$ 180,731$ 123,149$ 56,467$ (95,050)$

Summary 14,025 6,031,924$ 2,775,411$ 3,709,740$ 2,489,713$ 1,213,356$ (934,329)$

Total Outpatient 32,701 17,326,446$ 6,519,245$ 8,914,998$ 6,149,124$ 2,753,185$ (2,395,753)$

Grand Total Inpatient and Outpatient 34,246 51,881,691$ 22,557,622$ 32,900,248$ 22,689,719$ 10,197,840$ (10,342,626)$

MEDICAID MANAGED CARE

Financial Class Grp

Financial Class Grp

MEDICAID MANAGED CARE

6

Market Share Analysis: JDH ranks fourth in its own primary service areaFiscal Year 2006Source: Connecticut Hospital Association (CHIME) October to September

Inpatient Discharges, John Dempsey Hospital's Primary Service Area

Hospital FY 2006John Dempsey Hospital 9.8%Hartford Hospital 31.9%Saint Francis Hospital and Medical Center 27.8%The Hospital of Central Connecticut ( New Britain) 20.5%Bristol Hospital 1.1%All Other Connecticut Hospitals 8.9%

Totals 100.0%

Market Share Percent of John Dempsey Hospital's Primary Service Area,excluding the City of Hartford

Hospital FY 2006John Dempsey Hospital 12.4%Hartford Hospital 25.4%Saint Francis Hospital and Medical Center 23.1%The Hospital of Central Connecticut ( New Britain) 28.5%Bristol Hospital 1.5%All Other Connecticut Hospitals 9.1%

Totals 100.0%

Primary Service Area is defined as: Avon; Burlington; Canton; Farmington; Simsbury; West Hartford; Bloomfield; East Hartford;Granby; Hartford; New Britain; Newington

7

Volume: Demand is growing at all area hospitalsFiscal Year 2000 to FY 2006

Source: Connecticut Hospital Association (CHIME) October to September

Inpatient Discharges

Hospital FY 2000 FY 2006 Change PercentJohn Dempsey Hospital 6,581 9,252 2,671 * 40.6%Hartford Hospital 31,671 35,507 3,836 12.1%Saint Francis Hospital and Medical Center 27,080 28,728 1,648 6.1%The Hospital of Central Connecticut ( New Britain) 13,558 16,890 3,332 24.6%Bristol Hospital 7,064 7,229 165 2.3%

Totals 85,954 97,606 11,652 13.6%

All Other Connecticut Hospitals 251,022 283,140 32,118 12.8%

Total State of Connecticut 336,976 380,746 43,770 13.0%

Inpatient Discharges, Residents from John Dempsey Hospital's Primary Service Area

Hospital FY 2000 FY 2006 Change PercentJohn Dempsey Hospital 3,081 5,228 2,147 * 69.7%Hartford Hospital 16,126 17,013 887 5.5%Saint Francis Hospital and Medical Center 14,614 14,839 225 1.5%The Hospital of Central Connecticut ( New Britain) 8,513 10,936 2,423 28.5%Bristol Hospital 605 592 (13) -2.1%All Other Connecticut Hospitals 4,072 4,777 705 17.3%

Totals 47,011 53,385 6,374 13.6%

Primary Service Area is defined as: Avon; Burlington; Canton; Farmington; Simsbury; West Hartford; Bloomfield; East Hartford; Granby; Hartford; New Britain; Newington

* Note: Over 80% of JDH volume growth is from the JDH primary service area.

8

Volume: JDH care has grown at the same rate for Hartford residents as it has for all other primary service area residents.

Fiscal Year 2000 to FY 2006Source: Connecticut Hospital Association (CHIME) October to September

Inpatient Discharges, Hartford residents only

Hospital FY 2000 FY 2006 Change PercentJohn Dempsey Hospital 338 565 227 67.2%Hartford Hospital 6,698 7,437 739 11.0%Saint Francis Hospital and Medical Center 6,280 6,104 (176) -2.8%The Hospital of Central Connecticut ( New Britain) 146 161 15 10.3%Bristol Hospital 51 22 (29) -56.9%All Other Connecticut Hospitals 1,093 1,341 248 22.7%

Totals 14,606 15,630 1,024 7.0%

Inpatient Discharges, Primary Service Area residents without Hartford residents

Hospital FY 2000 FY 2006 Change PercentJohn Dempsey Hospital 2,743 4,663 1,920 70.0%Hartford Hospital 9,428 9,576 148 1.6%Saint Francis Hospital and Medical Center 8,334 8,735 401 4.8%The Hospital of Central Connecticut ( New Britain) 8,367 10,775 2,408 28.8%Bristol Hospital 554 570 16 2.9%All Other Connecticut Hospitals 2,979 3,704 725 24.3%

Totals 32,405 38,023 5,618 17.3%

Primary Service Area is defined as: Avon; Burlington; Canton; Farmington; Simsbury; West Hartford; Bloomfield; East Hartford;Granby; Hartford; New Britain; Newington

9

John Dempsey HospitalComparative Admissions Fiscal Year 2007 (October)

Four Months Ended January 2007

6,825

10,112

3,278 2,646

12,980

7,682

10,594

13,389

3,410 2,794

0

5,000

10,000

15,000

JohnDempsey

Hartford St. Francis Bristol New Britain

Hospital

Ad

mis

sio

ns

Jan-06 Jan-07

Volume: the demand trend continues

VarianceJ an-06 J an-07 FY07 vs FY06 %

J ohn Dempsey 3,278 3,410 132 3.87%Hartford 12,980 13,389 409 3.05%St. Francis 10,112 10,594 482 4.55%Bristol 2,646 2,794 148 5.30%New Britain 6,825 7,682 857 11.16%TOTALS 35,841 37,869 2,028 5.36%

SHARE % of ADMISSIONSJ ohn Dempsey 9.15% 9.00% -0.14%Hartford 36.22% 35.36% -0.86%St. Francis 28.21% 27.98% -0.24%Bristol 7.38% 7.38% 0.00%New Britain 19.04% 20.29% 1.24%TOTALS 100.00% 100.00% 0.00%

Four Month Ended

Source: Connecticut Hospital Association

10

Current Current Current PercentageLicensed Beds Staffed Beds Unstaffed Beds Staffed Beds

Hartford Hospital 867 774 93 89%St. Francis 682 564** 118** 83%New Britain GH 362 290 72 80%JDH* 224 224 0 100%*Bristol Hospital* 154 154 0 100%*

Total 2,289 2,006 283 88%

A 128 bed expansion of JDH would represent a 5.6% increase in total licensed beds and a 6.4%increase in total staffed beds in the region. (This does not include the pending St. Francis CON.)

* Only acute care hospitals in Connecticut that staff all their licensed beds

** Does not include St. Francis pending CON application with an increase of 53 staffed beds.

Source: Connecticut Hospital Association

Hartford Region Hospital Beds

11

St. Francis outpatient medical office St. Francis proposed medical officeHartford Hospital outpatient medical officeHartford Hospital proposed medical officeUconn locationsHospital of Central CT Locations

Hospital Medical Office Locations

Revised June 2007

12

Revised June, 2007

Hospital Medical Office Locations

Hartford Hospital University of Connecticut Health Center Hartford Hospital Locations Health Center Locations

o Avon, Avon Wellness Center, 100 Simsbury Road o West Hartford, 65 Kane St o Avon, Avon Cancer Center, CON approved, 80 Fisher Drive o East Hartford, 99 Ash St o Glastonbury, Health Center, 704 Hebron Ave o Simsbury, 381 Hopmeadow St o Glastonbury, Endoscopy Center, Hartford Hospital and Conn. GI,

proposed

o Wethersfield, Health Center, 1260 Silas Deane Highway o Windsor, Health Center, 1060 Day Hill Road o West Hartford, Ambulatory Surgery Center, under construction,

Blue Back Sq. The Hospital of Central Connecticut

New Britain General campus Hartford Medical Group Locations Bradley Memorial campus

o Avon, 100 Simsbury Road Outpatient Diagnostic Centers o West Hartford, 336 North Main St o Newington, 66 Cedar St o West Hartford, 1329 Boulevard o Kensington, 320 New Britain Road o West Hartford, 445 South Main St o Bristol, 59 North Main St o East Hartford, 265 Ellington Road o Plainville, 184 East Stret o Manchester, 256 North Main St o Southington, 360-1 North Main St. o Wethersfield, 1260 Silas Deane Highway o Windsor, 1060 Day Hill Road

St. Francis Hospital and Medical Center

St Francis Hospital Locations o Avon, 35 Nod Road o Avon, proposed, Konover Development o Enfield, 9 Cranbrook Blvd o Glastonbury, 31 Sycamore St o Winsted, 115 Spencer St o Hartford, Mt. Sinai campus

St. Francis Medical Group Locations

o Avon, 30 West Avon Road o East Hartford, 775 Main St

13

Patient Days per 1000 pop.

500.0

550.0

600.0

650.0

700.0

CT Patient days / 1000 599.4 556.8 530.4 526.1 542.7 527.1 542.8 588.6 547.7 608.6 626.7

NE Patient days / 1000 667.9 620.6 596.0 591.4 584.3 575.1 583.1 590.9 578.6 603.3 603.0

US Patient days / 1000 665.5 634.1 618.4 612.9 608.1 597.4 600.0 604.8 600.8 605.4 602.6

1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005

Admissions per 1000 pop.

100.0

105.0

110.0

115.0

120.0

CT Admissions / 1000 103.3 103.4 103.4 100.8 102.6 102.0 104.4 108.3 106.7 111.0 115.1

NE Admissions / 1000 113.3 111.2 112.8 109.7 109.4 107.6 110.4 110.7 111.1 114.0 114.9

US Admissions / 1000 116.4 115.6 115.9 115.7 116.7 116.0 117.2 118.4 118.4 118.5 118.2

1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005

Staffed Beds per 1000 pop.

1.50

2.00

2.50

3.00

3.50

CT Staffed Beds / 1000 2.27 2.16 2.14 2.09 2.13 2.01 2.12 2.09 1.98 2.15 2.16

NE Staffed Beds / 1000 2.72 2.58 2.48 2.42 2.38 2.32 2.33 2.27 2.23 2.29 2.27

US Staffed Beds / 1000 3.02 2.95 2.87 2.81 2.74 2.65 2.64 2.60 2.56 2.54 2.51

1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005

Comparative Hospital Statistics

Connecticut, New England and United States

Includes U.S. registered community hospitals (nonfederal, short term general and other specialty hospitals, including rehab)

New England includes Mass, Vermont, New Hamp, Rhode Is, Conn, and Main. Source: American Hospital Association.