County giving away $540 million in public healthcare
By Lou Ortiz
It's hard to imagine businesses giving away their products and surviving, but Jackson Health System does just that while expanding and improving services.
Miami-Dade County's public health system will give away more than $540 million in charity care this fiscal year, to tens of thousands of people who are uninsured and others who have limited health care coverage.
The amount to be spent on charity care is up $6 million over the 2006-07 fiscal year. "It's a very large challenge," said Marvin O'Quinn, the system's chief executive officer.
With a $1.9 billion budget, up from $1.5 billion in 2006, the system provides a wide range of highly specialized medical care to basic health services.
The recipients are mostly county residents who are served through three hospitals and a network of clinics and neighborhood mobile health vans.
In 2006, the system's staff and volunteers totaling more than 27,000 people tended to 773,057 adult and pediatric outpatient visits. Emergency room visits amounted to 191,114 that year, county documents show.
Thousands of other people were inpatients at the two other hospitals, where a variety of surgeries are performed, including kidney, lung and other organ transplants. The system's doctors also delivered 7,873 babies.
"We're meeting the community's needs," Mr. O'Quinn said. "There's still a lot of work to be done."
At Jackson South Medical, the system is moving forward with a $102 million expansion project that will increase the number of beds by 100 to 299, and provide more operating rooms and outpatient care.
The project is intended to ease overcrowding and give residents in South Miami-Dade more access to healthcare, according to the county.
Jackson South had 41,625 outpatient visits in 2006, performed more than 4,700 surgeries, while 35,485 others used its emergency room, documents show.
Groundbreaking for the expansion is expected to take place this spring. The project is scheduled for completion in 2010.
At the other end of the county, at Jackson North Medical Center, the system is partnering with Florida International University's new medical school, to start a teaching program for FIU medical students at the center.
"It will bring academic medicine to that part of the county," said Mr. O'Quinn. "Patients won't have to come to the main campus [Jackson Memorial]."
He said the university's doctors will begin at Jackson North in the spring, and the students will follow in 2011.
At Jackson Memorial, Mr. O'Quinn said that it's premature to assess the potential advantages or disadvantages of the recent purchase of the former Cedars Hospital by the University of Miami.
"Their [medical school] faculty is our medical staff," he said. "But it is too early to tell what the impact [the purchase] will be on our hospital."
Dr. William O'Neill, executive dean for clinical affairs at the university hospital, said recently that Jackson Memorial is a big part of the school's facility.
He said UM will continue to help expand programs at Jackson in pediatrics, obstetrics and heart and kidney transplants.
"Jackson is still a huge part of our program," he said.
Although the county health system is holding its own, the network of countywide medical care is being challenged financially like other public health systems in the United States.
"We've gotten the hospital to a better place than it was a few years ago," Mr. O'Quinn said. "We're in a reasonably stable financial condition."
The system is asking the state once again for $20 million this year to help defray the cost of medical care to the uninsured, and for the federal government not to implement new Medicare rules that could potentially cut payments to the system by $129 million.
Despite the challenges, neither the system nor any of its hospitals is facing the fate of Atlanta's Grady Memorial Hospital, which is experiencing a budget crisis and is in danger of closing.
The same business formula at Grady is used in the Jackson Health System: Caring for the uninsured and underinsured, "except here we have a fair amount of private patients, because of the high level of care we provide," Mr. O'Quinn said.
"We're trying to make sure that what's happening at Grady," he said, "doesn't happen at Jackson."
A number of revenue streams help support the system, including property taxes, commercial insurance, Medicare, Medicaid, ½-cent sales tax and state contributions.
"You've got to have a big vision and have a lot of support to run a public health system and provide quality care," Mr. O'Quinn said. "It's not easy. But I'm proud of where we are."