Community Connections

Fremont Area Chamber Business After Hours

September 6, 2006

Fremont Area Medical Center Overview

• Founded in 1940• Mission statement:

– Our Mission is to optimize the health status of individuals by providing a wide range of accessible, customer-centered health care services in an efficient, cost-effective manner.

Fremont Area Medical Center Overview

• 900+ employees• 300+ volunteers• 100+ on FAMC’s Medical Staff• Services provided:

Surgery Imaging/Diagnostic Emergency Rehab Long Term Care Acute Nursing Joint Center (orthopedics) Pediatrics OB/GYN Cardiovascular Cancer Workplace Wellness Community Health Education Sports Medicine

Outpatient Procedures/Clinics

Fremont Area Medical Center Overview

• Newest developments:– Renovation and move of Laboratory– Renovation and move of Outpatient

Procedures/Clinics and GI Lab– Addition of a second Sleep Center bed/room– Addition of 3 physicians to the Medical Staff– Recipient of 2 national awards in 2006– Renovation and move of Cath Lab– Groundbreaking for Imaging Center scheduled for October

By the Numbers• Last fiscal year, FAMC…..

– Performed 4,885 surgeries– Provided 36,349 physical, occupational and speech

therapy sessions– Assisted in 490 births– Helped 14,137 people in need of emergency care– Made 5,781 home care visits– Completed 43,187 imaging procedures– Conducted 6,616 radiation treatments– Carried out 462,658 laboratory tests– Touched 8,100 people’s lives through the occupational

medicine program– Performed 900 free pre-sports screenings– Served 304,519 meals– Washed 1,074,909 pounds of laundry

Community Benefits• In addition to providing exceptional health care 24/7,

Fremont Area Medical Center offers valuable community services, programs to meet special needs, professional development, cash and in-kind donations.

• In addition, FAMC provided…..– $1,297,969 of traditional charity care– $137,750 of community health education and outreach– $70,040 non-billed community services– $10,047,826 of unpaid costs of public programs

(Medicare and Medicaid shortfalls)– $740,113 subsidized health services

• One of the most significant community benefits contributed by FAMC is uncompensated healthcare – healthcare services provided to the uninsured and underinsured.

What are Community Benefits?

• The unconditional treatment and care provided to those who cannot afford it; and

• A wide range of free and subsidized community services that aid in disease prevention, promote health awareness, advance health technology, and create social and physical conditions in local communities that encouragepositive lifestyles and behaviors.

2005 Nebraska Hospitals Community Benefits Report

• The Nebraska Hospital Association (NHA) publishes an annual community benefits report highlighting how Nebraska’s hospitals are going above and beyond the delivery of essential health care services.

• Reported programs and services reflect Fiscal Year 2004.

Hospitals Caring for their Communities

• In FY 2004, Nebraska’s hospitals provided $632.8 million in care for which they received no reimbursement. These services included under-reimbursement for Medicare and Medicaid services, traditional charity care, community outreach and education, scholarships, subsidized health services and bad debt.

• Fremont Area Medical Center provided $12,296,793 incommunity benefits in FY 2005.

Serving Nebraska’s Uninsured and Underinsured

• One of the most significant community benefits provided by hospitals is “uncompensated health care” – health care services provided to the uninsured and underinsured.

• Uncompensated health care includes:– Traditional charity care– Medicare and Medicaid payment

shortfalls– Other public programs

Serving the Uninsured and Underinsured

• Reporting Nebraska hospitals provided over $421.6 million in traditional charity care, Medicare and Medicaid shortfalls and other public programs.

• Fremont Area Medical Center provided $11,345,795 in these services.

Other Community Benefits

• Other community benefits include:– non-billed community services– medical education– subsidized health services– research– cash and in-kind donations– “other” community benefits, such as

neighborhood improvements, economic development,

and volunteering

Fremont Area Medical Center Community Benefits

• Provided $950,998 in support of the following community programs (partial

list):Health Tracks Hispanic Health FairCommunity Health Programs Support GroupsProject Fit America Sports Injury ClinicCoaches Clinic Football TestingEducational Affiliations Wellness WorksWellness Center Patient TransportationLifeLine Language Services CoordinationPre-Sports Screening/Athletic TrainingHealth Care Explorations Camp & ToursGrandfriends Program/School Partnership

Fair Billing and Collections

• Principles and Guidelines for Financial Aid Practices in Nebraska Hospital Association Member Hospitals– NHA Board approved guidelines that outline

fair and consistent billing and collections policies.

– Fremont Area Medical Center ensures that all patients receive information and understand our billing practices, which include the criteriafor charity care.

Health Care Contributes to the Economy

• In 2002, health care expenditures represented 14% of Gross Domestic Product, approximately $1.5 trillion.

• Unlike sectors that lost vitality during the recent recession, health care grew 2.3%.

• In Nebraska, total hospital net revenue was $3.5 billion and total expenses were $3.2 billion in 2004 (AHA Statistics 2005).

Hospitals are Major Employers

• Hospitals support one out of every nine jobs in the U.S. directly and indirectly.

• In 2002, hospitals employed nearly 5 million people and spent $213 billion on goods and services in addition to employee wages.

• Each hospital dollar spent supports $2 of additional business activity (AHA Statistics 2004).

Employment

• Fremont Area Medical Center is the second largest employer in Dodge County.

• The hospital employs over 900 full and part-time people.

• The hospital helps support many local businesses, such as banks, food service, linens, florists, law firms, insurance agencies, accounting firms, printers, hotels,restaurants, equipment and supplies, etc.

Hospitals Make Healthy Communities

• A strong health care network, in which hospitals play a key role, adds to the attractiveness of a community as a place to settle, locate a business, raise a family or retire.

Nebraska Population

•US Census 2005 Total Nebraska Population Estimate: 1,758,787Source: U.S. Census Bureau, 2005 Population Estimates

Growing Elder Population

• As the Baby Boom generation (those born between 1946 and 1964) reaches retirement age, the growth of the elderly population (65 and over) is expected to accelerate rapidly, increasing the need for health care services.

• The proportion of Nebraska's population classified as elderly is expected to increase from 13.9 percent in 1995 to 21 percent in 2025. (Source: U.S. Census Data – Nebraska)

Increasing Life Expectancy

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10

30

50

70

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1940 1950 1960 1970 1980 1990 2000

male female

Facts about Nebraska Hospitals

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89 91 93 95 97 99 2001 2002 2004 2006

# of Hospitals

Fewer hospitals, growth in urban areas

NE Hospital Outpatient Visits

0

500,000

1,000,000

1,500,000

2,000,000

2,500,000

3,000,000

3,500,000

4,000,000

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004

Visits

NE Hospital Inpatient Admissions

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50,000

100,000

150,000

200,000

250,000

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004

Admissions

Key Issues for Nebraska Hospitals

• Improving patient safety and quality• Health care workforce shortage• Technology requirements/costs• Emergency preparedness• Financial challenges in

Medicare/Medicaid• Uninsured/Underinsured

Quality Initiatives

• Hospital Quality Alliance

• Most Wired Health System

• Magnet Status Designation

• Solucient’s Top 100• Medication Error

Reporting Project• CMS/Premier Hospital

Quality Demonstration Project

• Edgerton Quality Awards

• NHA Quest for Excellence

• Healthgrades.com• Foster G. McGaw Prize• American Hospital

Quest for Quality Prize• Rural QI Steering

Committee• IHI’s 100,000 Lives

Campaign

Hospital Quality Alliance

• Hospital Compare– Voluntary initiative– Over 4,000 hospitals report on up to 20

measures– 70 Nebraska hospitals participate– Information posted to CMS/Medicare

Web site

Patient Safety Act

• In 2005, the Nebraska State Legislature passed the Patient Safety Improvement Act, which helps foster a learning environment and a culture of quality in health care facilities.

• The Act established a reporting structure for medical errors and/or “near misses,” protecting the information reported to it from discovery, and sharing information designed to improve health care delivery systems and reduce the incidence of adverse health events.

Patient Safety Act

• The Act also created a patient safety organization, the Nebraska Coalition for Patient Safety (NCPS), which is comprised of organizations that are committed to achieving excellence in health care delivery: – Nebraska Hospital Association– Nebraska Academy of Physician Assistants– Nebraska Medical Association– Nebraska Nurses Association– Nebraska Pharmacists Association

Health Care Workforce Shortage

• Number of primary care physicians in NE from 1990 to 2001 decreased by 14.8%.1

• Few minorities in health care compared to percentage of general population.2

• In Nebraska, rural hospitals have the severest shortages in health care workers, esp. nurses.

• Dentists are also in shortage in the central and western regions.4

• Pharmacists have the highest vacancy rate at 20%.

1 and 2 The Nebraska Health Information Project 2001 Databook3 NHA Staffing Shortage Survey 20014 The Rural Monitor, Winter 2006

The Registered Nurse Population

• Nationally– Total 2,696,540– 5.4% increase since 1996– Lowest ever increase in four-year

period

• Nebraska – Total 19,580– 4.5% increase since 1996

Age – RNs

• Nationally– 1996: 44.5 years– 2000: 45.2 years

• Nebraska– 1996: 42.8 years– 2000: 45 years– Active practice is a

requirement for licensure

Technology Requirements

• Hospitals need both information system and clinical technology advancements.

• Hospitals and health care are behind banks and grocery stores in information technology

• HIPAA regulations have required Nebraska hospitals to pay millions for training and new software.

• Most of Nebraska’s CAHs built in late 50s – 60s, need renovations to better serve new health care needs and provide medical advancements.

Technology Advancements• Telehealth Network – enables specialists to

review cases across the state, participate in educational programs, meetings, etc.

• Nebraska Health Information Initiative – coalition of stakeholders to develop a secure health information exchange.

• Latest medical technology –

gamma knife, imaging systems, robotics, nanotechnology.

Emergency Preparedness

• Nebraska hospitals are participating in statewide emergency preparedness planning efforts.

• Nebraska hospitals are connected through the Health Alert Network to receive national and state health advisories and alerts.

• Hospitals are preparing for a variety of emergency scenarios, such as: smallpox, mumps, avian flu, West Nile virus, bioterrorism, and natural disasters.

Medicare/Medicaid Dependency

• Dependency on Medicare and Medicaid for payment for majority of CAHs patients.

• Government programs do not pay full cost of providing services.

• Medicaid Reform in Nebraska may shift more people from Medicare/Medicaid to uninsured.

Increasing Uninsured

• Approximately 45 million people are uninsured in the U.S., 15.6% of the population. (Source: US Census Bureau 2003 estimate)

• Approximately 145,000 people (9.9%) are uninsured in Nebraska.(Source: Nebraska Center for Rural Health Research, Dec. 2004)

Fremont Area Medical Center Uninsured

• FAMC provided $1,297,969 in care for patients without health insurance or government coverage for which we received no payment.

Our Community, Our Mission

• Fremont Area Medical Center pursues excellence for our patients.

• We offer comprehensive health care services to everyone who enters our doors, 24-hours a day, 7 days a week.

• Our staff is dedicated to saving lives, improving health care and building a better community.

Community Connections

• Working together to solve the challenges and pursue the opportunities, Fremont Area Medical Center will continue providing the highest quality health care to our community.