Earlier this month, The Indianapolis Star published ran articles and an editorial about the percentage of annual revenue local hospitals spend on charity care, and how that compares to the tax breaks they receive as not-for-profit organizations. In 2006, Community Health Network reported charity care at $9.2 million and revenue at $995 million. That same year, the network received tax exemptions worth $33.75 million. The big question: is this fair, based on the percentage of charity care provided?
So what do we mean when we say charity care? Charity care is care provided for which hospitals expect no payment. But this doesn't take into account unreimbursed costs for Medicaid, bills that non-charity patients are unable to pay, the gap between what some services cost to provide vs. what patients are actually billed, and education and research services that are provided as a service to the community. When these items are quantified along with charity care, the total figure is referred to as community benefit.
Community benefit is reported annually by each hospital/health network to the Indiana State Department of Health. For 2006, Community Health Network reported $69.5 million worth of community benefit, a figure that far exceeds the amount of charity care provided and the value of the tax exemptions.
According to Bill Corley, president and CEO of Community Health Network, "Our community's health care needs are great, and the price that we and central Indiana's other not-for-profit organizations pay to meet those needs, above and beyond our reimbursements, is in the hundreds of millions of dollars--far greater than the tax benefits we receive."
Perhaps the question now should be: is charity care alone a fair benchmark for assessing whether not-for-profit health care organizations deserve the tax breaks they receive?
The care of a patient who has experienced the loss of a pregnancy, newborn or infant does not end when the patient goes home from the doctor's office, emergency department or hospital. That is when Community's support programs, known as Open Arms both at Community Hospital Anderson and at Community's Indianapolis hospitals, offer services to help parents through the grieving process. Each December, memorial services are held in Anderson and Indianapolis to bring together families who have experienced a loss.
"We have families who have come for several years in a row," says Joni Cutshaw, R.N., bereavement coordinator for Open Arms. "This is often the one time of the year that parents say their baby's name."
The memorial service at Community Hospital Anderson was held at the hospital on Thursday, December 18. Dick True, chaplain, led the service. A mother who experienced a loss at 38 weeks shared what has helped her get through the holidays. Another mom who lost her baby at 37 weeks sang. Attendees were invited to share their experience with the group, and gathered at the end of the service for refreshments and fellowship. "It's very uplifting to the families," says Ruthie Smith, LPN, maternal child support services coordinator. "It's something that we do in the community that is very special to these families, and they appreciate that we remember them."
The Indianapolis memorial service took place on December 4 at Ellenberger United Church of Christ, near Community Hospital East, and followed a similar format. Approximately 25 families gathered for a sermon offering words of encouragement and a candle-lighting ceremony to remember each loss. This year a 13-year-old, whose mother has experienced three losses, played the harp, and Lorraine Garner, OB tech at Community Hospital North, played the organ. At the end of the service, families gathered for refreshments and fellowship. Parents were presented with a memory book and angel ornament, compliments of the Community Health Network Foundation. "This is an opportunity for parents to remember their baby at the beginning of the season, and it helps them to then enjoy their holiday," says Cutshaw.
Community's pregnancy, infant and newborn loss support services are available to all parents, regardless of whether they are patients at Community. Likewise, programs at other area hospitals welcome parents who may have experienced a loss at Community. For more information on these memorial services and other programs throughout the year, please visit https://www.ecommunity.com/openarms/.
Community Health Network, The Indiana Heart Hospital and cardiovascular physician practices are uniting services, creating a new structure to deliver an integrated model for heart and vascular care in central Indiana. Beginning January 1st, these integrated services will be called Community Heart and Vascular to reflect the comprehensive cardiovascular services offered, including hospital, ambulatory and physician sites of care.
"We strongly believe that integrating hospital and physician care more closely will benefit patients," says Tom Malasto, current CEO of The Indiana Heart Hospital and CEO of Community Heart and Vascular. “These new integrated relationships set the highest standards for heart and vascular care and will allow us to meet a growing demand for cardiovascular services in the area.”
The integrated model will unite cardiology, vascular and cardiothoracic physician practices with The Indiana Heart Hospital, part of Community Health Network, to form one cohesive entity.
Community Heart and Vascular will consist of the existing specialty heart hospital (The Indiana Heart Hospital); cardiovascular services at four acute care Community Hospitals (Community Hospitals East, North, South and Anderson); and 31 physicians (cardiologists, vascular and cardiothoracic surgeons) from five physicians groups, totaling over 600 combined employees. The physician groups include: Cardiothoracic Surgeons of Indiana; Indiana Heart Associates; Jetty Heart Clinic; Vascular Physicians of Indiana; Russell Dilley, M.D.; and Dennis Jacob, M.D.
“Community Heart and Vascular is unique in that all aspects of the program are co-managed with physicians,” says Ramu Yeleti, M.D., president of Community Heart and Vascular. “Patients will benefit from having access to a full continuum of integrated cardiovascular services.”
Advantages of integration include the development of innovative clinical care programming; the ability to better harmonize and leverage related clinical services, such as primary care, emergency departments and intensive care services; the expansion of clinical research and teaching opportunities; a paradigm shift to the longitudinal care of the patient; alignment of economic and operating efficiencies; and the ability to effectively apply physicians’ time and talents to program development, leadership and management at full program levels.
“Combining forces will have a very positive impact in the care of heart and vascular patients across the network,” says Bill Corley, president and CEO of Community Health Network. “This affiliation with the specialists we have worked with for several years will integrate the top-quality care and services of The Indiana Heart Hospital and physician practices with the other services of Community Health Network. This is the most desired and cost-effective way to deliver the best care for our patients.”
All physician practices will continue to care for patients at the same office locations. The Indiana Heart Hospital will continue to provide care at its current locations, and on the campuses of Community Hospital East, North and South in Indianapolis.
Opened as the nation’s first all-digital heart hospital, the programs and services of The Indiana Heart Hospital have been nationally recognized for clinical quality measures. Recently, Thomson Reuters Healthcare rated the hospital as one of the nation’s top 100 cardiovascular hospitals for the third consecutive year. The integration of cardiovascular services will reinforce the exceptional quality of programs network-wide.
The Indiana State Department of Health (ISDH) is alerting health care providers about oseltamivir resistance of the currently circulating influenza A (H1N1) virus.
Providers are strongly encouraged to submit specimens to the ISDH Laboratory for surveillance testing and should contact Katie Masterson at kmasterson@isdh.in.gov or 317-921-5843. The influenza specimen submission form is available on the ISDH web site located at http://www.in.gov/icpr/webfile/formsdiv/35212.pdf. Facilities are invited to participate in influenza sentinel surveillance and should contact Shawn Richards at srichard@isdh.in.gov or 317-233-7125.
CDC published an Influenza Update in the MMWR on Friday, December 12, 2008 describing these preliminary data. The entire document is located at http://www.cdc.gov/mmwr/. Highlights of the document include:
Recommendations regarding the use of antiviral medications might be revised if surveillance data indicate a substantial and widespread increase in the prevalence of oseltamivir-resistant influenza viruses in the United States.
Alternatives for antiviral treatment in the setting of widely circulating oseltamivir-resistant viruses have been suggested. These treatment options, which might include preferential use of zanamivir or therapy with a combination of antivirals for certain patients, have been outlined in the ACIP 2008 influenza recommendations. Currently, the neuraminidase inhibitors oseltamivir and zanamivir remain the recommended medications for treatment and chemoprophylaxis of influenza.
Vaccination remains the cornerstone of influenza prevention efforts. Influenza vaccination can prevent influenza infections from strains that are sensitive or resistant to antiviral medications.
CDC continues to conduct surveillance to provide up-to-date recommendations regarding prevention and treatment of influenza. Influenza surveillance reports for the United States are posted online weekly during October-May and are available at http://www.cdc.gov/flu/weekly/fluactivity.htm. Additional information regarding influenza viruses, influenza surveillance, influenza vaccine, and avian influenza is available at http://www.cdc.gov/flu.
Alex Pope, 9, president of Spreading Sunshine, was honored November 26 with the Community Hospital North Hero Award for his efforts to create an exceptional patient and family experience for young children who visit the emergency department.
“If you are waiting outside for your family member to get better, like my sister had to wait for me when I had my bad asthma attack, it can be very boring and long,” Pope says. “When I was there, I was scared and stuck in a bed with nothing to do but watch ‘Hee-Haw.’ It was not fun and there was nothing to get my mind off of my asthma attack and that it was so hard for me to breathe. I thought I was going to stop breathing and might even die. I decided that it would be good to bring stuff in for kids so they can get their minds off of their injury or sickness, or even their family member’s injury or sickness.”
More than 250 mothers who deliver at Community East, North and South each year leave the hospital without essential supplies for their newborns. It may take a couple of weeks after the baby is born for mothers to access WIC (Women, Infants, and Children) services. Thanks to a collaboration between Community case management, Community Home Health Services, the Community Health Network Foundation and the Hutson School, these mothers will go home with a diaper bag full of supplies they will need for their newborn.The following was forwarded by a colleague at Northpoint Pediatrics, who wanted to share this information with the community. Thanks for the input, Linda
The Centers for Disease Control and Google have teamed up to create a new web site. The CDC hopes this new site will serve as an early warning system for flu outbreaks. CDC said the information will allow them to alert hospitals, clinics and doctors to stock up on tests and drugs before an outbreak intensifies in their areas
It is a very user-friendly site. Take a look at it and let us know what you think... http://www.google.org/flutrends/
Our next Pediatric Grand Rounds speaker is Muhammad Munir, M.D., with Serenity Medical Associates. Dr. Munir is a child and adolescent psychiatrist. Dr. Munir will be providing a lecture titled “Management of Mood Disorders in the Primary Care Setting”. In this lecture, Dr. Munir will highlight the importance of mental health in pediatric care settings. He will provide an overview of management of mood disorders in children and adolescents. He will also illustrate the importance of collaboration for delivery of care to pediatric populations.
These sessions are provided monthly and are eligible for CME. We provide these offerings on the first Wednesday of each month at 7:30 a.m. in the multi-service conference rooms on the 3rd floor of the professional building. Breakfast refreshments will be served.
If you have any questions about this, you can contact Dr. Robert Lindeman at Community North’s pediatric unit at 317-621-5474.
Daron Earlewine, young adult pastor at East 91st Street Christian Church in Indianapolis, made a reference to Community Hospital North's state-of-the-art maternity unit in a November 30 sermon. Click here to hear the excerpt. Or, you can listen to the entire sermon.
To learn more about Community Hospital North's exceptional approach to maternity care, watch our video:
The Indiana Heart Hospital is the only hospital in the city to be named for the third consecutive year to the 100 Top Hospitals for cardiovascular care in the tenth annual study released by Thomson Reuters. The top performing 100 hospitals are identified as setting the nation’s benchmarks for clinical and managerial excellence in cardiovascular care. The winners and study results will be published by Modern Healthcare magazine.
“These hospitals provide enormous value to their communities because heart disease is still the nation’s number one killer,” says Jean Chenoweth, senior vice president for performance improvement and 100 Top Hospitals programs in the Healthcare business of Thomson Reuters. “They have set the new national standard for cardiovascular disease outcomes, process of care, efficiency and lower costs.”
The study, 2008 Thomson Reuters 100 Top Hospitals: Cardiovascular Benchmarks for Success, ranked the performance of 970 hospitals around the country by analyzing clinical outcomes for patients diagnosed with heart failure and heart attacks, and for those who received coronary bypass surgery and angioplasties. To qualify, hospitals must achieve high scores across eight equally weighted performance criteria that reflect use of evidence-based medicine, good clinical outcomes, high procedure volume, great efficiency, and reasonable cost.
"The Indiana Heart Hospital is one of the most innovative hospitals in the country," said CEO Tom Malasto. "To receive this honor again speaks to the quality of our employees and physicians, assisted by our state-of-the art technology. This award exemplifies our focus on delivering a safe and exceptional experience for both patients and their families."
The study found that the 100 Top Hospitals cardiovascular award winners, as a group, performed 63-percent more bypass surgeries and 42-percent more angioplasties than peer hospitals. According to Thomson Reuters, this suggests that performance of bypass surgery is increasingly performed in centers of excellence. In addition, Thomson Reuters says the mortality rate for bypass surgery was 26-percent lower in the 100 Top Hospitals cardiovascular winners. The award-winning hospitals demonstrated higher performance on the evidence-based core measures published by the Centers for Medicare and Medicaid Services and cost $1,542 less per case, on average.
The Indiana Heart Hospital will be formally recognized during a presentation at the 2009 100 Top Hospitals Summit in Dana Point, California, in June.
A complete list of winners and study results are available at www.100tophospitals.com and www.thomsonreuters.com
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