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For additional questions or information regarding this publication, please contact
Mercy Planning Research at 314-628-3611
Our Mission As the Sisters of Mercy before us,
we bring to life
the healing ministry of Jesus
through our compassionate care
and exceptional service.
Our Values Dignity | Justice | Service | Excellence | Stewardship
Our Vision We are the people
of Mercy Health Ministry.
Together, we are pioneering
a new model of care.
We will relentlessly pursue
our goal to get health care right.
Everywhere and every way
that Mercy serves,
we will deliver a
transformative health experience.
Mercy Charism Bias for Action: Practical; anticipating and responding to need; getting things done
Entrepreneurial Spirit: Seeing what needs to be done; having the courage to take risks; innovative; promoting system change
Hospitality: Welcoming and accepting; gracious; forgiving
Right Relationships: Speaking your truth with honesty; resolving differences; holding each other accountable; collaborating
Fullness of Life: Sense of joy; vibrancy for life even amongst suffering; magnanimous; authentic and relevant
Mercy Health WHO WE ARE
Mercy Health WHERE WE SERVE
UTILIZATION (FY11)
4,041 staffed beds
576,947 ED visits
6,646,738 outpatient visits
160,733 inpatient discharges
HOSPITALS
26 acute care hospitals
5 managed hospitals
3 heart hospitals
2 children's hospitals
1 rehab hospital
AMBULATORY SERVICES
271 clinic locations
8 outpatient surgery centers
14 urgent care centers
18 convenient care centers
MEDICAL STAFF & CO-WORKERS
38,000 co-workers
1,691 integrated physicians
618 advanced practitioners
5,276 medical staff * *includes integrated and non-integrated physicians
FINANCIALS (FY11)
$4.0 billion total operating revenue
$4.6 billion total assets
$272 million in community services
Mercy is the 6th largest Catholic Health System in the US (28th overall) based on Net Patient Service Revenue. Source: Modern Healthcare Survey, May 2012
Mercy serves in more than 120 communities across seven states. Nearly 8 million people live in the areas where we serve—3 million of those lives are touched by Mercy annually.
Total population of all Mercy Primary Service Areas including Sponsored Community Ministry areas: Webb County (Laredo, TX); Jefferson, Orleans and St. Tammany Parishes (New Orleans & Mandeville, LA); and Hinds & Rankin Counties (Jackson, MS).
As of July 2012
“When our Founder Catherine McAuley opened the first House of Mercy in Dublin, Ireland, in 1827, the needs were great. The needs today in the communities we serve across the Midwest continue to grow, and we continue to find ways to serve those needs. It’s in our DNA to serve those who are economically poor and to work for change on their behalf.”
– Lynn Britton, President and CEO of Mercy
Springfield 30% St. Louis/
Washington 25%
Oklahoma City/ Ardmore
14% Fort Smith 10%
Joplin 9%
Hot Springs 6%
Rogers 3%
SE KS 3%
Mercy Charity FY11 = $216,941,672 % Distribution by Community
Traditional Charity Care and Medicaid (unreimbursed costs)
Source: Mercy Finance; Mercy Communities, FY11
OUR SERVICES TO THE COMMUNITY
Mercy’s heritage and purpose is focused on the well-being of the communities we serve. Whether it’s much needed funds for domestic violence shelters, teen moms, families in crisis or counseling for those still suffering from the devastating effects of last year’s EF5 tornado in Joplin, Mercy continues to respond to the needs of the communities it serves.
Mercy works closely with several sponsored community partners to improve access to health care resources, provide medical equipment and supplies, advocacy, and spiritual and clinical aid to people in need through subsidized health services, preventive screenings, medical education and outreach ministries.
During FY11, Mercy invested nearly $272 million to help economically disadvantaged members of our communities.
The pie charts to the left depict Mercy Charity and Community Benefits for fiscal year 2011.
Springfield 36%
St. Louis/ Washington
22%
Mercy Ministry Office 12%
Joplin 10%
Laredo 6%
Oklahoma City/ Ardmore
5%
Fort Smith 5%
Hot Springs 3%
Rogers 1%
SE KS 0.3%
Mercy Community Benefits FY11 = $55,163,815 % Distribution by Community or Ministry
Source: Mercy Finance; Mercy Communities, FY11
Mercy Health SERVICES TO THE COMMUNITY
Photo of the 5th Annual Nixa Bike Ride which raises health awareness and funding in the community.
More Providers
Expand Footprint
Underserved Populations
Children
Telemedicine
Specialty Care
Renewal
Tactical Plan
Integrate and Align Providers
Leverage Technology
Broaden Access and Improve Continuity
Build Lifelong Customer Relationships
Influence Health Care Financing
Center for Innovative Care
Core Strategy
Realization
Our vision for delivering a New Model of Care manifested.
We asked our communities to help us define what the new model of care would look like.
From the planning process sprang objectives targeting local, regional and virtual services.
Executing our tactical plan requires focus.
The work of the day is defined by our seven Key Initiatives.
2015 New Model of Care
Mercy Health STRATEGIC DIRECTION
Growth Goals (2x)
Service Definition (Local, Regional. Virtual)
Margin Goals (4%)
Capital Investments
Facilities, Doctors & Philanthropy
Care Model Implementation
Cost Reduction Care Efficiency
Infrastructure & Operational Investments
STRATEGIC DIRECTION
The following pages depict Mercy’s strategic direction beginning in June 2009 with the adoption of a new care model and Mercy’s Core Strategies, growing into a community input-based Tactical Plan, and culminating into our seven Key Initiatives.
Each platform described in this section represents a natural evolution in Mercy’s strategic direction with the ultimate goal of delivering a transformative health experience to our communities by 2015.
Key Initiatives
Managing to Medicare
Performance Reengineering
Palliative Care
Ministry Growth
People Promise
Care Model
Clinical Integration
2009
2010
2011
2012
More Providers
Expand Footprint
Underserved Populations
Children
Telemedicine
Specialty Care
Renewal
Tactical Plan
Integrate and Align Providers
Leverage Technology
Broaden Access and Improve Continuity
Build Lifelong Customer Relationships
Influence Health Care Financing
Center for Innovative Care
Core Strategy
Realization
Our vision for delivering a New Model of Care manifested.
We asked our communities to help us define what the new model of care would look like.
From the planning process sprang objectives targeting local, regional and virtual services.
Executing our tactical plan requires focus.
The work of the day is defined by our seven Key Initiatives.
2015 New Model of Care
Mercy Health STRATEGIC DIRECTION
Growth Goals (2x)
Service Definition (Local, Regional. Virtual)
Margin Goals (4%)
Capital Investments
Facilities, Doctors & Philanthropy
Care Model Implementation
Cost Reduction Care Efficiency
Infrastructure & Operational Investments
Key Initiatives
Managing to Medicare
Performance Reengineering
Palliative Care
Ministry Growth
People Promise
Care Model
Clinical Integration
2009
2010
2011
2012
• Integrate and align physicians and advanced practitioners The integrated model will create a coordinated system of care that optimizes the roles of primary and specialty physicians as well as advanced practitioners, aligns incentives and supports improved outcomes.
• Leverage technology We will use technology to its fullest potential to improve coordination of care, access to services, clinical outcomes, safety and productivity.
• Broaden access and improve continuity of services By providing access to multiple touchpoints of care and reducing barriers, the redefined model will ease the path our customers take through the care process.
• Build lifelong customer relationships Every customer encounter will be a Mercy brand experience that builds loyalty to Mercy.
• Influence transformation of health care financing We will work with area payers to develop new payment methodologies and advance coordination of care management.
• Develop the Center for Innovative Care To accomplish and sustain the work, we will create a center for coordinating, supporting and constantly advancing all aspects of the care model.
Mercy Health STRATEGIC DIRECTION
By 2015, Mercy will deliver a new model of care.
Mercy’s Core Strategies
More Providers
Expand Footprint
Underserved Populations
Children
Telemedicine
Specialty Care
Renewal
Tactical Plan
Integrate and Align Providers
Leverage Technology
Broaden Access and Improve Continuity
Build Lifelong Customer Relationships
Influence Health Care Financing
Center for Innovative Care
Core Strategy
Realization
Our vision for delivering a New Model of Care manifested.
We asked our communities to help us define what the new model of care would look like.
From the planning process sprang objectives targeting local, regional and virtual services.
Executing our tactical plan requires focus.
The work of the day is defined by our seven Key Initiatives.
2015 New Model of Care
Mercy Health STRATEGIC DIRECTION
Growth Goals (2x)
Service Definition (Local, Regional. Virtual)
Margin Goals (4%)
Capital Investments
Facilities, Doctors & Philanthropy
Care Model Implementation
Cost Reduction Care Efficiency
Infrastructure & Operational Investments
Key Initiatives
Managing to Medicare
Performance Reengineering
Palliative Care
Ministry Growth
People Promise
Care Model
Clinical Integration
2009
2010
2011
2012
Mercy Children’s Services
Acute and preventive care
Large pediatric provider base
Pediatric specialists & sub-specialists
School-based health care
HealthTeacher
Outpatient Care
specialty
care
Orthopedics
Oncology
Cardiovascular
Other service lines delivered as an overall patient experience
Virtual radiology
Remote disease management
eICU, telestroke and teleneurology
Direct access to primary care
Pediatric cardiology
High risk pregnancy
Mental health
Post-op follow-up
renewal
Campus expansions and renovations
Improved care
settings
Replacement hospitals in some rural communities
As a result of listening to our communities, we discovered a shared vision for a future where our children will be healthier, technology will bring us closer together and into a more personal environment of care, and access to care will be within reach for more people. This is our continual and relentless pursuit to get health care right.
Mercy Health STRATEGIC DIRECTION
tele-
medicine
New primary care physicians
New specialty care providers
Nurse practitioners, physician assistants, care managers to coordinate care
more
providers children
under-
served
populations
Medicaid and indigent clinics
Project Access
Mobile services
Retail clinics
New communities
New locations
Align with regional hospitals
New and unique care settings
expanded
footprint
Tactical Plan
More Providers
Expand Footprint
Underserved Populations
Children
Telemedicine
Specialty Care
Renewal
Tactical Plan
Integrate and Align Providers
Leverage Technology
Broaden Access and Improve Continuity
Build Lifelong Customer Relationships
Influence Health Care Financing
Center for Innovative Care
Core Strategy
Realization
Our vision for delivering a New Model of Care manifested.
We asked our communities to help us define what the new model of care would look like.
From the planning process sprang objectives targeting local, regional and virtual services.
Executing our tactical plan requires focus.
The work of the day is defined by our seven Key Initiatives.
2015 New Model of Care
Mercy Health STRATEGIC DIRECTION
Growth Goals (2x)
Service Definition (Local, Regional. Virtual)
Margin Goals (4%)
Capital Investments
Facilities, Doctors & Philanthropy
Care Model Implementation
Cost Reduction Care Efficiency
Infrastructure & Operational Investments
Key Initiatives
Managing to Medicare
Performance Reengineering
Palliative Care
Ministry Growth
People Promise
Care Model
Clinical Integration
2009
2010
2011
2012
Mercy Health STRATEGIC DIRECTION
More Providers
Expand Footprint
Underserved Populations
Children
Telemedicine
Specialty Care
Renewal
Tactical Plan
Integrate and Align Providers
Leverage Technology
Broaden Access and Improve Continuity
Build Lifelong Customer Relationships
Influence Health Care Financing
Center for Innovative Care
Core Strategy
Realization
Our vision for delivering a New Model of Care manifested.
We asked our communities to help us define what the new model of care would look like.
From the planning process sprang objectives targeting local, regional and virtual services.
Executing our tactical plan requires focus.
The work of the day is defined by our seven Key Initiatives.
2015 New Model of Care
Mercy Health STRATEGIC DIRECTION
VISION We are the people of Mercy Health Ministry. Together, we are pioneering a new model of care. We will relentlessly pursue our goal to get health care right.
Everywhere and every way that Mercy serves, we will deliver a transformative health experience.
Growth Goals (2x)
Service Definition (Local, Regional. Virtual)
Margin Goals (4%)
Capital Investments
Facilities, Doctors & Philanthropy
Care Model Implementation
Cost Reduction Care Efficiency
Infrastructure & Operational Investments
Key Initiatives
Managing to Medicare
Performance Reengineering
Palliative Care
Ministry Growth
People Promise
Care Model
Clinical Integration
2009
2010
2011
2012
Mercy Health SPONSORED COMMUNITY MINISTRIES
Mercy Sponsored Community Ministries, located in Texas, Louisiana and Mississippi, provide health care and public support through Mercy Ministries of Laredo, Mercy Family Centers and the Mississippi Health Advocacy Program.
Mercy Health SPONSORED COMMUNITY MINISTRIES
Mercy Ministries of Laredo
Mercy Ministries of Laredo, in the tradition of the Sisters of Mercy, strives to address the needs of all persons—especially those who are economically poor and marginal—by providing primary health care, health education and social services in Laredo, Texas and surrounding communities. The Ministry demonstrates special concern for the needs of women and children while promoting family values and collaborates with other providers and partners who share in Mercy’s mission and values.
Primary Health Care Services
Mercy Clinic in Laredo offers women’s health services, general medicine for women and men, health education, a diabetic center, medication and cancer assistance programs, school physical exams, the Promotoras Program (consisting of five community health workers who help patients navigate the health system and provide health education and follow-up), social services and advocacy. The clinic offers these services at its primary location, in community self-help centers and in underserved areas with its mobile medical van. The health services are provided by nurse practitioners and, when indicated, patients are referred to local physicians who collaborate with Mercy and have agreed to see the patients for specific conditions in their offices at Medicaid rates.
Nearly 100% of the patients who visit Mercy Clinic in Laredo are uninsured and have limited financial resources, making it difficult for them to get health services anywhere else.
Casa de Misericordia (CASA)
CASA is a domestic violence shelter with both residential and outreach components. It serves over 200 women and almost 600 children annually.
While many domestic violence shelters provide a safe haven for victims of physical violence, CASA also addresses their mental, emotional, legal, educational and social needs. An educational center provides classes in language and job skills, exercise and support groups, and after-school tutoring for children. The shelter’s vision statement proclaims the belief “that battered women, despite all they have endured, can reclaim their lives by receiving comprehensive, holistic services and consistent long-term support.” CASA is a founding member of the Webb County Domestic Violence Coalition.
Mercy Health SPONSORED COMMUNITY MINISTRIES
Mississippi Health Advocacy Program (MHAP)
Established in 1992 by a grant from the Sisters of Mercy Health System, the Mississippi Health Advocacy Program (MHAP) is a non-profit, non-partisan public interest health advocacy organization. MHAP combines research, analysis and grass-roots organizing to improve health policies, practices and funding in Mississippi, especially in support of the state's poor and underserved population. MHAP promotes health system change by developing and monitoring implementation of innovative health and human services policies. MHAP works to make health policy and funding patterns more responsive to health needs by providing data and policy information to lawmakers through testimony, position papers and informal discussions throughout the legislative process. The program also provides information and support to front-line workers and communities as they work to address problems at the local level.
Mercy Family Center
Mercy Family Center, founded in 1992, is a multidisciplinary outpatient behavioral health clinic for children, adolescents and their families providing quality assessment and intervention services that are accessible to people of all income levels.
Mercy Family Center has locations in Metairie, Mandeville and the greater New Orleans area in Louisiana. Mercy Family Center is a primary referral site for the identification and treatment of Attention Deficit/Hyperactivity Disorder (AD/HD), Autism Spectrum Disorders, and other childhood disorders. Treatment emphasizes behavior change, problem-solving and promotion of self-esteem for the individual and the family.
Mercy Health SPONSORED COMMUNITY MINISTRIES
Mercy Family Center (continued)
Mercy Learning Center Provides academic support to students identified with learning style differences. The goal of Mercy Learning Center is to help these children acquire the necessary oral and written communication and mathematics skills to be successful in school and eventually in life. In spite of remediation services provided within the schools, these children are not keeping up with the skill acquisition pace of their peers, resulting in their learning gap increasing with age. Without appropriate instruction and support, these children often become discouraged as adolescents and eventually drop out of school causing additional problems for their families and our communities.
Project Fleur-de-lis TM
An intermediate and long-term school-based mental health service model for children who have been exposed to traumatic events as a result of natural and man-made disasters. This collaborative endeavor involving key entities within schools (Catholic, public, public charter, and private), Catholic Healthcare and Catholic Social Services in the greater New Orleans area is currently working with 60 schools encompassing over 29,500 eligible students.
Mercy Community Hope Project
A partnership with Catholic Charities of New Orleans and other community organizations to respond to the stress on children, parents and school staff brought about by exposure to the BP oil disaster. The oil spill in the coastal parishes is yet another traumatic event that has affected all populations living in these areas. The project will make a difference in the lives of participants by introducing the skills necessary to reinforce the resiliency and coping mechanisms needed to reduce or prevent risk behavior due to the traumatic circumstances surrounding the oil spill.
Mercy Health COMMUNITY HEALTH & ACCESS GRANTS
Catherine’s Fund
Beginning in 1991, Catherine’s Fund was established as a means to encourage new and innovative ways of responding to issues that improve community health and quality of life, especially for people who are economically poor. At a funding level of $1 million dollars payable over a three-year period, this fund is intended to have a greater impact on the community in which it is granted than Mercy’s other grant programs.
The Catherine’s Fund award for FY11-FY13 will be utilized to implement Project Access across the Mercy Ministry. Project Access is designed to increase health care access and provide primary prevention strategies for those individuals with unmet health-related needs. The target population for potential participants are those with chronic illness who are using the Emergency Department for their health care needs. These patients are uninsured and without a primary care physician to manage their illness. Key programming strategies include access to primary and preventive care through a medical home, care coordination and education by care managers with 24/7 telephonic access to nurses for self-care advice and triage, and medication assistance. In FY12, hospitals in Mercy communities engaged in a plan to implement Project Access. Funds in FY13 will be dedicated to executing these local plans and expanding the target populations served.
Mercy Caritas Fund
The purpose of Mercy Caritas is to provide funding for community-based programs that improve community health and well-being, with particular concern for people who are economically poor. Annual awards total $500,000 with a maximum award of $50,000 to any single recipient. In FY12, 20 different programs were supported through Mercy Caritas funding. Awards are granted for a twelve-month period. Access to health and social services, quality of life improvements, prevention/wellness activities, and systemic change efforts are areas of focus that receive priority funding consideration. Programs awarded grants in FY12 provide access to health care, wellness education, dental care, mental health services, medication assistance, support for children and new mothers, and various other programs that promote health and assist with the management of chronic illnesses.
Catherine McAuley Area of Greatest Need Fund
The Catherine McAuley Area of Greatest Need Fund (formerly known as the Mercy Make a Difference Fund) is designated annually through a grant process to areas within Mercy demonstrating the greatest need. Each year, co-workers associated with the Ministry Office are invited to participate in a co-worker giving campaign known as Mercy Way. Gifts designated to this fund in the past have been used to support Mercy Ministries of Laredo in purchasing a new mobile health van, provide medical equipment and other furnishings for a community outreach clinic in an underserved area of Southwest Missouri, and in support of medication assistance programs in Springfield, MO and Laredo, TX. Grant amounts vary from $100,000 to $150,000 annually. In FY12, $100,000 was split between two dental clinics, one in Washington, MO and one in Fort Smith, AR.
Saint Louis PRIMARY SERVICE AREA
The St. Louis Primary Service Area (PSA) comprises 194 zip codes in east central
Missouri and west central Illinois
MO
IL
Private 61%
Medicare 14%
Uninsured 13%
Medicaid 12%
DEMOGRAPHICS St. Louis Service Area Missouri 2011
US 2011 2011 2016 % Growth
Total Population 2,738,424 2,789,850 2% 6,015,487 310,650,750
0-17 24% 24% 0% 24% 24%
18-44 Females 18% 17% -2% 18% 18%
18-44 Males 17% 17% -0.4% 18% 19%
45-64 27% 27% 2% 26% 26%
65+ 13% 15% 14% 14% 13%
Median Age 38 - - 38 37
White 75% 74% 1% 81% 64%
Black 18% 19% 3% 11% 12%
American Indian <1% <1% 11% 1% 1%
Asian/Pacific Islander 2% 2% 16% 2% 5%
Multiracial and Other 2% 2% 12% 2% 2%
Hispanic (of any race) 3% 3% 19% 4% 16%
Speak Spanish in Home 2% - - 3% 12%
Total No. of Households 1,087,193 1,106,372 2% 2,393,904 116,862,390
Households with Children 33% - - 33% 34%
HH Income Under $15K 11% - - 14% 13%
HH Income Over $75K 31% - - 25% 30%
Average HH Income $ 67,147 - - $ 58,797 $ 67,529
Some High School 8% - - 9% 9%
High School Graduate/GED 28% - - 33% 29%
Some College 31% - - 29% 28%
Bachelor’s Degree or greater 29% - - 25% 28%
MAJOR EMPLOYERS
Mercy East Communities has over 9,500 co-workers, joining three other health care providers (BJC, SSM and Tenet) in the St. Louis Metro area with workforces exceeding 5,000.
Below are the largest employers (all industries) with employment size of 10,000 or greater:
Hypertension 31%
Arthritis 24%
Asthma 13%
Diabetes 9%
COPD 5%
Coronary Heart Disease 5%
Angina 2%
Congestive Heart Failure 2%
CHRONIC DISEASE
Within the 194-zip code St. Louis Service Area, the following chronic conditions have been identified among the adult (18+) population:
In addition, 3% have had a stroke 4% have had a heart attack, and 5% are living with some type of cancer
Source: Thomson Reuters Continuum of Care, 2011
Saint Louis DEMOGRAPHICS
Note: St. Louis Service Area consists of 194 zip codes in Missouri and Illinois; Education Level based on population age 25+ Source: Thomson Reuters, 2011
Rac
e &
Eth
nic
ity
Age
Gro
up
s H
ou
seh
old
s Ed
uca
tio
n
Health Factor St. Louis County Missouri
National Benchmark
Adult Smoking (% smoking >= 100 cigarettes) 18% 24% 14%
Adult Obesity (% with BMI >= 30) 29% 31% 25%
Physical Inactivity (% of adults age 20+ not active) 25% 28% 21%
Excessive/Binge Drinking 19% 17% 8%
Teen Birth Rate (per 1,000 females age 15-19) 27 44 22
Children in Poverty (% of children under 18 in poverty) 14% 21% 13%
Preventable Hospital Stays (per 1,000 Medicare enrollees) 65 75 49 Sources: (state) Overall Health Ranking – America’s Health Rankings, 2011, provided by United Health Foundation; (county) Overall Health Ranking and Health Factors table – 2012 County Health Rankings provided by the Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute
COMMUNITY HEALTH MEASURES
Overall Health Ranking: Missouri = 40 (/50 states); St. Louis County = 20 (/115 counties) Rankings are out of total number of states or reporting counties. The lower the number, the healthier the community.
Below are some of the factors which attribute to community health.
Source: Mercy Human Resources, April 2012; St. Louis Regional Chamber & Growth Association (RCGA), 2011
BJC HealthCare Schnucks (grocer)
Boeing Defense, Space & Security Walmart
Scott Air Force Base Washington University
SSM Health Care
Source: Thomson Reuters Insurance Coverage Estimates, 2011
Private 57% 56% Medicare 16% 14% Medicaid 13% 14% Uninsured 15% 16%
US MO INSURANCE COVERAGE
8.4% 7.4%
8.2%
UNEMPLOYMENT RATE
Change over 12 months
↓0.8% MSA*
↓1.3% Missouri
↓0.7% US
*St. Louis, MO-IL Metropolitan Statistical Area Note: US & State rates are seasonally adjusted; MSA, non-seasonally adjusted Source: US Dept. of Labor – Bureau of Labor Statistics
MARCH 2012
1a
1b
2
12
33
22
31
20
18
25
3
10 28
16 17
8 15
13 6
14 4 7 26
23
30
29
32
9
11
21 1
Saint Louis REGIONAL PROVIDER LANDSCAPE
The map below depicts all inpatient hospitals and freestanding general outpatient surgery centers in the St. Louis Service Area.
19
24
27
5
Freestanding General Outpatient
Surgery Center
Mercy Health
BJC HealthCare
SSM Health Care
St. Anthony’s Med Ctr
Physician Owned
IndependentSource: Buxton ASC database, 2012
Hospitals (*indicates on-site outpatient surgery center) Health System Affiliation
Mercy Hospital St. Louis* Mercy
Mercy Heart & Vascular Hospital (on campus) Mercy
Mercy Children's Hospital (on campus) Mercy
Mercy Hospital Washington* Mercy
Mercy Rehabilitation Hospital St. Louis Mercy & Centerre Healthcare
Barnes-Jewish Hospital* BJC HealthCare
Missouri Baptist Medical Center* BJC HealthCare
Christian Hospital* BJC HealthCare
St. Louis Children's Hospital* BJC HealthCare
Barnes-Jewish St. Peters* BJC HealthCare
Alton Memorial Hospital* BJC HealthCare
Progress West HealthCare Center* BJC HealthCare
Barnes-Jewish West County* BJC HealthCare
Missouri Baptist Sullivan Hospital* BJC HealthCare
SSM DePaul Health Center* SSM Health Care
SSM St. Mary's Health Center* SSM Health Care
SSM St. Joseph Health Center* (St. Charles, MO) SSM Health Care
SSM St. Joseph Health Center (Wentzville, MO) SSM Health Care
SSM St. Joseph Hospital West* (Lake St. Louis, MO) SSM Health Care
SSM St. Clare Health Center SSM Health Care
SSM Cardinal Glennon Children's Medical Center* SSM Health Care
Hospitals (*indicates on-site outpatient surgery center) Health System Affiliation
St. Anthony's Medical Center* St. Anthony's
St. Luke's Hospital* St. Luke's
St. Elizabeth's Hospital* Hospital Sisters Health System
Touchette Regional Hospital* Southern IL Health Care Foundation
St. Alexius Hospital* Success Healthcare
Des Peres Hospital* Tenet Healthcare
St. Louis University Hospital* Tenet Healthcare
Gateway Regional Medical Center* Community Health Systems
CenterPointe Hospital Independent
Jefferson Regional Medical Center Independent
Anderson Hospital* Independent
Memorial Hospital* Independent
Saint Anthony's Health Center* Independent
Lincoln County Medical Center* Independent
20
21
22
23
24
25
26
Saint Louis REGIONAL PROVIDER LANDSCAPE
1
1a
1b
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
29
30
27
31
32
33
35
28
INPATIENT MARKET SHARE 12%
TOTAL ASSETS $718M
NET PATIENT REVENUE $892M
OPER. PROFIT MARGIN 2.4%
• Non-profit, owned by BJC HealthCare
• Eight general acute care hospitals in the region, a pediatric specialty hospital, a network of outpatient health centers offering physician and urgent care services, home health agencies, fitness rehabilitation center, long-term care facilities, and onsite wellness programs
• BJC Medical Group, affiliated with Washington University School of Medicine, consists of 300 physicians and advanced practice providers in 80 locations
• Rehabilitation Institute of St. Louis, a 96-bed freestanding acute rehab hospital with 1,500 inpatient discharges in FY11, is a joint venture with HealthSouth
INPATIENT MARKET SHARE 29%
TOTAL ASSETS $4.6B
NET PATIENT REVENUE $2.9B
OPER. PROFIT MARGIN 0.5% www.bjc.org
Hospital FTEs Staffed
Beds Service Area IP Discharges
Total Hospital IP Discharges
Total Births
Barnes-Jewish Hospital 9,292 1,279 41,530 56,641 3,434
Missouri Baptist Medical Center 2,331 448 20,539 24,556 3,956
Christian Hospital 1,708 262 15,266 15,839 0
St. Louis Children’s Hospital 2,716 250 7,515 11,579 0
Barnes-Jewish St. Peters 697 113 6,428 6,630 564
Alton Memorial Hospital 755 252 5,773 6,489 535
Progress West HealthCare Center 297 42 3,120 3,231 527
Barnes-Jewish West County 465 84 2,163 2,961 0
Missouri Baptist Sullivan Hospital 335 56 1,198 2,454 276
TOTAL 18,596 2,786 103,532 130,380 9,292
• Non-profit, member of Mercy
• Two general acute care hospitals, heart hospital, children’s hospital, rehabilitation hospital, cancer center, home health, urgent care centers, outreach ministries and skilled nursing facilities
• As of July 1, 2012, Patients First, based in Washington, MO will join Mercy. As a part of Mercy, Patients First includes 77 primary care and specialty physicians, 30 advanced practice providers and over 500 co-workers. Patients First supports 20 specialties in 20 locations across the region and has specialty treatment centers focusing on diabetes & nutrition, diagnostics, heart & vascular, sleep, cancer and outpatient surgery, as well as two urgent care sites
• Mercy Clinic East Communities includes 463 primary care, specialty and hospital-based physicians, 101 advanced practice providers and 979 clinic co-workers supporting over 978,000 outpatient visits to patients in 61 clinics and four urgent/convenient care sites within the St. Louis and Washington areas (physician counts as of April 2012; does not include addition of Patients First providers)
Source: IP Discharges, market share (for PSA) – HIDI, FFY11 (does not include Normal Newborns); beds, births, FTEs – AHA Guide, 2010 data; total assets, NPR, OPM – AHD, 2010
Source: IP Discharges, market share (for PSA) – HIDI, FFY11 (does not include Normal Newborns); beds, births, ED visits, total assets, NPR, OPM – Mercy Finance, FY11; Mercy FTEs & clinic co-workers – Mercy Pension & Comp, April 2012; Mercy Rehab FTEs, beds – Mercy Rehab Hospital, FY11
www.mercy.net Note: Hospitals only
Note: Hospitals only
Saint Louis REGIONAL PROVIDER STATISTICS
Hospital FTEs Staffed
Beds Service Area IP Discharges
Total Hospital IP Discharges
Total Births
Total ED Visits
Mercy Hospital St. Louis 4,588 979 37,585 40,374 7,830 81,163
Mercy Hospital Washington 533 179 5,050 5,383 872 31,902
Mercy Rehabilitation Hospital 229 90 1,070 1,237 0 0
TOTAL 5,350 1,248 43,705 46,994 8,702 113,065
Service Area IP Discharges represent inpatient discharges within a
specified service area, typically where 85%-95% of Mercy’s patients reside. Market share is calculated based on discharges within the service area. Total Hospital IP Discharges account for all discharges from a facility regardless of where patients reside.
INPATIENT MARKET SHARE 7%
TOTAL ASSETS $601M
NET PATIENT REVENUE $422M
OPER. PROFIT MARGIN -3.2%
Hospital FTEs Staffed
Beds Service Area IP Discharges
Total Hospital IP Discharges
Total Births
St. Anthony’s Medical Center 3,599 602 25,623 27,495 1,538 Source: IP Discharges, market share (for PSA) – HIDI, FFY11 (does not include Normal Newborns); beds, births, FTEs – AHA Guide, 2010 data; total assets, NPR, OPM – AHD, 2010
• For-profit, independently owned • General acute care hospital, 53-member primary and specialty physician organization in 11 locations, four urgent care facilities
www.stanthonysmedcenter.com
Hospital
Health System FTEs
Staffed Beds
Service Area IP Discharges
Total Hospital IP Discharges
Total Births
St. Luke’s Hospital (Chesterfield, MO) Independent 2,995 568 15,808 17,064 2,049
Memorial Hospital (Belleville, IL) Independent 1,870 345 15,436 16,232 1,554
St. Louis University Hospital (St. Louis, MO) Tenet Healthcare 1,381 332 12,352 15,318 0
St. Elizabeth’s Hospital (Belleville, IL) Hospital Sisters Health System 1,231 260 10,701 11,911 1,061
Jefferson Regional Medical Center (Festus, MO) Independent 1,203 196 8,184 11,921 529
Anderson Hospital (Maryville, IL) Independent 798 151 7,513 8,138 1,874
Gateway Regional Medical Center (Granite City, IL) Community Health Systems 608 337 NA 8,133 270
Des Peres Hospital (St. Louis, MO) Tenet Healthcare 723 142 5,657 6,945 0
St. Alexius Hospital (St. Louis, MO) Success Healthcare 748 189 4,984 5,660 0
Saint Anthony’s Health Center (Alton, IL) Independent 755 253 3,247 3,635 535
Touchette Regional Hospital (Centerville, IL) Southern IL Healthcare Foundation 593 89 2,962 3,143 418
CenterPointe Hospital (St. Charles, MO) Independent 311 84 2,326 2,881 0
Lincoln County Medical Center (Troy, MO) Independent 274 25 1,100 1,175 0 Source: IP Discharges (for PSA) – HIDI, FFY11 (does not include Normal Newborns); beds, births, FTEs – AHA Guide, 2010 data; Includes providers between 1% and 5% market share
Note: Hospital only
Saint Louis REGIONAL PROVIDER STATISTICS
Other Health Care Providers in the St. Louis Service Area
In June 2012, Mercy and Jefferson Regional Medical Center entered into exclusive negotiations to transition Jefferson Regional to Mercy. Negotiations are expected to conclude by the end of 2012.
• Non-profit, sponsored by SSM Health Care
• Five general acute care hospitals, a pediatric specialty hospital and an inpatient rehabilitation hospital
• SSM Medical Group has over 250 primary care and specialty physicians in 40 locations
INPATIENT MARKET SHARE 24%
TOTAL ASSETS $1.4B
NET PATIENT REVENUE $1.6B
OPER. PROFIT MARGIN 1.5% www.ssmhc.com
Hospital FTEs Staffed
Beds Service Area IP Discharges
Total Hospital IP Discharges
Total Births
SSM DePaul Health Center 1,836 476 22,532 23,705 1,229
SSM St. Mary’s Health Center 1,768 374 20,239 21,164 2,925
SSM St. Joseph Health Center (St. Charles, MO) (includes SSM St. Joseph – Wentzville, MO)
1,255 331 14,751 15,903 630
SSM St. Clare Health Center 985 178 12,289 13,305 1,260
SSM St. Joseph Hospital West 666 126 8,885 9,610 1,170
SSM Cardinal Glennon Children’s Med Ctr 1,502 176 5,444 7,354 2
TOTAL 8,012 1,661 84,140 91,041 7,216
Note: Hospitals only
Source: IP Discharges, market share (for PSA) – HIDI, FFY11 (does not include Normal Newborns); FTEs, beds, births – AHA Guide, 2010 data; total assets, NPR, OPM – AHD, 2010
Advanced Practice
18%
Hospital-based 25%
Specialists 21%
Primary Care 36%
Saint Louis PATIENT CARE
INPATIENT PHYSICIANS OUTPATIENT
20%
9%
7%
11%
22%
0 5,000 10,000
Neonate
Pulm
Cardio
Behav Hlth
OB
FFY11 Discharges
Ranks 1st in market share
Note: Primary Care = FP/GP, IM, OB/Gyn, Pediatrics Source: Thomson Reuters Physician Estimates, 2011
Mercy Clinic Physicians 52%
West County Surgical Specialists 3%
Mercy Hospitalists Group 3%
Pediatrics Medical Group 2%
Mid County Orthopedic Surg. & Sports Med. 2%
Midwest Maternal Fetal Medicine 2%
OB-GYN Physicians, Inc. 2%
L. Peter Zhang, MD (Psychiatrist) 1%
Ophthalmology Consultants 1%
Allied Assoc. in OB/Gyn, Inc. 1%
Martin, Merenda and Galakatos (Ortho Surg) 1%
Other 30%
St. Louis MO US
Primary Care 141 121 116
Specialty 103 83 81
Total 244 204 197
Mercy Hospital St. Louis
Note: Mercy service lines used; based on volume within the PSA Source: HIDI, FFY11
Note: Total (n) = 491 integrated Mercy physicians and advanced practitioners serving the St. Louis community Source: Mercy Regional Business Development, April 2012
Of the region’s 10M hospital-based outpatient visits, 3% occurred outside the St. Louis PSA (0.01% at Mercy hospitals)
Medical Facility 2010
Physician's Offices* 46%
Independent Labs* 21%
St. Luke’s Hospital-Chesterfield, MO 3%
Mercy Hospital St. Louis-MO 2%
Barnes-Jewish Hospital-St. Louis, MO 2%
St. Anthony's Medical Center-St. Louis, MO 2%
Missouri Baptist Medical Center-St. Louis, MO 2%
Memorial Hospital-Belleville, IL 2%
SSM St. Joseph's Health Center-St. Charles, MO 2%
Christian Hospital-St. Louis, MO 1%
Barnes-Jewish St. Peters Hospital-St. Peters, MO 1%
St. Elizabeth Hospital-Belleville, IL 1%
Other Mercy hospitals 1%
Other (incl. hospitals and freestanding facilities) 15%
In FFY11, only 1% of patients received inpatient care at hospitals located outside the St. Louis PSA, including 0.02% at Mercy hospitals
Source: HIDI, FFY10-FFY11 (does not include Normal Newborns)
Hospital FFY10 FFY11
Barnes-Jewish Hospital-St. Louis, MO 12% 12%
Mercy Hospital St. Louis-MO 10% 11%
St. Anthony's Medical Center-St. Louis, MO 7% 7%
SSM DePaul Health Center-Bridgeton, MO 7% 6%
Missouri Baptist Medical Center-St. Louis, MO 6% 6%
SSM St. Mary's Health Ctr.-Richmond Hts., MO 5% 6%
St. Luke's Hospital-Chesterfield, MO 5% 4%
Memorial Hospital-Belleville, IL 4% 4%
Christian Hospital-St. Louis, MO 4% 4%
SSM St. Joseph Health Center-St. Charles, MO 4% 4%
St. Louis University Hospital-MO 3% 3%
SSM St. Clare Health Center-Fenton, MO 3% 3%
St. Elizabeth's Hospital-Belleville, IL 3% 3%
SSM St. Joseph Hosp. West-Lake St. Louis, MO 2% 3%
Jefferson Regional Medical Center-Festus, MO 2% 2%
Other Mercy hospitals 2% 2%
Other facilities 24% 19%
Source: Epic data, FY11 inpatient discharges; Buxton physician database, April 2012
Mercy Hospital Volume and Market Share
INPATIENT MARKET SHARE TRENDS PHYSICIAN SUPPLY/100,000 POPULATION
INPATIENT DISCHARGES BY PHYSICIAN GROUP
MERCY INTEGRATED MEDICAL STAFF
TOP INPATIENT SERVICE LINES
OUTPATIENT MARKET SHARE (Hospital-based)
OUTPATIENT UTILIZATION – MARKET ESTIMATES
% Change
Select Clinical Service Categories
2011 Procedures
Adjusted and Trended*
5 Yr 10 Yr
Physical and Occ. Therapy 6,552,453 30% 42%
Cardiology 1,154,304 16% 24%
Hematology/Oncology 1,110,125 21% 31%
Nephrology 705,536 44% 70%
Orthopedics 454,256 25% 37%
Neurology 445,241 19% 29%
OB/Gyn 424,197 37% 38%
General Surgery 192,018 20% 29%
Gastroenterology 186,801 24% 31%
*Physician Offices and Independent Laboratories represent procedures performed in a physician’s office and/or lab regardless of the provider’s affiliation with a hospital or health system Note: Data represents 187 procedure groups (categories of CPT and HCPCS codes); Hospitals include hospital-based outpatient services only Source: Thomson Reuters Outpatient Market Profiles, 2010
Note: Data is available for additional clinical service categories *Adjusted and Trended estimates take into account technology trends, health care reform, and changes in disease incidence and prevalence Source: Thomson Reuters Outpatient Estimates, 2011
Source: www.hospitalcompare.hhs.gov. Most current data available updated April 19, 2012 – results from patients who had overnight hospital stays during April 1, 2010 and March 31, 2011. More than 300 surveys were completed for each facility with an average response rate of 40%.
Mercy believes in listening to our communities and responding to their needs. As part of the People Promise key initiative, the Ministry is standardizing the survey tool and vendor used to obtain patient feedback – reinforcing our mission and culture of providing exceptional service, and to enhance the Mercy experience for our patients. Currently, we can look to HCAHPS survey results as a measure of patients’ perspectives of care.
Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a national survey developed by the Centers for Medicare & Medicaid Services (CMS) and the Agency for Healthcare Research and Quality (AHRQ). The data is publicly available to consumers.
Mercy’s HCAHPS results from patients who had overnight hospital stays during April 1, 2010 and March 31, 2011 are shown below, and are compared to other area providers as well as state and national averages for all reporting hospitals. Percentage of patients who gave the hospital
the highest rankings Percentage of patients who gave the hospital
the lowest rankings
Mercy Hospital
Barnes Jewish
MO Baptist
MO US Mercy
Hospital Barnes Jewish
MO Baptist
MO US
78% 73% 74% 77% 76% 4% 6% 7% 5% 5%
80% 80% 82% 81% 80% 5% 5% 3% 4% 4%
63% 52% 60% 65% 64% 9% 16% 13% 10% 10%
70% 67% 72% 69% 70% 6% 7% 8% 7% 7%
58% 62% 54% 60% 61% 23% 20% 24% 21% 21%
72% 65% 68% 72% 72% 8% 14% 13% 9% 9%
59% 54% 54% 57% 58% 10% 15% 14% 11% 11%
79% 88% 83% 84% 82% 21% 12% 17% 16% 18%
76% 67% 69% 68% 68% 6% 9% 11% 9% 9%
80% 73% 75% 68% 70% 3% 4% 7% 5% 5%
Saint Louis PATIENT SATISFACTION
Scale (Question 1 – 7): highest = “always”; lowest = “sometimes” or “never”
Scale (Question 8): highest = “yes/did”; lowest = “no/did not”
Scale (Question 9): highest = “9” or “10”; lowest = “6” or lower
Scale (Question 10): highest = “YES, definitely”; lowest = “No, probably/definitely not”
1 How often did nurses communicate well with patients?
2 How often did doctors communicate well with patients?
3 How often did patients receive help quickly from staff?
4 How often was patients’ pain well controlled?
5 How often did staff explain about medicines before giving them to patients?
6 How often were patients’ rooms & bathrooms kept clean?
7 How often was the area around patients’ rooms kept quiet at night?
8 Were patients given information about what to do during their recovery at home?
9 How do patients rate the hospital overall?
10 Would patients recommend the hospital to friends and family?
= indicates an equal or greater percentage of Mercy patients gave the hospital the highest rankings compared to competitors shown
33% 32%31% 31%
20% 19% 19% 19%
0%
10%
20%
30%
40%
2008 2009 2010 2011
Barnes-Jewish HospitalMercy Hospital St. LouisMissouri Baptist Medical CenterSt. Luke's HospitalSt. Anthony's Medical Center
40% 39%40%
38%
19% 18% 16% 16%
0%
10%
20%
30%
40%
2008 2009 2010 2011
Barnes-Jewish HospitalMercy Hospital St. LouisSiteman Cancer Center at BJHMissouri Baptist Medical CenterSt. Luke's HospitalSt. Anthony's Medical Center
26% 25% 24% 25%
17% 16% 15%17%
0%
10%
20%
30%
40%
2008 2009 2010 2011
Mercy Hospital St. LouisBarnes-Jewish HospitalMissouri Baptist Medical CenterSt. Luke's HospitalSt. Anthony's Medical CenterSSM St. Mary's Health Center
Saint Louis CONSUMER PERCEPTIONS Another way Mercy listens to our customer is through syndicated opinion surveys. National Research Corporation (NRC) administers an annual consumer opinion survey related specifically to health care, providing historical and current data on more than 3,200 hospitals and health systems nationwide.
When asked about preferred providers for quality, image/reputation and select service lines, participating residents from the surveyed region provided feedback displayed here.
Source: NRC Healthcare Market Guide, 2011 (data collected Sep 2010 – Aug 2011); St. Louis 14 Regions
BEST OVERALL QUALITY 2011
Total number of respondents: 3,789 Providers with 2% or less are included in “Other Facilities”; Mercy Hospital Washington, 1%
Average number of respondents (4 yrs trending): 2,521
% r
esp
on
den
ts
Heart Care
Average number of respondents (4 yrs trending): 2,318
% r
esp
on
den
ts
Maternity/OB
Average number of respondents (4 yrs trending): 2,433
% r
esp
on
den
ts
Cancer Treatment
Average number of respondents (4 yrs trending): 2,400
% r
esp
on
den
ts
Pediatric Services
SELECT SERVICE LINE PREFERENCE TRENDS
BEST IMAGE/REPUTATION 2011
Total number of respondents: 3,826 Providers with 2% or less are included in “Other Facilities”; Mercy Hospital Washington, 1%
Last year, 17% of St. Louis consumers who took the survey chose a Mercy Hospital for best overall quality and 16% selected Mercy as having the best image or reputation.
42%
15%5%
5%3%
31%
Barnes-Jewish Hospital Mercy Hospital St. Louis
St. Luke's Hospital Missouri Baptist Medical Center
St. Anthony's Medical Center Other Facilities
34%
16%6%6%
4%3%
3%
28%
Barnes-Jewish Hospital Mercy Hospital St. LouisMissouri Baptist Medical Center St. Luke's HospitalSt. Anthony's Medical Center Barnes-Jewish St. Peters HospitalSSM DePaul Health Center Other Facilities
30%28% 26%
20%
20%22% 21% 15%
0%
10%
20%
30%
40%
2008 2009 2010 2011
St. Louis Children's HospitalSSM Cardinal Glennon Children's HospitalBarnes-Jewish HospitalMercy Hospital St. LouisSt. Luke's HospitalSt. Anthony's Medical CenterMissouri Baptist Medical Center
Washington PRIMARY SERVICE AREA
The Washington Primary Service Area (PSA) comprises 14 zip codes in
west central Missouri
MO
Private 63%
Medicare 17%
Uninsured 10%
Medicaid 10%
DEMOGRAPHICS Washington Service Area Missouri 2011
US 2011 2011 2016 % Growth
Total Population 110,987 114,478 3% 6,015,487 310,650,750
0-17 24% 24% 1% 24% 24%
18-44 Females 16% 16% -0.3% 18% 18%
18-44 Males 17% 17% 1% 18% 19%
45-64 28% 28% 3% 26% 26%
65+ 14% 16% 15% 14% 13%
Median Age 39 - - 38 37
White 95% 95% 3% 81% 64%
Black 2% 2% 14% 11% 12%
American Indian <1% <1% 10% 1% 1%
Asian/Pacific Islander <1% <1% 12% 2% 5%
Multiracial and Other 1% 1% 13% 2% 2%
Hispanic (of any race) 1% 1% 21% 4% 16%
Speak Spanish in Home 1% - - 3% 12%
Total No. of Households 42,196 43,256 3% 2,393,904 116,862,390
Households with Children 34% - - 33% 34%
HH Income Under $15K 11% - - 14% 13%
HH Income Over $75K 25% - - 25% 30%
Average HH Income $ 59,510 - - $ 58,797 $ 67,529
Some High School 10% - - 9% 9%
High School Graduate/GED 33% - - 33% 29%
Some College 33% - - 29% 28%
Bachelor’s Degree or greater 18% - - 25% 28%
MAJOR EMPLOYERS
Largest employers in the Washington area as provided by the community and economic development council:
Source: Thomson Reuters Insurance Coverage Estimates, 2011
Hypertension 31%
Arthritis 25%
Asthma 13%
Diabetes 8%
COPD 5%
Coronary Heart Disease 5%
Angina 3%
Congestive Heart Failure 2%
CHRONIC DISEASE
Within the 14-zip code Washington Service Area, the following chronic conditions have been identified among the adult (18+) population:
In addition, 3% have had a stroke 4% have had a heart attack, and 6% are living with some type of cancer
Source: Thomson Reuters Continuum of Care, 2011
Private 57% 56% Medicare 16% 14% Medicaid 13% 14% Uninsured 15% 16%
US MO INSURANCE COVERAGE
Washington DEMOGRAPHICS
Note: Washington Service Area consists of 14 zip codes in Missouri; Education Level based on population age 25+ Source: Thomson Reuters, 2011
Rac
e &
Eth
nic
ity
Age
Gro
up
s H
ou
seh
old
s Ed
uca
tio
n
Health Factor Franklin County Missouri
National Benchmark
Adult Smoking (% smoking >= 100 cigarettes) 28% 24% 14%
Adult Obesity (% with BMI >= 30) 31% 31% 25%
Physical Inactivity (% of adults age 20+ not active) 27% 28% 21%
Excessive/Binge Drinking 16% 17% 8%
Teen Birth Rate (per 1,000 females age 15-19) 39 44 22
Children in Poverty (% of children under 18 in poverty) 19% 21% 13%
Preventable Hospital Stays (per 1,000 Medicare enrollees) 74 75 49 Sources: (state) Overall Health Ranking – America’s Health Rankings, 2011, provided by United Health Foundation; (county) Overall Health Ranking and Health Factors table – 2012 County Health Rankings provided by the Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute
COMMUNITY HEALTH MEASURES
Overall Health Ranking: Missouri = 40 (/50 states); Franklin County = 36 (/115 counties) Rankings are out of total number of states or reporting counties. The lower the number, the healthier the community.
Below are some of the factors which attribute to community health.
Source: Washington, MO Community and Economic Development Council, March 2012
Company Industry Type Staff
Parker Hanifin–Sporlan Valve Division Manufacturing 1,087
Mercy Hospital Health care 688
Patients First Health care 580
Washington School District Education 529
CG Power Systems USA, Inc. Transformers 450
9.2%
7.4% 8.2%
UNEMPLOYMENT RATE
Change over 12 months
↓0.9% Franklin County
↓1.3% Missouri
↓0.7% US
Note: US & State rates are seasonally adjusted; County, non-seasonally adjusted Source: US Dept. of Labor – Bureau of Labor Statistics
MARCH 2012
Hospitals (*indicates on-site outpatient surgery center) Health System Affiliation
Mercy Hospital Washington* Mercy
Missouri Baptist Sullivan Hospital* BJC HealthCare
Hermann Area District Hospital Independent
2
3
1
2
4
The map below depicts all inpatient hospitals and freestanding general outpatient surgery centers in the Washington Service Area.
Washington REGIONAL PROVIDER LANDSCAPE
1
3
FreestandingGeneral Outpatient
Surgery Center
Independent
Mercy
Source: Buxton ASC database, 2012
Mercy Hospital Washington
37%
20%
40%
50%
48%
0 200 400 600 800
Gastro
Cardio
Pulm
Ortho
OB
FFY11 Discharges
Note: Primary Care = FP/GP, IM, OB/Gyn, Pediatrics Source: Thomson Reuters Physician Estimates, 2011
In FFY11, 61% of patients received inpatient care at hospitals located outside the Washington 14-zip code PSA, including 16% at Mercy hospitals
Mercy Clinic Physicians 46%
Patients First (Mercy owned as of July 2012) 32%
SLUCare Washington Medical Group 4%
Cassat Surgery 3%
Martin D. Rudloff, MD (Pediatrics) 3%
Saint Clair Medical Center 2%
Sunil M. Apte, MD (Urology) 1%
Family Healthcare 1%
Andrew A. Zupan, MD (Adolescent Medicine) 1%
Michelle L. Buemer, MD (Pediatrics) 1%
Other 6%
Washington MO US
Primary Care 81 121 116
Specialty 35 83 81
Total 116 204 197
Source: HIDI, FFY10-FFY11 (does not include Normal Newborns)
Hospital FFY10 FFY11
Mercy Hospital Washington-MO 33% 31%
Mercy Hospital St. Louis-MO 15% 16%
SSM St. Clare Health Center-Fenton, MO 11% 13%
Missouri Baptist Sullivan Hospital-MO 7% 7%
Missouri Baptist Medical Ctr.-St. Louis, MO 6% 6%
Barnes-Jewish Hospital-St. Louis, MO 4% 5%
St. Luke's Hospital-Chesterfield, MO 4% 4%
St. Anthony's Medical Center-St. Louis, MO 3% 3%
St. Louis Children's Hospital-St. Louis, MO 2% 2%
Des Peres Hospital-St. Louis, MO 2% 1%
CenterPointe Hospital-St. Charles, MO 1% 1%
St. Louis University Hospital-MO 1% 1%
Capital Region Med. Ctr.-Jefferson City, MO 1% 1%
SSM DePaul Health Center-Bridgeton, MO 1% 1%
SSM St. Joseph Health Center-St. Charles, MO 1% 1%
Mercy Rehabilitation Hospital-St. Louis, MO 1% 1%
Phelps County Regional Med. Ctr.-Rolla, MO 1% 1%
Other hospitals (including 0.03% Mercy) 7% 6%
Ranks 2nd in market share
Note: Total (n) = 73 integrated Mercy physicians and advanced practitioners serving the Washington community Source: Mercy Hospital Regional Business Development, April 2012
Advanced Practice
19%
Hospital-based 40%
Specialists 15%
Primary Care 26%
Of the region’s 432,813 hospital-based outpatient visits, 31% occurred outside the Washington PSA (7% at Mercy hospitals)
Medical Facility 2010
Physician's Offices* 54%
Independent Labs* 15%
Mercy Hospital Washington-MO 11%
Missouri Baptist Sullivan Hospital-MO 7%
Mercy Hospital St. Louis-MO 2%
St. Luke's Hospital-Chesterfield, MO 1%
Missouri Baptist Medical Center-St. Louis, MO 1%
Barnes Jewish Hospital-St. Louis, MO 1%
SSM St. Clare Health Center-Fenton, MO 1%
St. Anthony's Medical Center-St. Louis, MO 1%
Hermann Area District Hospital-MO 0.5%
SSM St. Joseph Health Center-St. Charles, MO 0.4%
Other (incl. hospitals and freestanding facilities) 5%
Ranks 1st in market share
Mercy Hospital Volume and Market Share
Washington PATIENT CARE
INPATIENT PHYSICIANS OUTPATIENT INPATIENT MARKET SHARE TRENDS PHYSICIAN SUPPLY/100,000 POPULATION
INPATIENT DISCHARGES BY PHYSICIAN GROUP
MERCY INTEGRATED MEDICAL STAFF
TOP INPATIENT SERVICE LINES
OUTPATIENT MARKET SHARE (Hospital-based)
OUTPATIENT UTILIZATION – MARKET ESTIMATES
Note: Mercy service lines used; based on volume within the PSA Source: HIDI, FFY11
Source: Epic data, FY11 inpatient discharges; Buxton physician database, April 2012
% Change
Select Clinical Service Categories
2011 Procedures
Adjusted and Trended*
5 Yr 10 Yr
Physical and Occ. Therapy 275,123 27% 41%
Cardiology 60,025 16% 25%
Hematology/Oncology 43,008 21% 33%
Nephrology 24,238 93% 145%
OB/Gyn 16,605 36% 41%
Orthopedics 15,997 27% 41%
Neurology 15,820 24% 36%
Gastroenterology 8,757 26% 33%
General Surgery 6,541 19% 30%
*Physician Offices and Independent Laboratories represent procedures performed in a physician’s office and/or lab regardless of the provider’s affiliation with a hospital or health system Note: Data represents 187 procedure groups (categories of CPT and HCPCS codes); Hospitals include hospital-based outpatient services only Source: Thomson Reuters Outpatient Market Profiles, 2010
Note: Data is available for additional clinical service categories *Adjusted and Trended estimates take into account technology trends, health care reform, and changes in disease incidence and prevalence Source: Thomson Reuters Outpatient Estimates, 2011
Mercy believes in listening to our communities and responding to their needs. As part of the People Promise key initiative, the Ministry is standardizing the survey tool and vendor used to obtain patient feedback – reinforcing our mission and culture of providing exceptional service, and to enhance the Mercy experience for our patients. Currently, we can look to HCAHPS survey results as a measure of patients’ perspectives of care.
Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a national survey developed by the Centers for Medicare & Medicaid Services (CMS) and the Agency for Healthcare Research and Quality (AHRQ). The data is publicly available to consumers.
Mercy’s HCAHPS results from patients who had overnight hospital stays during April 1, 2010 and March 31, 2011 are shown below, and are compared to other area providers as well as state and national averages for all reporting hospitals. Percentage of patients who gave the hospital
the highest rankings Percentage of patients who gave the hospital
the lowest rankings
Mercy Hospital
SSM St. Clare
MO Bap Sullivan
MO US Mercy
Hospital SSM
St. Clare MO Bap Sullivan
MO US
80% 80% 83% 77% 76% 3% 4% 3% 5% 5%
84% 81% 84% 81% 80% 3% 5% 3% 4% 4%
64% 62% 71% 65% 64% 8% 10% 6% 10% 10%
73% 72% 73% 69% 70% 5% 6% 5% 7% 7%
63% 60% 63% 60% 61% 20% 21% 18% 21% 21%
78% 79% 80% 72% 72% 5% 6% 5% 9% 9%
59% 71% 71% 57% 58% 11% 3% 6% 11% 11%
85% 83% 82% 84% 82% 15% 17% 18% 16% 18%
67% 80% 71% 68% 68% 6% 6% 6% 9% 9%
71% 82% 70% 68% 70% 4% 3% 4% 5% 5%
Washington PATIENT SATISFACTION
Scale (Question 1 – 7): highest = “always”; lowest = “sometimes” or “never”
Scale (Question 8): highest = “yes/did”; lowest = “no/did not”
Scale (Question 9): highest = “9” or “10”; lowest = “6” or lower
Scale (Question 10): highest = “YES, definitely”; lowest = “No, probably/definitely not”
1 How often did nurses communicate well with patients?
2 How often did doctors communicate well with patients?
3 How often did patients receive help quickly from staff?
4 How often was patients’ pain well controlled?
5 How often did staff explain about medicines before giving them to patients?
6 How often were patients’ rooms & bathrooms kept clean?
7 How often was the area around patients’ rooms kept quiet at night?
8 Were patients given information about what to do during their recovery at home?
9 How do patients rate the hospital overall?
10 Would patients recommend the hospital to friends and family?
Source: www.hospitalcompare.hhs.gov. Most current data available updated April 19, 2012 – results from patients who had overnight hospital stays during April 1, 2010 and March 31, 2011. More than 300 surveys were completed for each facility with an average response rate of 40%.
= indicates an equal or greater percentage of Mercy patients gave the hospital the highest rankings compared to competitors shown
Fort Smith PRIMARY SERVICE AREA
The Fort Smith Primary Service Area (PSA) comprises 13 counties in east central Oklahoma
and west central Arkansas
AROK
Private 42%
Medicare 18%
Uninsured 20%
Medicaid 20%
DEMOGRAPHICS Fort Smith Service Area Arkansas 2011
US 2011 2011 2016 % Growth
Total Population 446,358 456,485 2% 2,932,778 310,650,750
0-17 26% 26% 2% 25% 24%
18-44 Females 17% 16% -0.3% 18% 18%
18-44 Males 17% 17% 1% 18% 19%
45-64 26% 25% -1% 25% 26%
65+ 15% 16% 12% 15% 13%
Median Age 38 - - 38 37
White 76% 74% -1% 75% 64%
Black 3% 3% 8% 16% 12%
American Indian 7% 7% 1% 1% 1%
Asian/Pacific Islander 2% 2% 11% 1% 5%
Multiracial and Other 4% 4% 7% 2% 2%
Hispanic (of any race) 9% 10% 23% 6% 16%
Speak Spanish in Home 5% - - 4% 12%
Total No. of Households 171,261 175,808 3% 1,157,580 116,862,390
Households with Children 35% - - 34% 34%
HH Income Under $15K 20% - - 18% 13%
HH Income Over $75K 15% - - 18% 30%
Average HH Income $ 46,070 - - $ 50,392 $ 67,529
Some High School 13% - - 11% 9%
High School Graduate/GED 37% - - 35% 29%
Some College 28% - - 28% 28%
Bachelor’s Degree or greater 13% - - 19% 28%
Source: Ft. Smith Chamber of Commerce, 2012
Company Industry Staff
Sparks Health System Health care 2,400
Baldor Electric Company Manufacturing 2,393
O.K. Industries, Inc. Industrial Recycling 1,800
Fort Smith Public Schools Education 1,783
Mercy Hospital Health care 1,487
University of AR-Fort Smith Education 951
Arkansas Best Corporation Trucking 936
MAJOR EMPLOYERS
Largest employers in the greater Fort Smith region as provided by the Chamber of Commerce:
Source: Thomson Reuters Insurance Coverage Estimates, 2011
Hypertension 31%
Arthritis 24%
Asthma 12%
Diabetes 9%
Coronary Heart Disease 5%
COPD 4%
Angina 2%
Congestive Heart Failure 2%
CHRONIC DISEASE
Within the thirteen-county Fort Smith Service Area, the following chronic conditions have been identified among the adult (18+) population:
In addition, 3% have had a stroke 4% have had a heart attack, and 5% are living with some type of cancer
Source: Thomson Reuters Continuum of Care, 2011
INSURANCE COVERAGE
Fort Smith DEMOGRAPHICS
Note: Fort Smith Service Area consists of 13 counties in Arkansas (8) and Oklahoma (5); Education Level based on population age 25+ Source: Thomson Reuters, 2011
Rac
e &
Eth
nic
ity
Age
Gro
up
s H
ou
seh
old
s Ed
uca
tio
n
Health Factor Sebastian
County Arkansas National
Benchmark
Adult Smoking (% smoking >= 100 cigarettes) 22% 23% 14%
Adult Obesity (% with BMI >= 30) 30% 32% 25%
Physical Inactivity (% of adults age 20+ not active) 34% 31% 21%
Excessive/Binge Drinking 11% 12% 8%
Teen Birth Rate (per 1,000 females age 15-19) 68 61 22
Children in Poverty (% of children under 18 in poverty) 31% 27% 13%
Preventable Hospital Stays (per 1,000 Medicare enrollees) 64 81 49 Sources: (state) Overall Health Ranking – America’s Health Rankings, 2011, provided by United Health Foundation; (county) Overall Health Ranking and Health Factors table – 2012 County Health Rankings provided by the Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute
COMMUNITY HEALTH MEASURES
Overall Health Ranking: Arkansas = 47 (/50 states); Sebastian County = 19 (/75 counties) Rankings are out of total number of states or reporting counties. The lower the number, the healthier the community.
Below are some of the factors which attribute to community health.
Private 45% 56% Medicare 17% 14% Medicaid 19% 14% Uninsured 19% 16%
AR US
8.0% 7.4% 8.2%
UNEMPLOYMENT RATE
Change over 12 months
↓0.8% MSA*
↓0.6% Arkansas
↓0.7% US
*Fort Smith, AR-OK Metropolitan Statistical Area Note: US & State rates are seasonally adjusted; MSA, non-seasonally adjusted Source: US Dept. of Labor – Bureau of Labor Statistics
MARCH 2012
The map below depicts all inpatient hospitals and freestanding general outpatient surgery centers in the Fort Smith Service Area.
1
2
4
3 6
5
13
14
12 15
9
10
7
11
Fort Smith REGIONAL PROVIDER LANDSCAPE
8
FreestandingGeneral Outpatient
Surgery Center
Mercy
Physician Owned
Independent
Source: Buxton ASC database, 2012
Hospitals (*indicates on-site outpatient surgery center) Health System Affiliation
Mercy Hospital Fort Smith* Mercy
Mercy Hospital Waldron Mercy
Mercy Hospital Ozark* Mercy
Mercy Hospital Paris* Mercy
Sparks Regional Medical Center* Health Management Associates
Summit Medical Center Health Management Associates
Haskell County Community Hospital* HMC/CAH Consolidated
Mena Regional Health System* Independent
Booneville Community Hospital* Independent
Chambers Memorial Hospital Independent
Eastern Oklahoma Medical Center* Independent
Johnson Regional Medical Center Independent
Latimer County General Hospital Independent
Memorial Hospital Independent
Sequoyah Memorial Hospital Independent
1
3
4
2
5
6
7
8
9
10
15
11
12
14
13
Fort Smith REGIONAL PROVIDER LANDSCAPE
7
• Non-profit, member of Mercy
• One general acute care and three critical access hospitals, home health/hospice agency, wellness center, area’s only Level III NICU and home to Arkansas's only Ronald McDonald Family Room
• River Valley Musculoskeletal Center provides orthopedic and neurosurgery care with ambulatory surgery capabilities
• Mercy Clinic includes 108 primary care, specialty and hospital-based physicians, 13 advanced practice providers and 229 clinic co-workers supporting almost 163,000 outpatient visits in 15 clinics and two urgent/convenient care sites (physician counts as of April 2012)
• For-profit, member of Health Management Associates
• One acute care hospital; ambulatory surgery center; a fitness center; nationally recognized stroke program; accredited Chest Pain Center; Sparks Radiation Treatment Center (opened in 2011) provides the area’s only TrueBeam linear accelerator
• Sparks Clinics, a multi-specialty physician group, with approximately 90 physicians and 36 clinics including two urgent care centers
INPATIENT MARKET SHARE *33%
TOTAL ASSETS $171M
NET PATIENT REVENUE $241M
OPER. PROFIT MARGIN 19.8% www.sparkshealth.com
Hospital FTEs Staffed
Beds Total Hospital
IP Volume Total Births
Sparks Regional Medical Center 1,754 274 16,624 1,205 *Market share reflects FY10 inpatient volume for Mercy and 2010 AHA Guide IP volume for other facilities Source: IP admits (total hospital), market share (total hospital), beds, births, FTEs – AHA Guide, 2010 data; total assets, NPR, OPM – AHD, 2010
Hospital FTEs Staffed
Beds Total Hospital
IP Volume Total Births
Total ED Visits
Mercy Hospital Fort Smith 1,361 373 13,928 2,228 58,703
Mercy Hospital Ozark 55 25 537 0 5,565
Mercy Hospital Paris 40 16 536 0 2,506
Mercy Hospital Waldron 54 24 523 0 6,538
TOTAL 1,510 438 15,524 2,228 73,312
INPATIENT MARKET SHARE *32%
TOTAL ASSETS $219M
NET PATIENT REVENUE $211M
OPER. PROFIT MARGIN 4.7%
*Market share reflects FY10 inpatient volume for Mercy and 2010 AHA Guide IP volume for other facilities Source: IP discharges (total hospital), market share (total hospital), beds, births, ED visits, total assets, NPR, OPM – Mercy Finance, FY11; Mercy FTEs & clinic co-workers – Mercy Pension & Comp, April 2012
• For-profit, member of Health Management Associates
• One acute care hospital, outpatient surgery and home health agency
• Alignment through HMA with Sparks Health System physicians
INPATIENT MARKET SHARE *4%
TOTAL ASSETS $14M
NET PATIENT REVENUE $23M
OPER. PROFIT MARGIN -3.3%
www.summitmedicalcenter.net
Hospital FTEs Staffed
Beds Total Hospital
IP Volume Total Births
Summit Medical Center 182 103 2,098 0 *Market share reflects FY10 inpatient volume for Mercy and 2010 AHA Guide IP volume for other facilities Source: IP admits (total hospital), beds, births, FTEs – AHA Guide, 2010 data; total assets, NPR, OPM – AHD, 2010
www.mercy.net Note: Hospitals only
Note: Hospital only
Note: Hospital only
Fort Smith REGIONAL PROVIDER STATISTICS
Cooper Clinic
• Largest physician-owned multi-specialty medical group in Arkansas
• For-profit, 100 providers (27 primary care – FM, IM, Peds) in 16 locations including three ProMed urgent care sites www.cooperclinic.com
Arkansas Hospitals Health System FTEs
Staffed Beds
Total Hospital IP Volume
Total Births
Johnson Regional Medical Center (Clarksville, AR) Independent 341 80 3,000 513
Chambers Memorial Hospital (Danville, AR) Independent 174 41 2,221 0
Mena Regional Health System (Mena, AR) Independent 259 45 1,574 366
Booneville Community Hospital (Booneville, AR) Independent 125 25 508 0
Other Health Care Providers in the Fort Smith Service Area
HealthSouth Rehabilitation Hospital of Fort Smith
• For-profit, largest provider of outpatient surgery and rehabilitative services in the US
• One inpatient rehabilitation hospital, ambulatory surgery center, home health agency and sleep disorder center
• Ranked in the top 10 percent of 827 rehabilitation hospitals in the nation for exceptional patient outcomes
www.healthsouthfortsmith.com
Oklahoma Hospitals Health System FTEs
Staffed Beds
Total Hospital IP Volume
Total Births
Eastern Oklahoma Medical Center (Poteau, OK) Independent 258 84 2,774 474
Memorial Hospital (Stilwell, OK) Independent 209 34 1,651 63
Sequoyah Memorial Hospital (Sallisaw, OK) Independent 199 26 913 2
Haskell County Community Hospital (Stigler, OK) HMC/CAH Consolidated 163 32 730 0
Latimer County General Hospital (Wilburton, OK) Independent 74 33 556 0
Source: IP admits (total hospital), beds, births, FTEs – AHA Guide, 2010 data; Latimer and Haskell County data – AHA Guide, 2009 data
Fort Smith REGIONAL PROVIDER STATISTICS
0 1,000 2,000 3,000
Ortho
Gen Surg
Pulm
OB
Cardio
FY11 Discharges
Note: Primary Care = FP/GP, IM, OB/Gyn, Pediatrics Source: Thomson Reuters Physician Estimates, 2011
Mercy Clinic Physicians 37%
Cooper Clinic 25%
Eastside OB/Gyn 9%
HealthSouth Rehab Center 5%
Center for Pediatrics & Adolescent Medicine 4%
Pediatric Partners 3%
Advance Care Hospital 2%
Cecil W. Gaby, MD (Pediatrics) 2%
Randall S. Beallis, MD (Family Practice) 2%
John C. Whitaker, MD (Adolescent Medicine) 1%
Other 10%
Fort Smith AR US
Primary Care 77 88 116
Specialty 38 61 81
Total 115 149 197
Mercy Hospital Fort Smith
Note: Mercy service lines used; service line market share not available for AR Source: Trendstar Data, FY2011
Hospitall 2008 2009 2010
Sparks Regional Medical Ctr.-Fort Smith, AR 29% 29% 34%
Mercy Hospital Fort Smith-AR 30% 30% 29%
Johnson Regional Medical Ctr.-Clarksville, AR 7% 7% 6%
Eastern Oklahoma Medical Ctr.-Poteau, OK 7% 7% 6%
Chambers Memorial Hosp.-Danville, AR 5% 5% 5%
Summit Medical Ctr.-Van Buren, AR 5% 5% 4%
Memorial Hosp.-Stilwell, OK 4% 4% 3%
Mena Regional Health System-AR 4% 4% 3%
Sequoyah Memorial Hosp.-Sallisaw, OK 2% 2% 2%
Mercy Hospital Waldron-AR 1% 1% 2%
Haskell County Community Hosp.-Stigler, OK 2% 2% 2%
Latimer County General Hosp.-Wilburton, OK NA 2% 1%
Booneville Community Hosp.-AR 2% 1% 1%
Mercy Hospital Ozark-AR 1% 1% 1%
Mercy Hospital Paris-AR 1% 1% 1%
Note: Total (n) = 121 integrated Mercy physicians and advanced practitioners Serving Fort Smith, Ozark, Paris and Waldron communities Source: Mercy Hospital Fort Smith Medical Staff Services, April 2012
Advanced Practice
11%
Hospital-based 55%
Specialists 21%
Primary Care 13%
Medical Facility 2010
Physician's Offices* 48%
Independent Labs* 20%
Sparks Regional Medical Center-Fort Smith, AR 9%
Mercy Hospital Fort Smith-AR 4%
Mena Regional Health System-AR 2%
Johnson Regional Medical Center-Clarksville, AR 1%
Sequoyah Memorial Hospital-Sallisaw, OK 1%
Summit Medical Center-Van Buren, AR 1%
UAMS Medical Center-Little Rock, AR 1%
Wm. H. Hastings Indian Hospital-Tahlequah, OK 1%
Mercy Hospital Waldron-AR 1%
Eastern Oklahoma Medical Center-Poteau, OK 1%
Other Mercy hospitals 1%
Other (incl. hospitals and freestanding facilities) 9%
Note: Includes total inpatient discharges for hospitals located within the Fort Smith 13-county PSA; does not account for outmigration Source: Mercy facilities-Mercy Finance Data, FY08-FY10; All others-AHA Guide, 2008-2010 data (does not include Normal Newborns)
Mercy Hospital Volume
16%
14%
10%
9%
8%
% of Volume
Fort Smith PATIENT CARE
INPATIENT MARKET SHARE TRENDS PHYSICIAN SUPPLY/100,000 POPULATION
INPATIENT DISCHARGES BY PHYSICIAN GROUP
MERCY INTEGRATED MEDICAL STAFF
INPATIENT PHYSICIANS OUTPATIENT
TOP INPATIENT SERVICE LINES
OUTPATIENT MARKET SHARE (Hospital-based)
OUTPATIENT UTILIZATION – MARKET ESTIMATES
% Change
Select Clinical Service Categories
2011 Procedures
Adjusted and Trended*
5 Yr 10 Yr
Physical and Occ. Therapy 445,807 35% 47%
Cardiology 175,109 20% 27%
Hematology/Oncology 166,289 20% 28%
Nephrology 95,678 70% 103%
Neurology 62,181 32% 42%
OB/Gyn 56,299 52% 54%
Orthopedics 50,190 33% 45%
Gastroenterology 29,457 29% 34%
General Surgery 27,825 24% 33%
*Physician Offices and Independent Laboratories represent procedures performed in a physician’s office and/or lab regardless of the provider’s affiliation with a hospital or health system Note: Data represents 187 procedure groups (categories of CPT and HCPCS codes); Hospitals include hospital-based outpatient services only Source: Thomson Reuters Outpatient Market Profiles, 2010
Note: Data is available for additional clinical service categories *Adjusted and Trended estimates take into account technology trends, health care reform, and changes in disease incidence and prevalence Source: Thomson Reuters Outpatient Estimates, 2011
Of the region’s 1.6M hospital-based outpatient visits, 20% occurred outside the Fort Smith PSA (0.4% at Mercy hospitals)
Source: Epic data, FY11 inpatient discharges; Buxton physician database, April 2012
Mercy believes in listening to our communities and responding to their needs. As part of the People Promise key initiative, the Ministry is standardizing the survey tool and vendor used to obtain patient feedback – reinforcing our mission and culture of providing exceptional service, and to enhance the Mercy experience for our patients. Currently, we can look to HCAHPS survey results as a measure of patients’ perspectives of care.
Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a national survey developed by the Centers for Medicare & Medicaid Services (CMS) and the Agency for Healthcare Research and Quality (AHRQ). The data is publicly available to consumers.
Mercy’s HCAHPS results from patients who had overnight hospital stays during April 1, 2010 and March 31, 2011 are shown below, and are compared to other area providers as well as state and national averages for all reporting hospitals.
Source: www.hospitalcompare.hhs.gov. Most current data available updated April 19, 2012 – results from patients who had overnight hospital stays during April 1, 2010 and March 31, 2011. More than 300 surveys were completed for each facility with an average response rate of 35%.
Percentage of patients who gave the hospital the highest rankings
Percentage of patients who gave the hospital the lowest rankings
Mercy Hospital
Sparks Regional
AR US Mercy
Hospital Sparks
Regional AR US
73% 68% 77% 76% 5% 8% 6% 5%
77% 73% 84% 80% 5% 7% 4% 4%
58% 48% 65% 64% 10% 17% 11% 10%
68% 57% 70% 70% 7% 11% 7% 7%
57% 47% 62% 61% 23% 34% 21% 21%
63% 52% 71% 72% 11% 18% 10% 9%
47% 51% 65% 58% 15% 15% 8% 11%
81% 79% 80% 82% 19% 21% 20% 18%
65% 52% 68% 68% 8% 18% 9% 9%
75% 57% 68% 70% 2% 10% 6% 5%
Fort Smith PATIENT SATISFACTION
1 How often did nurses communicate well with patients?
2 How often did doctors communicate well with patients?
Scale (Question 1 – 7): highest = “always”; lowest = “sometimes” or “never”
Scale (Question 8): highest = “yes/did”; lowest = “no/did not”
3 How often did patients receive help quickly from staff?
4 How often was patients’ pain well controlled?
5 How often did staff explain about medicines before giving them to patients?
6 How often were patients’ rooms & bathrooms kept clean?
7 How often was the area around patients’ rooms kept quiet at night?
8 Were patients given information about what to do during their recovery at home?
Scale (Question 9): highest = “9” or “10”; lowest = “6” or lower
9 How do patients rate the hospital overall?
Scale (Question 10): highest = “YES, definitely”; lowest = “No, probably/definitely not”
10 Would patients recommend the hospital to friends and family?
= indicates an equal or greater percentage of Mercy patients gave the hospital the highest rankings compared to competitors shown
43% 43% 40%
53%
24%28% 28%
25%
4% 2% 5% 3%
0%
15%
30%
45%
60%
2008 2009 2010 2011
Mercy Hospital Fort Smith
Sparks Regional Medical Center
Arkansas Heart Hospital
Average number of respondents (4 yrs trending): 360
% r
esp
on
den
ts
Heart Care
Fort Smith CONSUMER PERCEPTIONS Another way Mercy listens to our customer is through syndicated opinion surveys. National Research Corporation (NRC) administers an annual consumer opinion survey related specifically to health care, providing historical and current data on more than 3,200 hospitals and health systems nationwide.
When asked about preferred providers for quality, image/reputation and select service lines, participating residents from the surveyed region provided feedback displayed here.
Last year, 50% of Fort Smith consumers who took the survey chose a Mercy Hospital for best overall quality and 55% selected Mercy as having the best image or reputation.
BEST OVERALL QUALITY 2011
Total number of respondents: 383 Providers with 1% or less are included in “Other Facilities”; Mercy Hospital Hot Springs, 1%
43% 44% 44%
53%
26% 28% 28% 29%
6% 3% 2% 2%
0%
15%
30%
45%
60%
2008 2009 2010 2011
Mercy Hospital Fort Smith
Sparks Regional Medical Center
Eastern Oklahoma Medical Center
Average number of respondents (4 yrs trending): 327
% r
esp
on
den
ts
Maternity/OB
SELECT SERVICE LINE PREFERENCE TRENDS
BEST IMAGE/REPUTATION 2011
Total number of respondents: 380 Providers with 1% or less are included in “Other Facilities”; Mercy Hospital Hot Springs, 1%
49%
26%
4%2%2%
2%
16%
Mercy Hospital Fort Smith Sparks Regional Medical CenterCooper Clinic Central Texas HospitalEastern Oklahoma Medical Center St. Francis HospitalOther Facilities
54%
23%
3%2%
19%
Mercy Hospital Fort Smith Sparks Regional Medical Center
Cooper Clinic Central Texas Hospital
Other Facilities
Average number of respondents (4 yrs trending): 343
% r
esp
on
den
ts
Cancer Treatment
36% 38%40%
47%
22%26% 25% 24%
13%7% 5%
10%0%
15%
30%
45%
60%
2008 2009 2010 2011
Mercy Hospital Fort Smith
Sparks Regional Medical Center
CTCA at Southwestern Reg Med Ctr
Average number of respondents (4 yrs trending): 326 %
res
po
nd
ents
Pediatric Services
37%40% 38%
47%
26% 28% 27% 28%
7% 7% 10%7%
0%
15%
30%
45%
60%
2008 2009 2010 2011
Mercy Hospital Fort Smith
Sparks Regional Medical Center
Arkansas Children's Hospital
Source: NRC Healthcare Market Guide, 2011 (data collected Sep 2010 – Aug 2011); Fort Smith Community (13-county PSA: Scott County, AR, Haskell and Latimer Counties, OK not surveyed)
% Market Share 2010
OP Volume
45% PHYSICIAN OFFICES 124,185
28% INDEPENDENT LABS 75,890
9% MERCY HOSPITAL OZARK 25,480
4% SPARKS REGIONAL MEDICAL CENTER 10,905
4% MERCY HOSPITAL FORT SMITH 10,232
2% UAMS MEDICAL CENTER-LITTLE ROCK 6,486
1% BOONEVILLE COMMUNITY HOSPITAL 3,623
1% JOHNSON REGIONAL MEDICAL CTR. 3,544
5% OTHER (including 0.4% Mercy) 13,184
Community Snapshot OZARK PRIMARY SERVICE AREA & PATIENT ORIGIN The majority (90%) of Mercy Hospital Ozark’s acute care patients reside in Franklin County in northwest Arkansas. Three in four patients share the same zip code (72949) as the hospital.
HOUSEHOLD ECONOMICS
Total Households: 8,958 Average Income: $43,169 Annual Income <$15K: 20%
INSURANCE COVERAGE
45% Private 19% Medicare 18% Medicaid 18% Uninsured
Race: 93% White; 2% Multiracial Ethnicity: 2% Hispanic (of any race)
Total Area Population: 22,740 5-Yr Growth: 0.1%
Age Cohorts: 24% Children (0-17) 18% Females (15-44) 17% Seniors (65+)
Median Age: 40
POPULATION
SERVICES & PHYSICIANS
In FY11, Mercy Hospital Ozark’s top inpatient service lines were pulmonary (19%), gastroenterology (13%) and cardiovascular (11%).
There are approximately 12 physicians (67% primary care) located in the PSA, of which 42% are integrated with Mercy.
EDUCATION (based on population ages 25+)
12% Some High School 28% Some College 41% High School Diploma 12% Bachelor’s Degree/greater
75% 2%
OUTPATIENT MARKET SHARE (hospital-based only)
Sources: Map – Mercy Locations Directory & AHD (other locations); Inpatient Market Share – Mercy Finance, FY2010 (does not include Normal Newborns), all others – AHA Guide 2010 data; Outpatient Market Share – Data represents 187 procedure groups (categories of CPT and HCPCS codes). Hospitals include hospital-based outpatient services only. Physician Offices and Independent Laboratories represent procedures performed in a physician’s office and/or lab regardless of affiliation with a hospital or health system. Thomson Reuters Outpatient Market Profiles, 2010; Demographics – Thomson Reuters, 2011; Payer Mix – Thomson Reuters Insurance Estimates, 2011; County Health Rankings, 2012; Inpatient Services and Patient Origin – Mercy Hospital Fort Smith, FY2011; Physicians – Buxton, April 2012
Health Factor County AR US
Adult Smoking (% smoking >= 100 cigarettes) 24% 23% 14%
Adult Obesity (% with BMI >= 30) 34% 32% 25%
Physical Inactivity (% of 20+ pop. not active) 31% 31% 21%
Excessive/Binge Drinking 8% 12% 8%
Teen Birth Rate (per 1,000 females age 15-19) 57 61 22
Children in Poverty (% of children 0-17) 27% 27% 13%
Preventable Hospital Stays (per 1k Medicare) 62 81 49
COUNTY HEALTH RANKINGS
Franklin County Overall Health Rank = 10 (out of 75 counties) The lower the ranking, the healthier the community.
Below are some of the factors which attribute to the county’s health status compared to state and national benchmarks.
total outpatient volume in the Ozark PSA 273,529
13%
INPATIENT MARKET SHARE
% Market Share 2010
Discharges
71% JOHNSON REGIONAL MEDICAL CTR. 3,000
12% BOONEVILLE COMMUNITY HOSPITAL 508
11% MERCY HOSPITAL OZARK 462
6% MERCY HOSPITAL PARIS 252
4,222 total inpatient discharges within a 25-mile radius of Mercy Hospital Ozark
Note: Includes total inpatient discharges for hospitals located within a 25-mile radius of Mercy Hospital Ozark; does not account for outmigration
AR
Mercy Hospital
Mercy Clinic
Mercy Urgent/Convenient Care Clinic
Mercy Freestanding OP Surgery Center
Mercy Patient Origin by Zip Codebased on inpatient volume(volumes 1% or less not shown)
Other hospital (non-Mercy)
%
Community Snapshot PARIS PRIMARY SERVICE AREA & PATIENT ORIGIN The majority (88%) of Mercy Hospital Paris’s acute care patients reside in Logan County in west central Arkansas. Seven in ten patients share the same zip code (72855) as the hospital.
HOUSEHOLD ECONOMICS
Total Households: 8,943 Average Income: $43,256 Annual Income <$15K: 20%
INSURANCE COVERAGE
41% Private 21% Medicare 21% Medicaid 17% Uninsured
Race: 92% White; 2% Multiracial Ethnicity: 3% Hispanic (of any race)
Total Area Population: 22,761 5-Yr Growth: -2%
Age Cohorts: 24% Children (0-17) 17% Females (15-44) 17% Seniors (65+)
Median Age: 41
POPULATION
SERVICES & PHYSICIANS
In FY11, the top inpatient service lines for Mercy Hospital Paris were pulmonary (17%), cardiovascular (16%) and gastroenterology (14%).
There are approximately 13 physicians (62% primary care) located in the PSA, of which none are integrated with Mercy.
EDUCATION (based on population ages 25+)
15% Some High School 22% Some College 43% High School Diploma 11% Bachelor’s Degree/greater
OUTPATIENT MARKET SHARE (hospital-based only)
Sources: Map – Mercy Locations Directory & AHD (other locations); Inpatient Market Share – Mercy Finance, FY2010 (does not include Normal Newborns), all others – AHA Guide 2010 data; Outpatient Market Share – Data represents 187 procedure groups (categories of CPT and HCPCS codes). Hospitals include hospital-based outpatient services only. Physician Offices and Independent Laboratories represent procedures performed in a physician’s office and/or lab regardless of affiliation with a hospital or health system. Thomson Reuters Outpatient Market Profiles, 2010; Demographics – Thomson Reuters, 2011; Payer Mix – Thomson Reuters Insurance Estimates, 2011; County Health Rankings, 2012; Inpatient Services and Patient Origin – Mercy Hospital Fort Smith, FY2011; Physicians – Buxton, April 2012
Health Factor County AR US
Adult Smoking (% smoking >= 100 cigarettes) 32% 23% 14%
Adult Obesity (% with BMI >= 30) 29% 32% 25%
Physical Inactivity (% of 20+ pop. not active) 32% 31% 21%
Excessive/Binge Drinking 15% 12% 8%
Teen Birth Rate (per 1,000 females age 15-19) 63 61 22
Children in Poverty (% of children 0-17) 28% 27% 13%
Preventable Hospital Stays (per 1k Medicare) 95 81 49
COUNTY HEALTH RANKINGS
Logan County Overall Health Rank = 41 (out of 75 counties) The lower the ranking, the healthier the community.
Below are some of the factors which attribute to the county’s health status compared to state and national benchmarks.
total outpatient volume in the Paris PSA 299,574
% Market Share 2010
OP Volume
37% PHYSICIAN OFFICES 109,920
30% INDEPENDENT LABS 88,648
12% BOONEVILLE COMMUNITY HOSPITAL 34,954
5% MERCY HOSPITAL PARIS 15,426
4% SPARKS REGIONAL MEDICAL CENTER 13,149
3% MERCY HOSPITAL FORT SMITH 8,438
1% JOHNSON REGIONAL MEDICAL CTR. 4,393
1% UAMS MEDICAL CENTER-LITTLE ROCK 3,328
7% OTHER (including 0.01% Mercy) 21,318
69% 6%
4%
3%
2%
INPATIENT MARKET SHARE
total inpatient discharges within a 25-mile radius of Mercy Hospital Paris
6,443
% Market Share 2010
Discharges
47% JOHNSON REGIONAL MEDICAL CTR. 3,000
34% CHAMBERS MEMORIAL HOSPITAL 2,221
8% BOONEVILLE COMMUNITY HOSPITAL 508
7% MERCY HOSPITAL OZARK 462
4% MERCY HOSPITAL PARIS 252
AR
Note: Includes total inpatient discharges for hospitals located within a 25-mile radius of Mercy Hospital Paris; does not account for outmigration
Mercy Hospital
Mercy Clinic
Mercy Urgent/Convenient Care Clinic
Mercy Freestanding OP Surgery Center
Mercy Patient Origin by Zip Codebased on inpatient volume(volumes 1% or less not shown)
Other hospital (non-Mercy)
%
Community Snapshot WALDRON PRIMARY SERVICE AREA & PATIENT ORIGIN The majority (89%) of Mercy Hospital Waldron’s acute care patients reside in Scott County in west central Arkansas. Three in four patients share the same zip code (72958) as the hospital.
HOUSEHOLD ECONOMICS
Total Households: 8,100 Average Income: $41,474 Annual Income <$15K: 20%
INSURANCE COVERAGE
39% Private 20% Medicare 21% Medicaid 20% Uninsured
Race: 87% White; 3% Asian/Pacific Isl. Ethnicity: 6% Hispanic (of any race)
Total Area Population: 20,938 5-Yr Growth: -0.4%
Age Cohorts: 25% Children (0-17) 18% Females (15-44) 17% Seniors (65+)
Median Age: 39
POPULATION
Health Factor County AR US
Adult Smoking (% smoking >= 100 cigarettes) 30% 23% 14%
Adult Obesity (% with BMI >= 30) 32% 32% 25%
Physical Inactivity (% of 20+ pop. not active) 33% 31% 21%
Excessive/Binge Drinking 8% 12% 8%
Teen Birth Rate (per 1,000 females age 15-19) 84 61 22
Children in Poverty (% of children 0-17) 36% 27% 13%
Preventable Hospital Stays (per 1k Medicare) 124 81 49
COUNTY HEALTH RANKINGS
Scott County Overall Health Rank = 15 (out of 75 counties) The lower the ranking, the healthier the community.
Below are some of the factors which attribute to the county’s health status compared to state and national benchmarks.
SERVICES & PHYSICIANS
In FY11, Mercy Hospital Waldron’s top inpatient service lines were cardiovascular (20%), pulmonary (15%) and rehabilitation (13%).
There are approximately three primary care physicians located in the Waldron PSA, all of which are integrated with Mercy.
EDUCATION (based on population ages 25+)
15% Some High School 22% Some College 43% High School Diploma 10% Bachelor’s Degree/greater
OUTPATIENT MARKET SHARE (hospital-based only)
Sources: Map – Mercy Locations Directory & AHD (other locations); Inpatient Market Share – Mercy Finance, FY2010 (does not include Normal Newborns), all others – AHA Guide 2010 data; Outpatient Market Share – Data represents 187 procedure groups (categories of CPT and HCPCS codes). Hospitals include hospital-based outpatient services only. Physician Offices and Independent Laboratories represent procedures performed in a physician’s office and/or lab regardless of affiliation with a hospital or health system. Thomson Reuters Outpatient Market Profiles, 2010; Demographics – Thomson Reuters, 2011; Payer Mix – Thomson Reuters Insurance Estimates, 2011; County Health Rankings, 2012; Inpatient Services and Patient Origin – Mercy Hospital Fort Smith, FY2011; Physicians – Buxton, April 2012
total outpatient volume in the Waldron PSA 151,661
% Market Share 2010
OP Volume
38% PHYSICIAN OFFICES 58,053
26% MERCY HOSPITAL WALDRON 39,281
16% INDEPENDENT LABS 24,326
7% SPARKS REGIONAL MEDICAL CENTER 10,733
4% MERCY HOSPITAL FORT SMITH 6,522
2% UAMS MEDICAL CENTER-LITTLE ROCK 3,016
1% MENA REGIONAL HEALTH SYSTEM 1,899
0.4% BOONEVILLE COMMUNITY HOSPITAL 576
5% OTHER (including 0.03% Mercy) 7,255
76%
5%
4%
INPATIENT MARKET SHARE
total inpatient discharges within a 25-mile radius of Mercy Hospital Waldron
2,829
% Market Share 2010
Discharges
56% MENA REGIONAL HEALTH SYSTEM 1,574
26% MERCY HOSPITAL WALDRON 747
18% BOONEVILLE COMMUNITY HOSPITAL 508
AR
Note: Includes total inpatient discharges for hospitals located within a 25-mile radius of Mercy Hospital Waldron; does not account for outmigration
Mercy Hospital
Mercy Clinic
Mercy Urgent/Convenient Care Clinic
Mercy Freestanding OP Surgery Center
Mercy Patient Origin by Zip Codebased on inpatient volume(volumes 1% or less not shown)
Other hospital (non-Mercy)
%
Hot Springs PRIMARY SERVICE AREA
The Hot SpringsPrimary Service Area (PSA) comprises six counties in
west central Arkansas
AR
Private 40% Medicare
23%
Uninsured 19%
Medicaid 18%
DEMOGRAPHICS Hot Springs Service Area Arkansas 2011
US 2011 2011 2016 % Growth
Total Population 196,727 201,831 3% 2,932,778 310,650,750
0-17 21% 21% 2% 25% 24%
18-44 Females 15% 15% 1% 18% 18%
18-44 Males 16% 16% 1% 18% 19%
45-64 27% 25% -3% 25% 26%
65+ 21% 23% 13% 15% 13%
Median Age 43 - - 38 37
White 82% 81% 1% 75% 64%
Black 11% 11% 4% 16% 12%
American Indian 1% 1% 6% 1% 1%
Asian/Pacific Islander 1% 1% 14% 1% 5%
Multiracial and Other 2% 2% 13% 2% 2%
Hispanic (of any race) 5% 6% 23% 6% 16%
Speak Spanish in Home 3% - - 4% 12%
Total No. of Households 81,923 82,285 <1% 1,157,580 116,862,390
Households with Children 28% - - 34% 34%
HH Income Under $15K 19% - - 18% 13%
HH Income Over $75K 16% - - 18% 30%
Average HH Income $ 47,033 - - $ 50,392 $ 67,529
Some High School 10% - - 11% 9%
High School Graduate/GED 35% - - 35% 29%
Some College 30% - - 28% 28%
Bachelor’s Degree or greater 19% - - 19% 28%
Source: Hot Springs Chamber of Commerce; Garland County Economic Development Corporation
Company Industry Staff
Mercy Hospital Health care 2,300
Oaklawn Park Thoroughbred Racing 1,210
Walmart Retail 1,102
National Park Medical Center Health care 649
City of Hot Springs Government 620
Hot Springs School District Education 610
National Park Community College Higher Education 607
MAJOR EMPLOYERS
Top area employers as listed by The Greater Hot Springs Chamber of Commerce:
Source: Thomson Reuters Insurance Coverage Estimates, 2011
INSURANCE COVERAGE
Hot Springs DEMOGRAPHICS
Note: Hot Springs Service Area consists of six counties in Arkansas; Education Level based on population age 25+ Source: Thomson Reuters, 2011
Rac
e &
Eth
nic
ity
Age
Gro
up
s H
ou
seh
old
s Ed
uca
tio
n
Health Factor Garland County Arkansas
National Benchmark
Adult Smoking (% smoking >= 100 cigarettes) 27% 23% 14%
Adult Obesity (% with BMI >= 30) 28% 32% 25%
Physical Inactivity (% of adults age 20+ not active) 28% 31% 21%
Excessive/Binge Drinking 15% 12% 8%
Teen Birth Rate (per 1,000 females age 15-19) 64 61 22
Children in Poverty (% of children under 18 in poverty) 38% 27% 13%
Preventable Hospital Stays (per 1,000 Medicare enrollees) 56 81 49 Sources: (state) Overall Health Ranking – America’s Health Rankings, 2011, provided by United Health Foundation; (county) Overall Health Ranking and Health Factors table – 2012 County Health Rankings provided by the Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute
COMMUNITY HEALTH MEASURES
Overall Health Ranking: Arkansas = 47 (/50 states); Garland County = 37 (/75 counties) Rankings are out of total number of states or reporting counties. The lower the number, the healthier the community.
Below are some of the factors which attribute to community health.
AR US
Hypertension 34%
Arthritis 28%
Asthma 13%
Diabetes 10%
Coronary Heart Disease 6%
COPD 5%
Angina 3%
Congestive Heart Failure 2%
CHRONIC DISEASE
Within the six-county Hot Springs Service Area, the following chronic conditions have been identified among the adult (18+) population:
In addition, 4% have had a stroke 5% have had a heart attack, and 6% are living with some type of cancer
Source: Thomson Reuters Continuum of Care, 2011
Private 45% 56% Medicare 17% 14% Medicaid 19% 14% Uninsured 19% 16%
7.8% 7.4% 8.2%
UNEMPLOYMENT RATE
Change over 12 months
↓0.8% MSA*
↓0.6% Arkansas
↓0.7% US
*Hot Springs, AR Metropolitan Statistical Area Note: US & State rates are seasonally adjusted; MSA, non-seasonally adjusted Source: US Dept. of Labor – Bureau of Labor Statistics
MARCH 2012
1
3
2
The map below depicts all inpatient hospitals and freestanding general outpatient surgery centers in the Hot Springs Service Area.
Hospitals (*indicates on-site outpatient surgery center) Health System Affiliation
Mercy Hospital Hot Springs* Mercy
National Park Medical Center* Capella Healthcare
Baptist Health Medical Center-Arkadelphia* Baptist Health
HSC Medical Center* Independent
Howard Memorial Hospital* Independent
4
3
1
2
4
Hot Springs REGIONAL PROVIDER LANDSCAPE
5
5
ARKANSAS
Freestanding General Outpatient
Surgery Center
Mercy
Independent
Source: Buxton ASC database, 2012
• Non-profit, member of Mercy
• General acute care hospital, ambulatory surgery center, a network of physician clinics, hospice and home health agency
• Offers the only Level II trauma center in southwest Arkansas, the region’s only da Vinci Surgical system and a newly established telestroke program
• Mercy Clinic includes 106 primary care, specialty and hospital-based physicians, 41 advanced practice providers and 455 clinic co-workers supporting more than 367,000 outpatient visits in 21 clinics and three urgent/convenient care sites (physician counts as of April 2012)
INPATIENT MARKET SHARE *56%
TOTAL ASSETS $126M
NET PATIENT REVENUE $170M
OPER. PROFIT MARGIN 2.4% *Market share reflects FY10 inpatient volume for Mercy and 2010 AHA Guide IP volume for National Park Source: IP discharges (total hospital), market share (total hospital), beds, births, ED visits, total assets, NPR, OPM – Mercy Finance, FY11; Mercy FTEs & clinic co-workers – Mercy Pension & Comp, April 2012
www.nationalparkmedical.com
Hospital FTEs Staffed
Beds Total Hospital
IP Volume Total Births
National Park Medical Center 600 181 5,102 689
• For-profit, owned by Capella Healthcare
• One acute care hospital, heart and vascular center, The Family Maternity Center, home health, a skilled nursing facility and medical offices in Hot Springs Village and Hot Springs, AR
• The hospital’s adult inpatient rehab department has earned five consecutive accreditations from the Commission on Accreditation of Rehabilitation Facilities, one of only six such programs in Arkansas to achieve this accreditation
INPATIENT MARKET SHARE *24%
TOTAL ASSETS $108M
NET PATIENT REVENUE $67M
OPER. PROFIT MARGIN 10.9% *Market share reflects FY10 inpatient volume for Mercy and 2010 AHA Guide IP volume for National Park Source: IP admits (total hospital), market share (total hospital), beds, births, FTEs – AHA Guide, 2010 data; total assets, NPR, OPM – AHD, 2010
Hospital Health System FTEs Staffed
Beds Total Hospital
IP Volume Total Births
HSC Medical Center (Malvern, AR) Independent 306 72 2,449 0
Baptist Health Medical Center-Arkadelphia Baptist Health 167 25 1,039 264
Howard Memorial Hospital (Nashville, AR) Independent 120 20 809 0
Source: IP admits (total hospital), beds, births, FTEs – AHA Guide, 2010 data
Other Health Care Providers in the Hot Springs Service Area
Hospital FTEs Staffed
Beds Total Hospital
IP Volume Total Births
Total ED Visits
Mercy Hospital Hot Springs 1,125 270 11,910 1,028 39,085 www.mercy.net
Note: Hospital only
Note: Hospital only
In May 2012, Mercy signed an Agreement in Principle with Capella Healthcare, the parent organization of National Park Medical Center, to explore a transfer of ownership of Mercy in Hot Springs to Capella by late 2012.
Hot Springs REGIONAL PROVIDER STATISTICS
0 500 1,000 1,500 2,000
OB
Pulm
Ortho
Neuro
Cardio
FY11 Discharges
Note: Primary Care = FP/GP, IM, OB/Gyn, Pediatrics Source: Thomson Reuters Physician Estimates, 2011
Mercy Clinic Physicians 68%
Richard Wyderski, MD (Geriatrics) 6%
Hot Springs Neurosurgery Clinic 4%
Family Medicine Clinic 3%
Hot Springs Bone & Joint Clinic 3%
Genesis Cancer Center 2%
Hot Springs Diagnostic Associates 2%
Psychiatric Clinic Hot Springs 2%
Pioneer Health Services 2%
Levi Hospital Physicians 2%
Hot Springs Pediatric Clinic 1%
Other 5%
Hot Springs AR US
Primary Care 78 88 116
Specialty 52 61 81
Total 130 149 197
Mercy Hospital Hot Springs
Note: Includes total inpatient discharges for hospitals located within the Hot Springs six-county PSA; does not account for outmigration Source: Mercy Finance Data, FY08-FY10; All others-AHA Guide, 2008-2010 Data (does not include Normal Newborns)
Hospital 2008 2009 2010
Mercy Hospital Hot Springs-AR 50% 51% 56%
National Park Medical Center-Hot Springs, AR 20% 19% 24%
HSC Medical Center-Malvern, AR 10% 10% 11%
HealthPark Hospital-Hot Springs, AR* 5% 5% NA
Baptist Health Medical Center-Arkadelphia, AR 4% 4% 5%
Howard Memorial Hospital-Nashville, AR 3% 2% 4%
Note: Total (n) = 147 integrated Mercy physicians and advanced practitioners serving the Hot Springs community Source: Mercy Hospital Hot Springs Medical Staff Coordinator, April 2012
Advanced Practice
28% Hospital-
based 21%
Specialists 22%
Primary Care 29%
Medical Facility 2010
Physician Offices* 61%
Independent Labs* 10%
Mercy Hospital Hot Springs-AR 7%
UAMS Medical Center-Little Rock, AR 3%
National Park Medical Center-Hot Springs, AR 2%
Howard Memorial Hospital-Nashville, AR 2%
HealthPark Hospital-Hot Springs, AR** 2%
HSC Medical Center-Malvern, AR 2%
Baptist Health Medical Center-Arkadelphia, AR 1%
Levi National Arthritis Hospital-Hot Springs, AR 1%
Other Mercy hospitals <1%
Other (incl. hospitals and freestanding facilities) 9%
Note: Mercy service lines used; service line market share data not available for AR Source: Trendstar Data, FY11
Mercy Hospital Volume
*As of January 2011, HealthPark Hospital (Mercy facility) converted to an Ambulatory Surgery Center
13%
11%
10%
10%
9%
% of Volume
Hot Springs PATIENT CARE
INPATIENT PHYSICIANS OUTPATIENT INPATIENT MARKET SHARE TRENDS PHYSICIAN SUPPLY/100,000 POPULATION
INPATIENT DISCHARGES BY PHYSICIAN GROUP
MERCY INTEGRATED MEDICAL STAFF
TOP INPATIENT SERVICE LINES
OUTPATIENT MARKET SHARE (Hospital-based)
OUTPATIENT UTILIZATION – MARKET ESTIMATES
% Change
Select Clinical Service Categories
2011 Procedures
Adjusted and Trended*
5 Yr 10 Yr
Physical and Occ. Therapy 460,181 32% 44%
Hematology/Oncology 118,167 20% 28%
Cardiology 135,486 19% 25%
Orthopedics 37,452 24% 32%
Nephrology 33,657 113% 135%
Neurology 29,176 28% 38%
OB/Gyn 25,402 52% 56%
General Surgery 19,208 19% 27%
Gastroenterology 16,234 29% 34%
*Physician Offices and Independent Laboratories represent procedures performed in a physician’s office and/or lab regardless of the provider’s affiliation with a hospital or health system **As of January 2011, HealthPark Hospital (Mercy facility) converted to an Ambulatory Surgery Center Note: Data represents 187 procedure groups (categories of CPT and HCPCS codes); Hospitals include hospital-based outpatient services only Source: Thomson Reuters Outpatient Market Profiles, 2010
Note: Data is available for additional clinical service categories *Adjusted and Trended estimates take into account technology trends, health care reform, and changes in disease incidence and prevalence Source: Thomson Reuters Outpatient Estimates, 2011
Of the region’s 737,430 hospital-based outpatient visits, 23% occurred outside the Hot Springs PSA (15% at Little Rock, AR facilities)
Source: Epic data, FY11 inpatient discharges; Buxton physician database, April 2012
Mercy believes in listening to our communities and responding to their needs. As part of the People Promise key initiative, the Ministry is standardizing the survey tool and vendor used to obtain patient feedback – reinforcing our mission and culture of providing exceptional service, and to enhance the Mercy experience for our patients. Currently, we can look to HCAHPS survey results as a measure of patients’ perspectives of care.
Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a national survey developed by the Centers for Medicare & Medicaid Services (CMS) and the Agency for Healthcare Research and Quality (AHRQ). The data is publicly available to consumers.
Mercy’s HCAHPS results from patients who had overnight hospital stays during April 1, 2010 and March 31, 2011 are shown below, and are compared to other area providers as well as state and national averages for all reporting hospitals. Percentage of patients who gave the hospital
the highest rankings Percentage of patients who gave the hospital
the lowest rankings
Mercy Hospital
National Park
HSC Med Ctr (Malvern)
AR US Mercy
Hospital National
Park HSC Med Ctr
(Malvern) AR US
75% 74% 71% 77% 76% 4% 8% 7% 6% 5%
79% 81% 88% 84% 80% 4% 4% 2% 4% 4%
59% 59% 61% 65% 64% 11% 11% 13% 11% 10%
72% 69% 62% 70% 70% 5% 6% 10% 7% 7%
58% 60% 62% 62% 61% 22% 21% 19% 21% 21%
69% 66% 69% 71% 72% 8% 12% 8% 10% 9%
53% 64% 56% 65% 58% 13% 8% 9% 8% 11%
78% 79% 77% 80% 82% 22% 21% 23% 20% 18%
68% 70% 58% 68% 68% 8% 8% 13% 9% 9%
70% 74% 58% 68% 70% 4% 5% 6% 6% 5%
Hot Springs PATIENT SATISFACTION
Scale (Question 1 – 7): highest = “always”; lowest = “sometimes” or “never”
Scale (Question 8): highest = “yes/did”; lowest = “no/did not”
Scale (Question 9): highest = “9” or “10”; lowest = “6” or lower
Scale (Question 10): highest = “YES, definitely”; lowest = “No, probably/definitely not”
1 How often did nurses communicate well with patients?
2 How often did doctors communicate well with patients?
3 How often did patients receive help quickly from staff?
4 How often was patients’ pain well controlled?
5 How often did staff explain about medicines before giving them to patients?
6 How often were patients’ rooms & bathrooms kept clean?
7 How often was the area around patients’ rooms kept quiet at night?
8 Were patients given information about what to do during their recovery at home?
9 How do patients rate the hospital overall?
10 Would patients recommend the hospital to friends and family?
Source: www.hospitalcompare.hhs.gov. Most current data available updated April 19, 2012 – results from patients who had overnight hospital stays during April 1, 2010 and March 31, 2011. More than 300 surveys were completed for each facility. Average response rate was 33%.
= indicates an equal or greater percentage of Mercy patients gave the hospital the highest rankings compared to competitors shown
Hot Springs CONSUMER PERCEPTIONS Another way Mercy listens to our customer is through syndicated opinion surveys. National Research Corporation (NRC) administers an annual consumer opinion survey related specifically to health care, providing historical and current data on more than 3,200 hospitals and health systems nationwide.
When asked about preferred providers for quality, image/reputation and select service lines, participating residents from the surveyed region provided feedback displayed here.
BEST OVERALL QUALITY 2011
Total number of respondents: 283 Providers with 1% or less are included in “Other Facilities”
BEST IMAGE/REPUTATION 2011
Total number of respondents: 287 Providers with 1% or less are included in “Other Facilities”
50%46%
50%
44%
0%
15%
30%
45%
60%
2008 2009 2010 2011
Mercy Hospital Hot SpringsNational Park Medical CenterBaptist Health Medical Center-Little RockArkansas Heart HospitalUAMS-University Hospital of Arkansas
Average number of respondents (4 yrs trending): 232
% r
esp
on
den
ts
Heart Care
51%
45%
53%
46%
17%23% 23% 22%
0%
15%
30%
45%
60%
2008 2009 2010 2011
Mercy Hospital Hot SpringsNational Park Medical CenterUAMS-University Hospital of ArkansasBaptist Health Medical Center-Little Rock
Average number of respondents (4 yrs trending): 199
% r
esp
on
den
ts
Maternity/OB
52% 53% 51%
42%
0%
15%
30%
45%
60%
2008 2009 2010 2011
Mercy Hospital Hot SpringsUAMS-University Hospital of ArkansasNational Park Medical CenterBaptist Health Medical Center-Little Rock
Average number of respondents (4 yrs trending): 223
% r
esp
on
den
ts
Cancer Treatment
Average number of respondents (4 yrs trending): 204 %
res
po
nd
ents
Pediatric Services
SELECT SERVICE LINE PREFERENCE TRENDS
Last year, 44% of Hot Springs consumers who took the survey chose a Mercy Hospital for best overall quality; 44% also selected Mercy as having the best image or reputation.
Source: NRC Healthcare Market Guide, 2011 (data collected Sep 2010 – Aug 2011); Hot Springs Community (6-county PSA: Clark and Montgomery Counties not surveyed)
44%
19%12%
9%
3%
12%
Mercy Hospital Hot SpringsNational Park Medical CenterUAMS-University Hospital of ArkansasBaptist Health Medical Center-Little RockCHRISTUS St. Michael Health SystemOther Facilities
44%
20%13%
8%
2%
13%
Mercy Hospital Hot SpringsNational Park Medical CenterUAMS-University Hospital of ArkansasBaptist Health Medical Center-Little RockCHRISTUS St. Michael Health SystemOther Facilities
(Texarkana, TX)
(Texarkana, TX)
41%
31%
39%36%
29% 31%
14%
22%
0%
15%
30%
45%
60%
2008 2009 2010 2011
Mercy Hospital Hot SpringsArkansas Children's HospitalNational Park Medical CenterUAMS-University Hospital of ArkansasBaptist Health Medical Center-Little Rock
Northwest Arkansas PRIMARY SERVICE AREA
The Northwest ArkansasPrimary Service Area (PSA) comprises
six counties in southwest Missouri and northwest Arkansas
AR
MO
Company Industry Staff
Rogers Public Schools Education 1,926
Mercy Hospital Health care 1,400
Pinnacle Healthcare Nursing Home 1,100
Tyson Chick-N-Quick Plant Poultry/food products 1,033
Walmart Claims Center Claims Administration 875
Crossland Construction General Contractor 700
Rogers Tool Works Cutting Tools 700
Private 56%
Medicare 14%
Uninsured 16%
Medicaid 15%
DEMOGRAPHICS Northwest AR Service Area Arkansas 2011
US 2011 2011 2016 % Growth
Total Population 549,229 605,598 10% 2,932,778 310,650,750
0-17 26% 27% 12% 25% 24%
18-44 Females 19% 18% 6% 18% 18%
18-44 Males 19% 19% 5% 18% 19%
45-64 23% 23% 11% 25% 26%
65+ 12% 13% 21% 15% 13%
Median Age 35 - - 38 37
White 78% 73% 4% 75% 64%
Black 2% 3% 38% 16% 12%
American Indian 2% 2% 14% 1% 1%
Asian/Pacific Islander 2% 3% 33% 1% 5%
Multiracial and Other 2% 2% 19% 2% 2%
Hispanic (of any race) 15% 18% 32% 6% 16%
Speak Spanish in Home 10% - - 4% 12%
Total No. of Households 206,758 229,034 11% 1,157,580 116,862,390
Households with Children 35% - - 34% 34%
HH Income Under $15K 14% - - 18% 13%
HH Income Over $75K 21% - - 18% 30%
Average HH Income $ 55,351 - - $ 50,392 $ 67,529
Some High School 10% - - 11% 9%
High School Graduate/GED 32% - - 35% 29%
Some College 26% - - 28% 28%
Bachelor’s Degree or greater 24% - - 19% 28%
Source: Rogers-Lowell Chamber of Commerce, 2011
MAJOR EMPLOYERS
Largest employers in Rogers as listed with the Rogers-Lowell Area Chamber of Commerce:
Source: Thomson Reuters Insurance Coverage Estimates, 2011
Hypertension 28%
Arthritis 22%
Asthma 13%
Diabetes 8%
COPD 4%
Coronary Heart Disease 4%
Angina 2%
Congestive Heart Failure 2%
CHRONIC DISEASE
Within the six-county Northwest Arkansas Service Area, the following chronic conditions have been identified among the adult (18+) population:
In addition, 3% have had a stroke 3% have had a heart attack, and 5% are living with some type of cancer
Source: Thomson Reuters Continuum of Care, 2011
INSURANCE COVERAGE
Northwest Arkansas DEMOGRAPHICS
Note: Northwest Arkansas Service Area consists of six counties in Arkansas (4) and Missouri (2); Education Level based on population age 25+ Source: Thomson Reuters, 2011
Rac
e &
Eth
nic
ity
Age
Gro
up
s H
ou
seh
old
s Ed
uca
tio
n
Health Factor Benton County Arkansas
National Benchmark
Adult Smoking (% smoking >= 100 cigarettes) 19% 23% 14%
Adult Obesity (% with BMI >= 30) 28% 32% 25%
Physical Inactivity (% of adults age 20+ not active) 28% 31% 21%
Excessive/Binge Drinking 12% 12% 8%
Teen Birth Rate (per 1,000 females age 15-19) 53 61 22
Children in Poverty (% of children under 18 in poverty) 14% 27% 13%
Preventable Hospital Stays (per 1,000 Medicare enrollees) 71 81 49 Sources: (state) Overall Health Ranking – America’s Health Rankings, 2011, provided by United Health Foundation; (county) Overall Health Ranking and Health Factors table – 2012 County Health Rankings provided by the Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute
COMMUNITY HEALTH MEASURES
Overall Health Ranking: Arkansas = 47 (/50 states); Benton County = 1 (/75 counties) Rankings are out of total number of states or reporting counties. The lower the number, the healthier the community.
Below are some of the factors which attribute to community health.
AR US
Private 45% 56% Medicare 17% 14% Medicaid 19% 14% Uninsured 19% 16% 5.7%
7.4% 8.2%
UNEMPLOYMENT RATE
Change over 12 months
↓0.6% MSA*
↓0.6% Arkansas
↓0.7% US
*Fayetteville-Springdale-Rogers, AR-MO Metropolitan Statistical Area Note: US & State rates are seasonally adjusted; MSA, non-seasonally adjusted Source: US Dept. of Labor – Bureau of Labor Statistics
MARCH 2012
5 The map below depicts all inpatient hospitals and freestanding general outpatient surgery centers in the Northwest Arkansas Service Area.
2
4
3
1
5
6
7 8
9
11
10
Northwest Arkansas REGIONAL PROVIDER LANDSCAPE
Freestanding General Outpatient
Surgery Center
Mercy
Community Health Systems
Washington Regional
Independent
Source: Buxton ASC database, 2012
12
1
3
4
2
5
10
11
8
6
7
Hospitals (*indicates on-site outpatient surgery center) Health System Affiliation
Mercy Hospital Northwest Arkansas Mercy
Mercy Hospital Berryville* Mercy
Mercy Hospital Cassville* Mercy
Cox Monett Hospital* CoxHealth
Northwest Medical Center-Springdale* Northwest Health System (Community Health Systems)
Northwest Medical Center-Bentonville* Northwest Health System (Community Health Systems)
Willow Creek Women's Hospital* Northwest Health System (Community Health Systems)
Siloam Springs Memorial Hospital* Community Health Systems
Washington Regional Medical Center* Washington Regional
Physicians’ Specialty Hospital* Physician Owned
Eureka Springs Hospital* Independent
Ozarks Community Hospital of Gravette Independent
9
Northwest Arkansas REGIONAL PROVIDER LANDSCAPE
12
Hospital
FTEs
Staffed Beds
Total Hospital IP Volume
Total Births
Total ED Visits
Mercy Hospital Northwest Arkansas 698 147 8,395 1,266 40,237
• Non-profit, member of Mercy
• One general acute care hospital, ambulatory surgery center, heart and vascular center, home health/hospice agency, imaging center and other specialty centers
• Mercy Clinic includes 92 primary care and specialty physicians, 30 advanced practice providers and 433 clinic co-workers providing 345,000 outpatient visits in 15 clinics and one urgent/convenient care site (physician counts as of April 2012)
INPATIENT MARKET SHARE 19%
TOTAL ASSETS $190M
NET PATIENT REVENUE $136M
OPER. PROFIT MARGIN 8.5%
www.wregional.com
Hospital
FTEs
Staffed Beds
Total Hospital IP Volume
Total Births
Washington Regional Medical Center 1,661 248 12,077 881
• Non-profit, community-owned
• One general acute care hospital in Fayetteville, surgery center, long-term care facility, rehabilitation hospital (joint venture with HealthSouth), two cancer support homes, three dialysis centers and 15 primary care and specialty clinics
• Home to Johnelle Hunt Women’s Center and the Walker Heart Institute
INPATIENT MARKET SHARE 26%
TOTAL ASSETS $293M
NET PATIENT REVENUE $205M
OPER. PROFIT MARGIN 1.2% Source: IP admits, market share (total facility), beds, births, FTEs – AHA Guide, 2010 data; total assets, NPR, OPM – AHD, 2010
www.northwesthealth.com
Hospital
FTEs
Staffed Beds
Total Hospital IP Volume
Total Births
Northwest Medical Center-Springdale 993 183 8,886 0
Northwest Medical Center-Bentonville 362 99 6,005 1,093
Willow Creek Women’s Hospital (Johnson, AR) 220 64 3,520 2,905
TOTAL 1,575 346 18,411 3,998
• For-profit, member of Community Health Systems
• Two general acute care hospitals, a women’s hospital, home health agency
• Northwest Physicians Clinics includes approximately 50 physicians and advanced practitioners in 36 primary care and specialty clinics
INPATIENT MARKET SHARE 40%
TOTAL ASSETS $181M
NET PATIENT REVENUE $289M
OPER. PROFIT MARGIN 4.7%
Source: IP admits, market share (total facility), beds, births, FTEs – AHA Guide, 2010 data; total assets, NPR, OPM – AHD, 2010
www.mercy.net
Note: Mercy Hospital Northwest Arkansas only
Note: Northwest Health System Hospitals only
Note: Hospital only
Source: IP discharges, market share (total facility), beds, births, FTEs, ED visits, total assets, NPR, OPM – Mercy Finance, FY11; Mercy FTEs & clinic co-workers – Mercy Pension & Comp, April 2012
Hospital
FTEs
Staffed Beds
Total Hospital IP Volume
Total Births
Total ED Visits
Mercy Hospital Berryville 136 25 797 100 9,380
Mercy Hospital Cassville 95 18 300 0 10,163 Source: IP discharges (for Berryville), beds, ED visits - Mercy Finance, FY11; Berryville births – AHD, 2010; IP discharges (Cassville) – HIDI, FFY11; Mercy FTEs & clinic co-workers – Mercy Pension & Comp, April 2012
Other Mercy Facilities in the NWA Service Area (part of Mercy Springfield)
Northwest Arkansas REGIONAL PROVIDER STATISTICS
Hospital
FTEs
Staffed Beds
Total Hospital IP Volume
Total Births
Siloam Springs Regional Hospital 246 43 2,873 571
Source: IP admits (total facility), beds, births, FTEs – AHA Guide, 2010 data • For-profit, member of Community Health Systems
• One general acute care hospital; affiliated but not integrated part of Northwest Health System
www.ssrh.net
Other CHS Facilities in the NWA Service Area
Northwest Health System Hospitals
INPATIENT MARKET SHARE 6%
TOTAL ASSETS $11M
NET PATIENT REVENUE $36M
OPER. PROFIT MARGIN 8.2% Note: Hospital only
www.chs.net
Hospital Health System
FTEs Staffed
Beds Total Hospital
IP Volume Total Births
Physicians’ Specialty Hospital (Fayetteville, AR) Physician-owned 151 20 886 0
Cox Monett Hospital (Missouri) CoxHealth 235 25 812 286
Ozarks Community Hospital of Gravette Independent 170 25 750 3
Eureka Springs Hospital Independent 79 15 488 0
Source: Physicians’ Specialty Hospital – AHD, 2010; Cox Monett IP discharges (total facility) – HIDI, FFY11; All others – IP admits (total facility), beds, births, FTEs – AHA Guide, 2010 data
Other Health Care Providers in the Northwest Arkansas Service Area
HealthSouth Rehabilitation Hospital of Fayetteville
• For-profit, joint venture between HealthSouth and Washington Regional Medical Center
• 60-bed facility offering inpatient and outpatient rehabilitation services www.healthsouthfayetteville.com
Northwest Arkansas REGIONAL PROVIDER STATISTICS
Advanced Practice
25%
Hospital-based 9%
Specialists 23%
Primary Care 43%
0 500 1,000 1,500 2,000
Gastro
Pulm
Gen Surg
OB
Cardio
FY11 Discharges
Note: Primary Care = FP/GP, IM, OB/Gyn, Pediatrics Source: Thomson Reuters Physician Estimates, 2011
Mercy Clinic Physicians 83%
Ozarks Ortho & Sports Medicine Clinic 5%
Highlands Oncology Group 2%
Urology Assoc. of Northwest Arkansas 1%
Benton County Urology 1%
Lowell Medical Center 1%
Randelon Smith, MD (Gastroenterology) 1%
Other 6%
NWA AR US
Primary Care 77 88 116
Specialty 47 61 81
Total 124 149 197
Mercy Hospital Northwest Arkansas
Note: Mercy service lines used; service line market share not available for AR Source: Trendstar Data, FY2011
Hospital 2008 2009 2010
Washington Reg. Med. Ctr.-Fayetteville, AR 31% 24% 26%
Northwest Medical Ctr.-Springdale-AR 16% 17% 19%
Mercy Hospital NW Arkansas-Rogers, AR 18% 19% 19%
Northwest Medical Ctr.-Bentonville-AR 12% 12% 13%
Willow Creek Women's Hosp.-Johnson, AR 8% 13% 8%
Siloam Springs Memorial Hosp.-AR 7% 6% 6%
Mercy Hospital Berryville-AR 3% 3% 2%
Cox Monett Hosp.-MO 2% 2% 2%
Physicians’ Specialty Hosp.-Fayetteville, AR NA 2% 2%
Ozarks Community Hosp. of Gravette-AR NA 1% 2%
Eureka Springs Hosp.-AR 1% 1% 1%
Mercy Hospital Cassville-MO 1% 1% 1%
Note: Total (n) = 122 integrated Mercy physicians and advanced practitioners serving the Northwest Arkansas community Source: Mercy Hospital Northwest Arkansas Medical Staff Services, April 2012
Medical Facility 2010
Physician's Offices* 65%
Independent Labs* 9%
NW Medical Centers-Bentonville & Springdale, AR 6%
Washington Regional Medical Ctr.-Fayetteville, AR 5%
Mercy Hospital NW Arkansas-Rogers, AR 3%
Cox Monett Hospital-MO 1%
Mercy Hospital Berryville-AR 1%
Mercy Hospital Cassville-MO 1%
Freeman Neosho Hospital-MO 1%
UAMS Medical Center-Little Rock, MO 1%
Eureka Springs Hospital-AR 1%
Other Mercy hospitals 1%
Other (incl. hospitals and freestanding facilities) 7%
Note: Includes total inpatient discharges for hospitals located within the Northwest Arkansas six-county PSA; does not account for outmigration Source: Mercy Finance Data, FY08-FY10; All others-AHA Guide, 2008-2010 Data (does not include Normal Newborns)
Mercy Hospital Volume
19%
16%
11%
8%
8%
% of Volume
Northwest Arkansas PATIENT CARE
INPATIENT PHYSICIANS OUTPATIENT INPATIENT MARKET SHARE TRENDS PHYSICIAN SUPPLY/100,000 POPULATION
INPATIENT DISCHARGES BY PHYSICIAN GROUP
MERCY INTEGRATED MEDICAL STAFF
TOP INPATIENT SERVICE LINES
OUTPATIENT MARKET SHARE (Hospital-based)
OUTPATIENT UTILIZATION – MARKET ESTIMATES
% Change
Select Clinical Service Categories
2011 Procedures
Adjusted and Trended*
5 Yr 10 Yr
Physical and Occ. Therapy 894,917 48% 77%
Hematology/Oncology 287,121 29% 49%
Cardiology 198,699 28% 47%
Neurology 76,625 33% 54%
OB/Gyn 74,220 55% 65%
Orthopedics 52,477 43% 70%
Nephrology 52,406 113% 188%
General Surgery 30,374 32% 52%
Gastroenterology 27,567 36% 54%
*Physician Offices and Independent Laboratories represent procedures performed in a physician’s office and/or lab regardless of the provider’s affiliation with a hospital or health system Note: Data represents 187 procedure groups (categories of CPT and HCPCS codes); Hospitals include hospital-based outpatient services only Source: Thomson Reuters Outpatient Market Profiles, 2010
Note: Data is available for additional clinical service categories *Adjusted and Trended estimates take into account technology trends, health care reform, and changes in disease incidence and prevalence Source: Thomson Reuters Outpatient Estimates, 2011
Of the region’s 1.4M hospital-based outpatient visits, 18% occurred outside the Northwest Arkansas PSA (4% at Mercy hospitals)
Source: Epic data, FY11 inpatient discharges; Buxton physician database, April 2012
Mercy believes in listening to our communities and responding to their needs. As part of the People Promise key initiative, the Ministry is standardizing the survey tool and vendor used to obtain patient feedback – reinforcing our mission and culture of providing exceptional service, and to enhance the Mercy experience for our patients. Currently, we can look to HCAHPS survey results as a measure of patients’ perspectives of care.
Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a national survey developed by the Centers for Medicare & Medicaid Services (CMS) and the Agency for Healthcare Research and Quality (AHRQ). The data is publicly available to consumers.
Mercy’s HCAHPS results from patients who had overnight hospital stays during April 1, 2010 and March 31, 2011 are shown below, and are compared to other area providers as well as state and national averages for all reporting hospitals. Percentage of patients who gave the hospital
the highest rankings Percentage of patients who gave the hospital
the lowest rankings
Mercy Hospital
NWMC* Washington
Regional AR US
Mercy Hospital
NWMC* Washington
Regional AR US
73% 73% 76% 77% 76% 5% 6% 4% 6% 5%
79% 79% 80% 84% 80% 4% 4% 4% 4% 4%
58% 59% 64% 65% 64% 11% 12% 10% 11% 10%
67% 70% 69% 70% 70% 8% 7% 6% 7% 7%
60% 58% 59% 62% 61% 21% 23% 20% 21% 21%
79% 69% 69% 71% 72% 6% 10% 10% 10% 9%
54% 62% 65% 65% 58% 10% 9% 7% 8% 11%
85% 85% 81% 80% 82% 15% 15% 19% 20% 18%
72% 69% 68% 68% 68% 7% 8% 7% 9% 9%
77% 72% 77% 68% 70% 3% 5% 3% 6% 5%
Northwest Arkansas PATIENT SATISFACTION
Scale (Question 1 – 7): highest = “always”; lowest = “sometimes” or “never”
Scale (Question 8): highest = “yes/did”; lowest = “no/did not”
Scale (Question 9): highest = “9” or “10”; lowest = “6” or lower
Scale (Question 10): highest = “YES, definitely”; lowest = “No, probably/definitely not”
1 How often did nurses communicate well with patients?
2 How often did doctors communicate well with patients?
3 How often did patients receive help quickly from staff?
4 How often was patients’ pain well controlled?
5 How often did staff explain about medicines before giving them to patients?
6 How often were patients’ rooms & bathrooms kept clean?
7 How often was the area around patients’ rooms kept quiet at night?
8 Were patients given information about what to do during their recovery at home?
9 How do patients rate the hospital overall?
10 Would patients recommend the hospital to friends and family?
*NWMC represents Northwest Arkansas Hospitals, LLC reporting as a combined 3-hospital system including Northwest Medical Centers Springdale and Bentonville, and Willow Creek Women’s Hospital in Johnson, AR Source: www.hospitalcompare.hhs.gov. Most current data available updated April 19, 2012 – results from patients who had overnight hospital stays during April 1, 2010 and March 31, 2011. More than 300 surveys were completed for each hospitals. Average response rate was 33%.
= indicates an equal or greater percentage of Mercy patients gave the hospital the highest rankings compared to competitors shown
Northwest Arkansas CONSUMER PERCEPTIONS Another way Mercy listens to our customer is through syndicated opinion surveys. National Research Corporation (NRC) administers an annual consumer opinion survey related specifically to health care, providing historical and current data on more than 3,200 hospitals and health systems nationwide.
When asked about preferred providers for quality, image/reputation and select service lines, participating residents from the surveyed region provided feedback displayed here.
49%
35%
40% 38%
12% 15% 15% 15%
0%
10%
20%
30%
40%
50%
2008 2009 2010 2011
Washington Regional Medical CenterMercy Hospital Northwest ArkansasNorthwest Medical Center-SpringdaleMercy Hospital Springfield
Average number of respondents (4 yrs trending): 341
% r
esp
on
den
ts
Heart Care
Average number of respondents (4 yrs trending): 310
% r
esp
on
den
ts
Maternity/OB
38%
27%
34%31%
6%11%
15% 13%
0%
10%
20%
30%
40%
50%
2008 2009 2010 2011
Washington Regional Medical Center
Mercy Hospital Northwest Arkansas
CTCA at Southwestern Regional Medical Center
Mercy Hospital Springfield
Northwest Medical Center-Springdale
Average number of respondents (4 yrs trending): 305
% r
esp
on
den
ts
Cancer Treatment
Average number of respondents (4 yrs trending): 303 %
res
po
nd
ents
Pediatric Services
SELECT SERVICE LINE PREFERENCE TRENDS
Last year, 27% of Northwest Arkansas consumers surveyed chose a Mercy Hospital for best overall quality and 25% selected Mercy as having the best image or reputation.
Source: NRC Healthcare Market Guide, 2011 (data collected Sep 2010 – Aug 2011); Northwest Arkansas Community (6-county PSA: Madison County not surveyed)
BEST OVERALL QUALITY 2011
Total number of respondents: 379 Providers with 1% or less are included in “Other Facilities”; Mercy Hospitals Berryville, Cassville and Fort Smith, <1% each
BEST IMAGE/REPUTATION 2011
Total number of respondents: 377 Providers with 1% or less are included in “Other Facilities”; Mercy Hospitals Berryville, Cassville and Fort Smith, <1% each
26%25%
29% 27%
13% 17% 18%15%
0%
10%
20%
30%
40%
50%
2008 2009 2010 2011
Washington Regional Medical CenterMercy Hospital Northwest ArkansasWillow Creek Women's HospitalNorthwest Medical Center-SpringdaleMercy Hospital Springfield
33%
31% 31% 31%
13% 13% 16%12%
0%
10%
20%
30%
40%
50%
2008 2009 2010 2011
Washington Regional Medical CenterMercy Hospital Northwest ArkansasArkansas Children's HospitalNorthwest Medical Center-SpringdaleMercy Hospital Springfield
34%
16%
10%
7%
4%
3%
2%
2%
2%2%
2%2%
2%11%
Washington Regional Medical Center Mercy Hospital Northwest ArkansasNorthwest Medical Center-Bentonville Northwest Medical Center-SpringdaleMercy Hospital Springfield Arkansas Children's HospitalMercy Hospital Aurora Cox SouthVeterans Affairs Medical Center Mercy Hospital JoplinSiloam Springs Memorial Hospital Willow Creek Women's HospitalFreeman Hospital West Other Facilities
36%
16%11%
6%
3%
3%
3%
2%2%
2%2%
13%
Washington Regional Medical Center Mercy Hospital Northwest ArkansasNorthwest Medical Center - Bentonville Northwest Medical Center-SpringdaleMercy Hospital Springfield Arkansas Children's HospitalVeterans Affairs Medical Center Freeman Hospital WestCox South Mercy Hospital JoplinSiloam Springs Memorial Hospital Other Facilities
Fort Scott PRIMARY SERVICE AREA
The Fort Scott Primary Service Area (PSA) comprises three counties in
southeast Kansas
KS
Company Industry Staff
Mercy Hospital Health care 570
Cigna Medical Insurance 410
Ward/Kraft Manufacturing 330
Unified School District #234 Public Schools 320
Peerless Products, Inc. Manufacturing 260
Valu Merchandisers Wholesale Grocers 250
DEMOGRAPHICS Fort Scott Service Area Kansas 2011
US 2011 2011 2016 % Growth
Total Population 64,521 63,998 -1% 2,864,235 310,650,750
0-17 23% 24% -0.1% 25% 24%
18-44 Females 18% 18% -1% 17% 18%
18-44 Males 19% 19% -1% 18% 19%
45-64 24% 23% -6% 26% 26%
65+ 16% 17% 6% 13% 13%
Median Age 36 - - 37 37
White 91% 90% -2% 79% 64%
Black 2% 2% 6% 6% 12%
American Indian 1% 1% 5% 1% 1%
Asian/Pacific Islander 1% 2% 18% 2% 5%
Multiracial and Other 2% 2% 9% 2% 2%
Hispanic (of any race) 3% 3% 15% 10% 16%
Speak Spanish in Home 2% - - 6% 12%
Total No. of Households 25,998 25,806 -1% 1,115,065 116,862,390
Households with Children 28% - - 33% 34%
HH Income Under $15K 20% - - 12% 13%
HH Income Over $75K 16% - - 28% 30%
Average HH Income $ 46,191 - - $ 62,175 $ 67,529
Some High School 7% - - 6% 9%
High School Graduate/GED 32% - - 29% 29%
Some College 33% - - 31% 28%
Bachelor’s Degree or greater 23% - - 29% 28%
Source: Fort Scott Area Chamber of Commerce, 2012
MAJOR EMPLOYERS
Largest employers as listed by the Fort Scott Area Chamber of Commerce:
Fort Scott DEMOGRAPHICS
Note: Fort Scott Service Area consists of three counties in Kansas; Education Level based on population age 25+ Source: Thomson Reuters, 2011
Rac
e &
Eth
nic
ity
Age
Gro
up
s H
ou
seh
old
s Ed
uca
tio
n
Health Factor Bourbon County Kansas
National Benchmark
Adult Smoking (% smoking >= 100 cigarettes) 21% 18% 14%
Adult Obesity (% with BMI >= 30) 35% 30% 25%
Physical Inactivity (% of adults age 20+ not active) 27% 24% 21%
Excessive/Binge Drinking 9% 15% 8%
Teen Birth Rate (per 1,000 females age 15-19) 69 43 22
Children in Poverty (% of children under 18 in poverty) 26% 18% 13%
Preventable Hospital Stays (per 1,000 Medicare enrollees) 88 70 49 Sources: (state) Overall Health Ranking – America’s Health Rankings, 2011, provided by United Health Foundation; (county) Overall Health Ranking and Health Factors table – 2012 County Health Rankings provided by the Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute
COMMUNITY HEALTH MEASURES
Overall Health Ranking: Kansas = 26 (/50 states); Bourbon County = 92 (/100 counties) Rankings are out of total number of states or reporting counties. The lower the number, the healthier the community.
Below are some of the factors which attribute to community health.
Source: Thomson Reuters Insurance Coverage Estimates, 2011
Hypertension 30%
Arthritis 25%
Asthma 13%
Diabetes 8%
COPD 5%
Coronary Heart Disease 5%
Angina 3%
Congestive Heart Failure 2%
CHRONIC DISEASE
Within the three-county Fort Scott Service Area, the following chronic conditions have been identified among the adult (18+) population:
In addition, 3% have had a stroke 4% have had a heart attack, and 6% are living with some type of cancer
Source: Thomson Reuters Continuum of Care, 2011
Private 65% 56% Medicare 14% 14% Medicaid 8% 14% Uninsured 13% 16%
KS US
INSURANCE COVERAGE
Private 53% Medicare
18%
Uninsured 20%
Medicaid 9%
8.2%
6.2%
8.2%
UNEMPLOYMENT RATE
Change over 12 months
↓0.6% Service Area
↓0.6% Kansas
↓0.7% US
*Fort Scott Service Area 3-county aggregate (Bourbon, Crawford & Linn Counties) Note: US & State rates are seasonally adjusted; County data, non-seasonally adjusted Source: KS Labor Information Center (KLIC); US Dept. of Labor – Bureau of Labor Statistics
MARCH 2012
1
2
1
Hospitals (*indicates on-site outpatient surgery center) Health System Affiliation
Mercy Hospital Fort Scott* Mercy
Via Christi Hospital* Via Christi Health
Girard Medical Center* Independent
2
3
3
Fort Scott REGIONAL PROVIDER LANDSCAPE
The map below depicts all inpatient hospitals and freestanding general outpatient surgery centers in the Fort Scott Service Area.
Freestanding General Outpatient
Surgery Center
Mercy
Independent
Source: Buxton ASC database, 2012
Hospital FTEs Staffed
Beds Service Area IP Discharges
Total Hospital IP Discharges
Total Births
Total ED Visits
Mercy Hospital Fort Scott 253 69 1,374 1,666 231 6,688
• Non-profit, member of Mercy
• General acute care hospital, rural outreach clinics and home health agencies
• Mercy Clinic includes 14 physicians, 9 advanced practice providers and 57 clinic co-workers supporting 52,000 outpatient visits to patients in four clinics including two urgent/convenient care sites (physician counts as of April 2012)
INPATIENT MARKET SHARE 16%
TOTAL ASSETS $40M
NET PATIENT REVENUE $32M
OPER. PROFIT MARGIN 3.3% Source: IP discharges, market share (for PSA) – HIDI, FFY11 (does not include Normal Newborns); beds, births, ED visits, total assets, NPR, OPM – Mercy Finance, FY11; Mercy FTEs & clinic co-workers – Mercy Pension & Comp, April 2012
Hospital FTEs Staffed
Beds Service Area IP Discharges
Total Hospital IP Discharges
Total Births
Via Christi Hospital (Pittsburg, KS) 645 114 3,260 4,022 575
• Non-profit, sponsored by Via Christi Health System
• General acute care hospital, primary care clinic in Iola, KS, senior assisted living and nursing care facility
INPATIENT MARKET SHARE 38%
TOTAL ASSETS $82M
NET PATIENT REVENUE $79M
OPER. PROFIT MARGIN 0.7% Source: IP discharges, market share (for PSA) – HIDI, FFY11 (does not include Normal Newborns); beds, births, FTEs – AHA Guide, 2010 data; total assets, NPR, OPM – AHD, 2010
Hospital FTEs Staffed
Beds Service Area IP Discharges
Total Hospital IP Discharges
Total Births
Girard Medical Center 189 35 862 1,021 0
• Government-owned
• Critical access hospital with five clinics
INPATIENT MARKET SHARE 10%
TOTAL ASSETS $25M
NET PATIENT REVENUE $18M
OPER. PROFIT MARGIN 0.5% Source: IP discharges, market share (for PSA) – HIDI, FFY11 (does not include Normal Newborns); FTEs, beds, births – AHA Guide, 2010 data; total assets, NPR, OPM – AHD, 2010
Hospital Health System FTEs Staffed
Beds Service Area IP Discharges
Total Hospital IP Discharges
Total Births
Freeman Health System (Joplin, MO) Freeman Health System 2,810 348 485 18,745 2,489
Mercy Hospital Joplin* (Joplin, MO) Mercy Health 1,139 150 477 9,973 532
Olathe Medical Center (Olathe, KS) Olathe Health System 1,402 227 427 10,971 1,329
University of Kansas Hospital (Kansas City, KS) University of Kansas 4,661 606 357 24,408 1,536
Other Health Care Providers outside the Fort Scott Service Area
*Note: Mercy Hospital in Joplin was destroyed by an E5 tornado in May 2011; currently Mercy operates a 150-bed component hospital until 2015 when the replacement facility will be complete. Source: IP discharges – HIDI, FFY11 (does not include Normal Newborns); beds, FTEs – AHA Guide, 2010 data; Mercy Joplin data – Mercy Finance, FY11
www.via-christi.org
www.girardmedicalcenter.com
www.mercy.net
Note: Hospital only
Note: Hospital only
Note: Hospital only
Fort Scott REGIONAL PROVIDER STATISTICS
Service Area IP Discharges represent inpatient discharges within a specified service area, typically where 85%-95% of Mercy’s patients reside. Market share is calculated based on discharges within the service area. Total Hospital IP Discharges account for all discharges from a facility regardless of where patients reside.
17%
9%
24%
24%
21%
0 50 100 150 200 250
Gen Surg
Cardio
Gastro
OB
Pulm
FFY11 Discharges
Advanced Practice
39%
Hospital-based
9%
Specialists 13%
Primary Care 39%
Note: Primary Care = FP/GP, IM, OB/Gyn, Pediatrics Source: Thomson Reuters Physician Estimates, 2011
Fort Scott KS US
Primary Care 75 112 116
Specialty 44 69 81
Total 119 180 197
Mercy Hospital Fort Scott
Ranks 2nd in market share
Medical Facility 2010
Physician's Offices* 40%
Independent Labs* 16%
Mercy Hospital Fort Scott-KS 14%
Via Christi Hospital-Pittsburg, KS 13%
Girard Medical Center-KS 7%
Miami County Medical Center-Paola, KS 2%
Mercy Hospital Joplin-MO 1%
University of Kansas Hospital-Kansas City, KS 1%
Olathe Medical Center-KS 1%
Freeman Health System-Joplin, MO 1%
Other Mercy hospitals < 1%
Other (incl. hospitals and freestanding facilities) 4%
Note: Total (n) = 23 integrated Mercy physicians and advanced practitioners serving the Fort Scott community Source: Mercy Hospital Administration, April 2012
In FFY11, 35% of patients received inpatient care at hospitals located outside the Fort Scott three-county PSA, including 7% at Mercy hospitals
Source: HIDI, FFY10-FFY11 (does not include Normal Newborns)
Hospital FFY10 FFY11
Via Christi Hospital-Pittsburg, KS 42% 38%
Mercy Hospital Fort Scott-KS 16% 16%
Girard Medical Center-KS 8% 10%
Freeman Health System-Joplin, MO 5% 6%
Mercy Hospital Joplin-MO 7% 6%
Olathe Medical Center-KS 4% 5%
University of Kansas Hospital-Kansas City, KS 4% 4%
Shawnee Mission Medical Center-KS 1% 2%
Children's Mercy Hosp & Clinics-Kansas City, MO 1% 1%
Miami County Medical Center Inc.-Paola, KS 1% 1%
Labette Health-Parsons, KS 1% 1%
Saint Luke's Hospital-Kansas City, MO 1% 1%
Overland Park Regional Medical Center-KS 1% 1%
Other Mercy hospitals 1% 1%
Other hospitals 8% 7%
Mercy Clinic Physicians 99%
John G. Yost, Jr., MD (Orthopedic Surgery) < 1%
Roxanna S. Jones, MD (Family Practice) < 1%
Talaat E. Yaghmour, MD (Urology) < 1%
11 Other physicians with 1 discharge each < 1%
Mercy Hospital Volume and Market Share
Fort Scott PATIENT CARE
INPATIENT MARKET SHARE TRENDS PHYSICIAN SUPPLY/100,000 POPULATION
INPATIENT DISCHARGES BY PHYSICIAN GROUP
MERCY INTEGRATED MEDICAL STAFF
INPATIENT PHYSICIANS OUTPATIENT
TOP INPATIENT SERVICE LINES
OUTPATIENT MARKET SHARE (Hospital-based)
OUTPATIENT UTILIZATION – MARKET ESTIMATES
% Change
Select Clinical Service Categories
2011 Procedures
Adjusted and Trended*
5 Yr 10 Yr
Physical and Occ. Therapy 96,360 19% 24%
Cardiology 37,840 10% 12%
Hematology/Oncology 32,157 15% 20%
Nephrology 10,311 89% 128%
Orthopedics 9,530 17% 20%
Neurology 8,677 27% 33%
OB/Gyn 7,744 60% 59%
General Surgery 4,370 18% 23%
Gastroenterology 4,156 4% 3%
Note: Mercy service lines used; based on volumes within the PSA Source: HIDI, FFY11
Of the region’s 397,101 hospital-based outpatient visits, 21% occurred outside the Fort Scott PSA (3% at Mercy hospitals)
*Physician Offices and Independent Laboratories represent procedures performed in a physician’s office and/or lab regardless of the provider’s affiliation with a hospital or health system Note: Data represents 187 procedure groups (categories of CPT and HCPCS codes); Hospitals include hospital-based outpatient services only Source: Thomson Reuters Outpatient Market Profiles, 2010
Source: Epic data, FY11 inpatient discharges; Buxton physician database, April 2012
Note: Data is available for additional clinical service categories *Adjusted and Trended estimates take into account technology trends, health care reform, and changes in disease incidence and prevalence Source: Thomson Reuters Outpatient Estimates, 2011
Mercy believes in listening to our communities and responding to their needs. As part of the People Promise key initiative, the Ministry is standardizing the survey tool and vendor used to obtain patient feedback – reinforcing our mission and culture of providing exceptional service, and to enhance the Mercy experience for our patients. Currently, we can look to HCAHPS survey results as a measure of patients’ perspectives of care.
Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a national survey developed by the Centers for Medicare & Medicaid Services (CMS) and the Agency for Healthcare Research and Quality (AHRQ). The data is publicly available to consumers.
Mercy’s HCAHPS results from patients who had overnight hospital stays during April 1, 2010 and March 31, 2011 are shown below, and are compared to other area providers as well as state and national averages for all reporting hospitals. Percentage of patients who gave the hospital
the highest rankings Percentage of patients who gave the hospital
the lowest rankings
Mercy Hospital
Via Christi
Girard Med Ctr
KS US Mercy
Hospital Via
Christi Girard
Med Ctr KS US
81% 79% 71% 79% 76% 1% 3% 4% 3% 5%
86% 86% 84% 84% 80% 2% 1% 4% 3% 4%
73% 65% 77% 70% 64% 3% 7% 8% 7% 10%
70% 68% 70% 71% 70% 4% 5% 8% 5% 7%
63% 65% 64% 63% 61% 15% 18% 17% 17% 21%
80% 70% 83% 75% 72% 5% 9% 3% 7% 9%
63% 60% 62% 63% 58% 5% 9% 12% 8% 11%
86% 84% 85% 84% 82% 14% 16% 15% 16% 18%
73% 70% 75% 74% 68% 6% 6% 7% 6% 9%
67% 67% 80% 75% 70% 2% 3% 5% 3% 5%
Fort Scott PATIENT SATISFACTION
Scale (Question 1 – 7): highest = “always”; lowest = “sometimes” or “never”
Scale (Question 8): highest = “yes/did”; lowest = “no/did not”
Scale (Question 9): highest = “9” or “10”; lowest = “6” or lower
Scale (Question 10): highest = “YES, definitely”; lowest = “No, probably/definitely not”
1 How often did nurses communicate well with patients?
2 How often did doctors communicate well with patients?
3 How often did patients receive help quickly from staff?
4 How often was patients’ pain well controlled?
5 How often did staff explain about medicines before giving them to patients?
6 How often were patients’ rooms & bathrooms kept clean?
7 How often was the area around patients’ rooms kept quiet at night?
8 Were patients given information about what to do during their recovery at home?
9 How do patients rate the hospital overall?
10 Would patients recommend the hospital to friends and family?
Source: www.hospitalcompare.hhs.gov. Most current data available updated April 19, 2012 – results from patients who had overnight hospital stays during April 1, 2010 and March 31, 2011. More than 300 surveys were completed for Mercy and Via Christi hospitals and between 100 and 299 surveys were received for Girard Medical Center. Average response rate was 28%.
= indicates an equal or greater percentage of Mercy patients gave the hospital the highest rankings compared to competitors shown
Independence PRIMARY SERVICE AREA
The IndependencePrimary Service Area (PSA) comprises four counties in
southeast Kansas
KS
Private 54% Medicare
22%
Uninsured 15%
Medicaid 9%
Company Industry Staff
Cessna (Aircraft) Assembly plant 650
Standard Motor Products Auto Parts 367
Unified School District #446 Education 362
Four County Mental Health Health care 329
Walmart Retail 280
Mercy Hospital Health care 278
DEMOGRAPHICS Independence Service Area Kansas 2011
US 2011 2011 2016 % Growth
Total Population 50,803 48,925 -4% 2,864,235 310,650,750
0-17 23% 24% -3% 25% 24%
18-44 Females 15% 15% -5% 17% 18%
18-44 Males 15% 16% -2% 18% 19%
45-64 27% 25% -10% 26% 26%
65+ 19% 21% 4% 13% 13%
Median Age 42 - - 37 37
White 86% 85% -5% 79% 64%
Black 4% 4% -2% 6% 12%
American Indian 3% 3% -3% 1% 1%
Asian/Pacific Islander 1% 1% 10% 2% 5%
Multiracial and Other 3% 4% 6% 2% 2%
Hispanic (of any race) 4% 4% 7% 10% 16%
Speak Spanish in Home 2% - - 6% 12%
Total No. of Households 21,042 20,276 -4% 1,115,065 116,862,390
Households with Children 31% - - 33% 34%
HH Income Under $15K 18% - - 12% 13%
HH Income Over $75K 15% - - 28% 30%
Average HH Income $ 46,010 - - $ 62,175 $ 67,529
Some High School 9% - - 6% 9%
High School Graduate/GED 35% - - 29% 29%
Some College 35% - - 31% 28%
Bachelor’s Degree or greater 17% - - 29% 28%
Source: Montgomery County Action Council (MCAC), 2012
MAJOR EMPLOYERS
As listed by the Montgomery County Action Council:
Independence DEMOGRAPHICS
Note: Independence Service Area consists of four counties in Kansas; Education Level based on population age 25+ Source: Thomson Reuters, 2011
Rac
e &
Eth
nic
ity
Age
Gro
up
s H
ou
seh
old
s Ed
uca
tio
n
Health Factor Montgomery
County Kansas National
Benchmark
Adult Smoking (% smoking >= 100 cigarettes) 25% 18% 14%
Adult Obesity (% with BMI >= 30) 31% 30% 25%
Physical Inactivity (% of adults age 20+ not active) 32% 24% 21%
Excessive/Binge Drinking 11% 15% 8%
Teen Birth Rate (per 1,000 females age 15-19) 66 43 22
Children in Poverty (% of children under 18 in poverty) 26% 18% 13%
Preventable Hospital Stays (per 1,000 Medicare enrollees) 97 70 49 Sources: (state) Overall Health Ranking – America’s Health Rankings, 2011, provided by United Health Foundation; (county) Overall Health Ranking and Health Factors table – 2012 County Health Rankings provided by the Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute
COMMUNITY HEALTH MEASURES
Overall Health Ranking: Kansas = 26 (/50 states); Montgomery County = 99 (/100 counties) Rankings are out of total number of states or reporting counties. The lower the number, the healthier the community.
Below are some of the factors which attribute to community health.
Source: Thomson Reuters Insurance Coverage Estimates, 2011
Hypertension 34%
Arthritis 28%
Asthma 13%
Diabetes 9%
Coronary Heart Disease 6%
COPD 5%
Angina 3%
Congestive Heart Failure 2%
CHRONIC DISEASE
Within the four-county Independence Service Area, the following chronic conditions have been identified among the adult (18+) population:
In addition, 3% have had a stroke 4% have had a heart attack, and 7% are living with some type of cancer
Source: Thomson Reuters Continuum of Care, 2011
Private 65% 56% Medicare 14% 14% Medicaid 8% 14% Uninsured 13% 16%
KS US
INSURANCE COVERAGE
9.0%
6.2%
8.2%
UNEMPLOYMENT RATE
Change over 12 months
↓1.6% Service Area*
↓0.6% Kansas
↓0.7% US
*Independence Service Area 4-county aggregate (Chautauqua, Elk, Montgomery and Wilson Counties) Note: US & State rates are seasonally adjusted; County data, non-seasonally adjusted Source: KS Labor Information Center (KLIC); US Dept. of Labor – Bureau of Labor Statistics
MARCH 2012
Hospitals (*indicates on-site outpatient surgery center) Health System Affiliation
Mercy Hospital Independence* Mercy
Coffeyville Regional Medical Center* Quorum Health Resources
Fredonia Regional Hospital* Great Plains Health Alliance
Wilson Medical Center* Independent
Sedan City Hospital Independent
1
4
5
2
The map below depicts all inpatient hospitals in the Independence Service Area.
denotes hospital outside the service area
Independence REGIONAL PROVIDER LANDSCAPE
3
4
5
2
1
3
Hospital FTEs Staffed
Beds Service Area IP Discharges
Total Hospital IP Discharges
Total Births
Total ED Visits
Mercy Hospital Independence 157 40 1,027 1,092 229 8,276
INPATIENT MARKET SHARE 17%
TOTAL ASSETS $32M
NET PATIENT REVENUE $24M
OPER. PROFIT MARGIN 8.5% Source: IP discharges, market share (for PSA) – HIDI, FFY11 (does not include Normal Newborns); beds, births, ED visits, total assets, NPR, OPM – Mercy Finance, FY11; Mercy FTEs & clinic co-workers – Mercy Pension & Comp, April 2012
Hospital FTEs Staffed
Beds Service Area IP Discharges
Total Hospital IP Discharges
Total Births
Coffeyville Regional Medical Center 344 88 1,929 2,255 224
• Non-profit, city-owned; managed by Quorum Health Resources
• General acute care facility; opened The Jerry Marquette Radiation Oncology Center in November 2011
INPATIENT MARKET SHARE 32%
TOTAL ASSETS $50M
NET PATIENT REVENUE $36M
OPER. PROFIT MARGIN -6.1% Source: IP discharges, market share (for PSA) – HIDI, FFY11 (does not include Normal Newborns); beds, births, FTEs – AHA Guide, 2010 data; total assets, NPR, OPM – AHD, 2010
www.crmcinc.com
Hospital Health System FTEs Staffed
Beds Service Area IP Discharges
Total Hospital IP Discharges
Total Births
Wilson Medical Center (Neodesha, KS) Independent 110 15 242 276 0
Sedan City Hospital (Sedan, KS) Independent 31 25 239 240 NA
Other Health Care Providers within the Independence Service Area
Source: IP discharges – HIDI, FFY11 (does not include Normal Newborns); beds, FTEs – AHA Guide, 2010 data
www.mercy.net
• Non-profit, member of Mercy
• General acute care hospital, rural outreach clinics and home health agencies
• Mercy Clinic includes 7 physicians, 7 advanced practice providers and 33 clinic co-workers supporting almost 27,000 outpatient visits to patients in four clinics including one urgent/convenient care site (physician counts as of April 2012)
Note: Hospital only
Note: Hospital only
Hospital FTEs Staffed
Beds Service Area IP Discharges
Total Hospital IP Discharges
Total Births
Fredonia Regional Hospital 107 25 675 842 0
• Government-owned, critical access; managed by Great Plains Health Alliance
• Includes a nine-bed geriatric psych unit
INPATIENT MARKET SHARE 11%
TOTAL ASSETS $20M
NET PATIENT REVENUE $10M
OPER. PROFIT MARGIN -15.7% Source: IP discharges, market share (for PSA) – HIDI, FFY11 (does not include Normal Newborns); beds, births, FTEs – AHA Guide, 2010 data; total assets, NPR, OPM – AHD, 2010
www.fredoniaregionalhospital.org Note: Hospital only
FREDONIA REGIONAL HOSPITAL
Hospital Health System FTEs Staffed
Beds Service Area IP Discharges
Total Hospital IP Discharges
Total Births
Labette Health (Parsons, KS) Independent 447 67 483 2,814 211
Via Christi Hospital (Wichita, KS) Via Christi Health 3,861 759 327 33,961 2,823
Wesley Medical Center (Wichita, KS) HCA 2,069 524 268 24,292 6,403
Key Providers outside the Independence Service Area
Independence REGIONAL PROVIDER STATISTICS
Service Area IP Discharges represent inpatient discharges within a specified service area, typically where 85%-95% of Mercy’s patients reside. Market share is calculated based on discharges within the service area. Total Hospital IP Discharges account for all discharges from a facility regardless of where patients reside.
Advanced Practice
50%
Specialists 14%
Primary Care 36%
13%
16%
19%
14%
38%
0 100 200 300
Cardio
Ortho
Gastro
Pulm
OB
FFY11 Discharges
Note: Primary Care = FP/GP, IM, OB/Gyn, Pediatrics Source: Thomson Reuters Physician Estimates, 2011
Independence KS US
Primary Care 71 112 116
Specialty 24 69 81
Total 95 180 197
Ranks 2nd in market share
Medical Facility 2010
Physician's Offices* 43%
Independent Labs* 13%
Coffeyville Regional Medical Center-KS 10%
Mercy Hospital Independence-KS 10%
Fredonia Regional Hospital-KS 4%
Wilson Medical Center-Neodesha, KS 3%
Labette Health-Parsons, KS 2%
Sedan City Hospital-KS 2%
William Newton Hospital-Winfield, KS 2%
Jane Phillips Medical Center-Bartlesville, OK 2%
Greenwood County Hospital-Eureka, KS 1%
Other Mercy hospitals <1%
Other (incl. hospitals and freestanding facilities) 9%
Note: Total (n) = 14 integrated Mercy physicians and advanced practitioners serving the Independence community Source: Mercy Hospital Medical Staff Coordinator, April 2012
In FFY11, 32% of patients received inpatient care at hospitals located outside the Independence four-county PSA, including 1% at Mercy hospitals
Source: HIDI, FFY10-FFY11 (does not include Normal Newborns)
Hospital FFY10 FFY11
Coffeyville Regional Medical Center-KS 34% 32%
Mercy Hospital Independence-KS 18% 17%
Fredonia Regional Hospital-KS 12% 11%
Labette Health-Parsons, KS 6% 8%
Via Christi Hospital-Wichita, KS 5% 5%
Wesley Medical Center-Wichita, KS 5% 4%
Wilson Medical Center-Neodesha, KS 3% 4%
Sedan City Hospital-KS 3% 4%
Neosho Memorial Reg. Medical Ctr.-Chanute, KS 3% 3%
University of Kansas Hospital-Kansas City, KS 2% 2%
Mercy Hospital Joplin-MO 1% 1%
Greenwood County Hospital-Eureka, KS 1% 1%
Other Mercy hospitals < 1% < 1%
Other hospitals 7% 7%
Mercy Hospital Independence
Ranks 1st in market share
Mercy Clinic Physicians 22%
Casana R. Brunton, MD (Family Practice) 19%
Joseph Spurlock, MD (Family Practice) 16%
Jason P. Brunton, MD (Family Practice) 13%
Gregory H. Mears, MD (Family Practice) 11%
Larry C. Atwood, MD (Family Practice) 9%
Virenda C. Patel, MD (Sports Medicine) 6%
Charles L. Empson, MD (Emergency Medicine) 3%
Other (8 physicians combined) 1%
Mercy Hospital Volume and Market Share
Independence PATIENT CARE
INPATIENT MARKET SHARE TRENDS PHYSICIAN SUPPLY/100,000 POPULATION
INPATIENT DISCHARGES BY PHYSICIAN GROUP
MERCY INTEGRATED MEDICAL STAFF
INPATIENT PHYSICIANS OUTPATIENT
TOP INPATIENT SERVICE LINES
OUTPATIENT MARKET SHARE (Hospital-based)
OUTPATIENT UTILIZATION – MARKET ESTIMATES
% Change
Select Clinical Service Categories
2011 Procedures
Adjusted and Trended*
5 Yr 10 Yr
Physical and Occ. Therapy 92,233 21% 23%
Cardiology 29,674 8% 7%
Hematology/Oncology 22,675 11% 12%
Nephrology 12,740 61% 82%
Orthopedics 6,125 18% 21%
OB/Gyn 5,140 43% 39%
Neurology 4,936 22% 25%
General Surgery 3,572 13% 14%
Gastroenterology 2,951 4% -0.2%
Note: Mercy service lines used; based on volumes within the PSA Source: HIDI, FFY11
Of the region’s 297,593 hospital-based outpatient visits, 8% occurred outside the Independence PSA (0.2% at Mercy hospitals)
*Physician Offices and Independent Laboratories represent procedures performed in a physician’s office and/or lab regardless of the provider’s affiliation with a hospital or health system Note: Data represents 187 procedure groups (categories of CPT and HCPCS codes); Hospitals include hospital-based outpatient services only Source: Thomson Reuters Outpatient Market Profiles, 2010
Source: Epic data, FY11 inpatient discharges; Buxton physician database, April 2012
Note: Data is available for additional clinical service categories *Adjusted and Trended estimates take into account technology trends, health care reform, and changes in disease incidence and prevalence Source: Thomson Reuters Outpatient Estimates, 2011
Percentage of patients who gave the hospital the highest rankings
Percentage of patients who gave the hospital the lowest rankings
Mercy Hospital
Coffeyville Regional
KS US Mercy
Hospital Coffeyville Regional
KS US
80% 76% 79% 76% 3% 5% 3% 5%
86% 81% 84% 80% 2% 5% 3% 4%
69% 61% 70% 64% 6% 11% 7% 10%
71% 68% 71% 70% 6% 8% 5% 7%
66% 54% 63% 61% 14% 26% 17% 21%
72% 68% 75% 72% 5% 10% 7% 9%
61% 50% 63% 58% 6% 14% 8% 11%
86% 73% 84% 82% 14% 27% 16% 18%
70% 62% 74% 68% 9% 11% 6% 9%
64% 58% 75% 70% 4% 7% 3% 5%
Independence PATIENT SATISFACTION
1 How often did nurses communicate well with patients?
2 How often did doctors communicate well with patients?
Scale (Question 1 – 7): highest = “always”; lowest = “sometimes” or “never”
Scale (Question 8): highest = “yes/did”; lowest = “no/did not”
3 How often did patients receive help quickly from staff?
4 How often was patients’ pain well controlled?
5 How often did staff explain about medicines before giving them to patients?
6 How often were patients’ rooms & bathrooms kept clean?
7 How often was the area around patients’ rooms kept quiet at night?
8 Were patients given information about what to do during their recovery at home?
Scale (Question 9): highest = “9” or “10”; lowest = “6” or lower
9 How do patients rate the hospital overall?
Scale (Question 10): highest = “YES, definitely”; lowest = “No, probably/definitely not”
10 Would patients recommend the hospital to friends and family?
Mercy believes in listening to our communities and responding to their needs. As part of the People Promise key initiative, the Ministry is standardizing the survey tool and vendor used to obtain patient feedback – reinforcing our mission and culture of providing exceptional service, and to enhance the Mercy experience for our patients. Currently, we can look to HCAHPS survey results as a measure of patients’ perspectives of care.
Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a national survey developed by the Centers for Medicare & Medicaid Services (CMS) and the Agency for Healthcare Research and Quality (AHRQ). The data is publicly available to consumers.
Mercy’s HCAHPS results from patients who had overnight hospital stays during April 1, 2010 and March 31, 2011 are shown below, and are compared to other area providers as well as state and national averages for all reporting hospitals.
= indicates an equal or greater percentage of Mercy patients gave the hospital the highest rankings compared to competitors shown
Source: www.hospitalcompare.hhs.gov. Most current data available updated April 19, 2012 – results from patients who had overnight hospital stays during April 1, 2010 and March 31, 2011. More than 300 surveys were completed for Coffeyville Regional Medical Center and between 100 and 299 surveys were received for Mercy Hospital. Average response rate was 26%.
Joplin PRIMARY SERVICE AREA
The Joplin Primary Service Area (PSA) comprises nine counties in southeast
Kansas, northeast Oklahoma and southwest Missouri
KS MO
OK
Private 48%
Medicare 18%
Uninsured 19%
Medicaid 16%
DEMOGRAPHICS Joplin Service Area Missouri 2011
US 2011 2011 2016 % Growth
Total Population 364,077 371,490 2% 6,015,487 310,650,750
0-17 25% 25% 3% 24% 24%
18-44 Females 17% 17% 0% 18% 18%
18-44 Males 18% 17% 1% 18% 19%
45-64 25% 24% -2% 26% 26%
65+ 15% 17% 11% 14% 13%
Median Age 37 - - 38 37
White 84% 83% <1% 81% 64%
Black 1% 1% 15% 11% 12%
American Indian 5% 5% -1% 1% 1%
Asian/Pacific Islander 1% 1% 25% 2% 5%
Multiracial and Other 3% 4% 7% 2% 2%
Hispanic (of any race) 5% 6% 22% 4% 16%
Speak Spanish in Home 4% - - 3% 12%
Total No. of Households 142,474 144,597 2% 2,393,904 116,862,390
Households with Children 33% - - 33% 34%
HH Income Under $15K 18% - - 14% 13%
HH Income Over $75K 15% - - 25% 30%
Average HH Income $ 46,534 - - $ 58,797 $ 67,529
Some High School 11% - - 9% 9%
High School Graduate/GED 37% - - 33% 29%
Some College 30% - - 29% 28%
Bachelor’s Degree or greater 17% - - 25% 28%
Source: Joplin Area Chamber of Commerce, 2011
Company Industry Staff
Freeman Health System Health care 2,897
Con-way Truckload Transportation 2,677
Mercy Hospital Health care 2,200
Joplin School District Education 1,200
Downstream Casino Resort Entertainment 1,083
EaglePicher Technologies, LLC Battery Manufacturing 1,022
Walmart Retail 920
MAJOR EMPLOYERS
Largest employers provided by the Joplin Area Chamber of Commerce:
Source: Thomson Reuters Insurance Coverage Estimates, 2011
Hypertension 30%
Arthritis 25%
Asthma 13%
Diabetes 8%
COPD 5%
Coronary Heart Disease 5%
Angina 3%
Congestive Heart Failure 2%
CHRONIC DISEASE
Within the nine-county Joplin Service Area, the following chronic conditions have been identified among the adult (18+) population:
In addition, 3% have had a stroke 4% have had a heart attack, and 5% are living with some type of cancer
Source: Thomson Reuters Continuum of Care, 2011
Private 57% 56% Medicare 16% 14% Medicaid 13% 14% Uninsured 15% 16%
US MO
INSURANCE COVERAGE
Joplin DEMOGRAPHICS
Note: Joplin Service Area consists of nine counties in Missouri (5), Kansas (2) and Oklahoma (2); Education Level based on population age 25+ Source: Thomson Reuters, 2011
Rac
e &
Eth
nic
ity
Age
Gro
up
s H
ou
seh
old
s Ed
uca
tio
n
Health Factor Jasper County Missouri
National Benchmark
Adult Smoking (% smoking >= 100 cigarettes) 24% 24% 14%
Adult Obesity (% with BMI >= 30) 33% 31% 25%
Physical Inactivity (% of adults age 20+ not active) 27% 28% 21%
Excessive/Binge Drinking 15% 17% 8%
Teen Birth Rate (per 1,000 females age 15-19) 68 44 22
Children in Poverty (% of children under 18 in poverty) 23% 21% 13%
Preventable Hospital Stays (per 1,000 Medicare enrollees) 74 75 49 Sources: (state) Overall Health Ranking – America’s Health Rankings, 2011, provided by United Health Foundation; (county) Overall Health Ranking and Health Factors table – 2012 County Health Rankings provided by the Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute
COMMUNITY HEALTH MEASURES
Overall Health Ranking: Missouri = 40 (/50 states); Jasper County = 41 (/115 counties) Rankings are out of total number of states or reporting counties. The lower the number, the healthier the community.
Below are some of the factors which attribute to community health.
6.8% 7.4% 8.2%
UNEMPLOYMENT RATE
Change over 12 months
↓1.2% MSA*
↓1.3% Missouri
↓0.7% US
*Joplin, MO Metropolitan Statistical Area Note: US & State rates are seasonally adjusted; MSA, non-seasonally adjusted Source: US Dept. of Labor – Bureau of Labor Statistics
MARCH 2012
The map below depicts all inpatient hospitals and freestanding general outpatient surgery centers in the Joplin Service Area.
Joplin REGIONAL PROVIDER LANDSCAPE
1
3 2
4
5
6
7
8
10
9
11
FreestandingGeneral Outpatient
Surgery Center
Physician Owned
Freeman Health Sys.
Source: Buxton ASC database, 2012
12
Hospitals (*indicates on-site outpatient surgery center) Health System Affiliation
Mercy Hospital Joplin* (new facility to open early 2015) Mercy
Mercy McCune-Brooks Hospital Mercy
Mercy Maude Norton Hospital Mercy
Freeman Hospital West Freeman Health System
Freeman Neosho Hospital Freeman Health System
Via Christi Hospital* Via Christi Health
Integris Baptist Regional Health Center* Integris Health
Integris Grove General Hospital* Integris Health
Nevada Regional Medical Center* Independent
Barton County Memorial Hospital Independent
Girard Medical Center* Independent
Stateline Specialty Hospital (new facility to open December 2012) Physician Owned
Joplin REGIONAL PROVIDER LANDSCAPE
6
7
8
10
9
11
1
3
2
4
5
12
• Non-profit, member of Mercy
• On May 22, 2011, Mercy Hospital in Joplin was destroyed by an EF5 tornado; currently Mercy operates a 110-bed component hospital until 2015 when the replacement facility will be complete
• One general acute care in Joplin, and two critical access hospitals: Mercy McCune-Brooks (acquired January 2012) in Carthage, MO and Mercy Maude Norton in Columbus, KS
• Landmark Hospital of Joplin, a 30-bed long-term care facility, is a joint venture between Mercy, Freeman Health System and four Joplin physicians
• Mercy Clinic consists of 111 primary care, specialty and hospital-based physicians, 42 advanced practice providers and 227 clinic co-workers supporting over 167,000 outpatient visits to patients in 18 clinics including one urgent/convenient care site (physician counts as of April 2012)
www.freemanhealth.com
Hospital FTEs Staffed
Beds Service Area IP Discharges
Total Hospital IP Discharges
Total Births
Freeman Hospital West 2,810 348 16,918 18,745 2,489
Freeman Neosho Hospital 188 25 1,607 1,675 0
TOTAL 2,998 373 18,525 20,420 2,489
• Non-profit, community-owned
• One general acute care hospital and one critical access hospital, home health, DME, cancer, heart and vascular, rehab, orthopedic and sports medicine, women’s centers and urgent care services
• Landmark Hospital of Joplin, a 30-bed long-term care facility, is a joint venture with Mercy, Freeman Health System and four Joplin physicians
• Freeman Physician Group includes approximately 180 physicians with clinics located in Joplin, Neosho and Anderson, MO, and Baxter Springs and Pittsburg, KS
INPATIENT MARKET SHARE 44%
TOTAL ASSETS $367M
NET PATIENT REVENUE $430M
OPER. PROFIT MARGIN -5.0%
www.mercy.net
Note: Hospitals only
Note: Hospitals only
Joplin REGIONAL PROVIDER STATISTICS
Hospital FTEs Staffed
Beds Service Area IP Discharges
Total Hospital IP Discharges
Total Births
Via Christi Hospital (Pittsburg, KS) 645 114 3,716 4,022 575
• Non-profit, sponsored by Via Christi Health
• General acute care hospital, primary care clinic in Iola, KS, senior assisted living and nursing care facility
INPATIENT MARKET SHARE 9%
TOTAL ASSETS $82M
NET PATIENT REVENUE $79M
OPER. PROFIT MARGIN 0.7% www.via-christi.org Note: Hospital only
Service Area IP Discharges represent inpatient discharges within the specified service area, typically where 85%-95% of Mercy’s patients reside. Market share is calculated based on discharges within the service area. Total Hospital IP Discharges account for all discharges from a facility regardless of where patients reside.
Note: Service Area IP discharges and market share include MO and KS counties only Source: IP discharges, market share (MO & KS only) – HIDI, FFY11 (does not include Normal Newborns); beds, births, FTEs – AHA Guide, 2010 data; total assets, NPR, OPM – AHD, 2010
Hospital FTEs Staffed
Beds Service Area IP Discharges
Total Hospital IP Discharges
Total Births
Total ED Visits
Mercy Hospital Joplin* 1,066 110 8,639 9,973 532 35,994
Mercy McCune-Brooks Hospital 365 35 1,968 2,115 155 NA
Mercy Maude Norton Hospital 34 25 110 111 0 2,060
TOTAL 1,465 170 10,717 12,199 687 38,054
INPATIENT MARKET SHARE 26%
TOTAL ASSETS $118M
NET PATIENT REVENUE $226M
OPER. PROFIT MARGIN 5.7%
*Note: Service Area IP discharges and market share include MO and KS counties only Source: IP discharges, market share (MO & KS only)– HIDI, FFY11 (does not include Normal Newborns); beds, births, ED visits, total assets, NPR, OPM – Mercy Finance, FY11; Mercy FTEs & clinic co-workers – Mercy Pension & Comp, as of April 2012; Mercy McCune-Brooks beds and births – AHA Guide, 2010 data
Note: Service Area IP discharges and market share include MO and KS counties only Source: IP discharges, market share (MO & KS only) – HIDI, FFY11 (does not include Normal Newborns); beds, births, FTEs – AHA Guide, 2010 data; total assets, NPR, OPM – AHD, 2010
Hospital FTEs Staffed
Beds Service Area IP Discharges
Total Hospital IP Discharges
Total Births
Barton County Memorial Hospital 181 25 1,284 1,411 0
www.nrmchealth.com
Hospital FTEs Staffed
Beds Service Area IP Discharges
Total Hospital IP Discharges
Total Births
Nevada Regional Medical Center 326 63 1,360 2,228 336
• Non-profit, community-owned in Nevada, MO; managed by Quorum Health Resources
• Operates the NowCare Clinic in Nevada, MO, rural health clinics in Rich Hill and Sheldon, MO, and a home health agency; owns a 40-bed Alzheimer’s unit and 108-bed nursing home
INPATIENT MARKET SHARE 3%
TOTAL ASSETS $48M
NET PATIENT REVENUE $31M
OPER. PROFIT MARGIN -3.2%
• Non-profit, sponsored by Integris Health
• Integris Baptist Regional in Miami, OK, provides critical care and surgical services, rehabilitation, geriatric behavioral health, diabetes management, hospice, home health care and home medical equipment; 40+ physicians and advanced practice providers on staff
• Integris Grove General Hospital in Grove, OK, includes a women’s health center, cardiac catheterization lab and four new operating rooms; 37 physicians and advanced practice providers on staff
INPATIENT MARKET SHARE NA
TOTAL ASSETS $149M
NET PATIENT REVENUE $105M
OPER. PROFIT MARGIN -4.5%
Note: Hospital only
Note: Hospitals only
www.integrisok.com
Hospital FTEs Staffed
Beds Service Area IP Discharges
Total Hospital IP Discharges
Total Births
Integris Baptist Regional Health Center 362 94 3,106* 3,607 300
Integris Grove General Hospital 290 48 2,666* 3,033 268
TOTAL 652 142 5,772 6,640 568
Joplin REGIONAL PROVIDER STATISTICS
www.bcmh.net
• For-profit, government-owned critical access facility in Lamar, MO
• New facility in 2007; clinics located in Lamar, Lockwood and Golden City, MO
INPATIENT MARKET SHARE 3%
TOTAL ASSETS $24M
NET PATIENT REVENUE $20M
OPER. PROFIT MARGIN -3.5% Note: Hospital only
• For-profit, government-owned in Girard, KS
• Critical access hospital with five clinics
INPATIENT MARKET SHARE 2%
TOTAL ASSETS $25M
NET PATIENT REVENUE $18M
OPER. PROFIT MARGIN 0.5% Note: Service Area IP discharges and market share include MO and KS counties only Source: IP discharges, market share (MO & KS only)– HIDI, FFY11 (does not include Normal Newborns); FTEs, beds, births – AHA Guide, 2010 data; total assets, NPR, OPM – AHD, 2010
www.girardmedicalcenter.com Note: Hospital only
Note: Service Area IP discharges and market share include MO and KS counties only Source: IP discharges, market share (MO & KS only)– HIDI, FFY11 (does not include Normal Newborns); beds, births, FTEs – AHA Guide, 2010 data; total assets, NPR, OPM – AHD, 2010
Note: Service Area IP discharges and market share include MO and KS counties only Source: IP discharges, market share (MO & KS only)– HIDI, FFY11 (does not include Normal Newborns); beds, births, FTEs – AHA Guide, 2010 data; total assets, NPR, OPM – AHD, 2010
*Represents discharges from residents in Delaware and Ottawa, OK counties only Source: IP discharges (for PSA) – OK State data 2010 (does not include Normal Newborns); beds, births, FTEs, total assets, NPR, OPM – AHA Guide, 2009 data/AHD, 2010
Hospital FTEs Staffed
Beds Service Area IP Discharges
Total Hospital IP Discharges
Total Births
Girard Medical Center 189 35 869 1,021 0
Mercy Clinic Physicians 34%
Mercy Hospital Joplin (non-integrated) 31%
Bazzano Clinic 3%
Orthopedic Specialists of the Four States 2%
Pediatric Associates Southwest MO 2%
American Diagnostics 1%
Neurological Associates 1%
Joplin Urology Associates 1%
Other 25%
Advanced Practice
27%
Hospital-based 30%
Specialists 25%
Primary Care 18%
24%
29%
20%
28%
24%
0 500 1,000 1,500 2,000
Neuro
Gen Med
Pulm
Behav Hlth
Cardio
FFY11 Discharges
Ranks 1st in market share
Note: Primary Care = FP/GP, IM, OB/Gyn, Pediatrics Source: Thomson Reuters Physician Estimates, 2011
Joplin MO US
Primary Care 78 121 116
Specialty 51 83 81
Total 129 204 197
Mercy Hospital Joplin
Ranks 2nd in market share
Note: Total (n) = 153 integrated Mercy physicians and advanced practitioners serving Joplin and Columbus communities Source: Mercy Hospital Joplin Medical Affairs Department, April 2012
Medical Facility 2010
Physician's Offices* 45%
Independent Labs* 13%
Freeman Health System-Joplin, MO 9%
Mercy Hospital Joplin-MO 9%
Integris Grove General Hospital-OK 3%
Via Christi Hospital-Pittsburg, KS 3%
Freeman Neosho Hospital-MO 2%
Integris Baptist Reg. Health Center-Miami, OK 2%
Mercy McCune-Brooks Hospital-Carthage, MO 2%
Barton County Memorial Hospital-Lamar, MO 2%
Girard Medical Center-MO 1%
Nevada Regional Medical Center-MO 1%
Mercy Maude Norton Hospital-Columbus, KS 1%
Other Mercy hospitals 1%
Other (incl. hospitals located outside the Joplin PSA) 6%
Prior to the May 2011 tornado, 9% of patients received inpatient care at hospitals located outside the Joplin PSA (1% at Mercy hospitals), compared to 16% leaving the area after the tornado (4% at Mercy hospitals)
Note: Market share includes discharges for Missouri and Kansas hospitals only Source: HIDI, FFY10-FFY11 (does not include Normal Newborns)
Hospital FFY 10
FFY 11
FFY11 Pre-
storm
FFY11 Post-storm
Freeman Health System-Joplin, MO 36% 40% 37% 47%
Mercy Hospital Joplin-MO 29% 20% 28% 5%
Via Christi Hospital-Pittsburg, KS 10% 9% 8% 10%
Mercy McCune-Brooks Hosp.-Carthage, MO 4% 5% 3% 8%
Freeman Neosho Hospital-MO 3% 4% 4% 4%
Nevada Regional Medical Center-MO 3% 3% 3% 4%
Barton County Memorial Hosp.-Lamar, MO 2% 3% 3% 3%
Girard Medical Center-KS 2% 2% 2% 2%
Mercy Hospital Springfield-MO 1% 2% 1% 3%
Missouri Residents/Arkansas Hospitals 1% 1% 1% 2%
Cox South-Springfield, MO 1% 1% 1% 2%
University of Kansas Hosp.-Kansas City, KS 1% 1% 1% 1%
Other Mercy hospitals 1% 1% 1% 1%
Other hospitals 6% 8% 7% 9%
Mercy Hospital Volume and Market Share
Joplin PATIENT CARE
INPATIENT PHYSICIANS OUTPATIENT INPATIENT MARKET SHARE TRENDS PHYSICIAN SUPPLY/100,000 POPULATION
INPATIENT DISCHARGES BY PHYSICIAN GROUP
MERCY INTEGRATED MEDICAL STAFF
TOP INPATIENT SERVICE LINES
OUTPATIENT MARKET SHARE (Hospital-based)
OUTPATIENT UTILIZATION – MARKET ESTIMATES
% Change
Select Clinical Service Categories
2011 Procedures
Adjusted and Trended*
5 Yr 10 Yr
Physical and Occ. Therapy 406,877 19% 27%
Cardiology 185,658 15% 20%
Hematology/Oncology 161,414 20% 29%
Nephrology 65,925 87% 128%
Orthopedics 65,467 23% 31%
Neurology 50,885 34% 46%
OB/Gyn 45,267 53% 55%
General Surgery 25,431 22% 31%
Gastroenterology 19,930 13% 15%
Note: Mercy service lines used; based on volumes within the PSA Source: HIDI, FFY11
Of the region’s 1.8M hospital-based outpatient visits, 10% occurred outside the Joplin PSA (2% at Mercy hospitals)
*Physician Offices and Independent Laboratories represent procedures performed in a physician’s office and/or lab regardless of the provider’s affiliation with a hospital or health system Note: Data represents 187 procedure groups (categories of CPT and HCPCS codes); Hospitals include hospital-based outpatient services only Source: Thomson Reuters Outpatient Market Profiles, 2010
Source: Mercy Hospital Joplin, July 1, 2010 – April 30, 2011; Buxton physician database, April 2012
Note: Data is available for additional clinical service categories *Adjusted and Trended estimates take into account technology trends, health care reform, and changes in disease incidence and prevalence Source: Thomson Reuters Outpatient Estimates, 2011
Source: www.hospitalcompare.hhs.gov. Most current data available updated April 19, 2012 – results from patients who had overnight hospital stays during April 1, 2010 and March 31, 2011. More than 300 surveys were completed for each facility with an average response rate of 35%.
Percentage of patients who gave the hospital the highest rankings
Percentage of patients who gave the hospital the lowest rankings
Mercy Hospital
Freeman West
MO US Mercy
Hospital Freeman
West MO US
75% 77% 77% 76% 5% 4% 5% 5%
79% 77% 81% 80% 6% 5% 4% 4%
61% 60% 65% 64% 10% 10% 10% 10%
69% 68% 69% 70% 6% 7% 7% 7%
54% 56% 60% 61% 25% 25% 21% 21%
71% 68% 72% 72% 7% 11% 9% 9%
53% 58% 57% 58% 12% 10% 11% 11%
78% 85% 84% 82% 22% 15% 16% 18%
69% 69% 68% 68% 9% 7% 9% 9%
72% 73% 68% 70% 5% 4% 5% 5%
Joplin PATIENT SATISFACTION
1 How often did nurses communicate well with patients?
2 How often did doctors communicate well with patients?
Scale (Question 1 – 7): highest = “always”; lowest = “sometimes” or “never”
Scale (Question 8): highest = “yes/did”; lowest = “no/did not”
3 How often did patients receive help quickly from staff?
4 How often was patients’ pain well controlled?
5 How often did staff explain about medicines before giving them to patients?
6 How often were patients’ rooms & bathrooms kept clean?
7 How often was the area around patients’ rooms kept quiet at night?
8 Were patients given information about what to do during their recovery at home?
Scale (Question 9): highest = “9” or “10”; lowest = “6” or lower
9 How do patients rate the hospital overall?
Scale (Question 10): highest = “YES, definitely”; lowest = “No, probably/definitely not”
10 Would patients recommend the hospital to friends and family?
Mercy believes in listening to our communities and responding to their needs. As part of the People Promise key initiative, the Ministry is standardizing the survey tool and vendor used to obtain patient feedback – reinforcing our mission and culture of providing exceptional service, and to enhance the Mercy experience for our patients. Currently, we can look to HCAHPS survey results as a measure of patients’ perspectives of care.
Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a national survey developed by the Centers for Medicare & Medicaid Services (CMS) and the Agency for Healthcare Research and Quality (AHRQ). The data is publicly available to consumers.
Mercy’s HCAHPS results from patients who had overnight hospital stays during April 1, 2010 and March 31, 2011 are shown below, and are compared to other area providers as well as state and national averages for all reporting hospitals.
= indicates an equal or greater percentage of Mercy patients gave the hospital the highest rankings compared to competitors shown
39%43%
47%
42%
29% 28%
32%
27%
0%
15%
30%
45%
60%
2008 2009 2010 2011
Freeman Hospital WestMercy Hospital JoplinMercy Hospital SpringfieldVia Christi Hospital
42%
48% 48%51%
31% 33%
38%
28%
0%
15%
30%
45%
60%
2008 2009 2010 2011
Freeman Hospital WestMercy Hospital JoplinMercy Hospital SpringfieldVia Christi Hospital
Joplin CONSUMER PERCEPTIONS Another way Mercy listens to our customer is through syndicated opinion surveys. National Research Corporation (NRC) administers an annual consumer opinion survey related specifically to health care, providing historical and current data on more than 3,200 hospitals and health systems nationwide.
When asked about preferred providers for quality, image/reputation and select service lines, participating residents from the surveyed region provided feedback displayed here.
Source: NRC Healthcare Market Guide, 2011 (data collected Sep 2010 – Aug 2011); Joplin Community (counties not surveyed: Barton, MO; Cherokee, KS; Ottawa and Delaware, OK)
BEST OVERALL QUALITY 2011
Total number of respondents: 366
BEST IMAGE/REPUTATION 2011
Total number of respondents: 363
Average number of respondents (4 yrs trending): 300
% r
esp
on
den
ts
Heart Care
Average number of respondents (4 yrs trending): 277
% r
esp
on
den
ts
Maternity/OB
Average number of respondents (4 yrs trending): 279
% r
esp
on
den
ts
Cancer Treatment
Average number of respondents (4 yrs trending): 266
% r
esp
on
den
ts
Pediatric Services
SELECT SERVICE LINE PREFERENCE TRENDS
Last year, 39% of Joplin consumers who took the survey chose a Mercy Hospital for best overall quality and 35% selected Mercy as having the best image or reputation.
45%
28%6%
5%
3%
3%
2%
1%
6%
Freeman Hospital West Mercy Hospital JoplinMercy McCune-Brooks Hospital Mercy Hospital SpringfieldVia Christi Hospital The University of Kansas HospitalCox South Nevada Regional Medical CenterOther Facilities
49%
26%6%
3%3%
4%
2%
1%
6%
Freeman Hospital West Mercy Hospital JoplinMercy Hospital Springfield Mercy McCune-Brooks HospitalVia Christi Hospital The University of Kansas HospitalNevada Regional Medical Center Cox SouthOther Facilities
47%
54%
64%
55%
22%
25% 25%
20%
0%
25%
50%
75%
2008 2009 2010 2011
Freeman Hospital WestMercy Hospital JoplinMercy Hospital SpringfieldVia Christi Hospital
44%
51% 51% 50%
21% 25%
29%
22%
0%
15%
30%
45%
60%
2008 2009 2010 2011
Freeman Hospital WestMercy Hospital JoplinMercy Hospital SpringfieldChildren's Mercy Hospital (Kansas City)Freeman Neosho HospitalVia Christi Hospital
Mercy Hospital
Mercy Clinic
Mercy Urgent/Convenient Care Clinic
Mercy Patient Origin by Zip Codebased on inpatient volume(volumes 1% or less not shown)
Other hospital (non-Mercy)
%
% Market Share 2010
OP Volume
46% PHYSICIAN OFFICES 1,036,718
15% FREEMAN HEALTH SYSTEM 327,628
14% INDEPENDENT LABS 325,482
13% MERCY HOSPITAL JOPLIN 300,394
4% MERCY MCCUNE-BROOKS HOSPITAL 97,847
3% FREEMAN NEOSHO HOSPITAL 77,927
0.2% BARTON COUNTY MEM. HOSPITAL 5,057
0.2% COX SOUTH 4,691
4% OTHER (including 0.2% Mercy) 81,708
Community Snapshot CARTHAGE PRIMARY SERVICE AREA & PATIENT ORIGIN The majority (80%) of Mercy McCune-Brooks Hospital’s acute care patients reside in Jasper and Newton Counties in southwest Missouri. Four in ten patients share the same zip code (64836) as the hospital.
HOUSEHOLD ECONOMICS
Total Households: 68,418 Average Income: $48,969 Annual Income <$15K: 16%
INSURANCE COVERAGE
49% Private 17% Medicare 16% Medicaid 18% Uninsured
Race:88% White; 2% Multiracial Ethnicity: 6% Hispanic (of any race)
Total Area Population: 175,621 5-Yr Growth: +4%
Age Cohorts: 26% Children (0-17) 20% Females (15-44) 14% Seniors (65+)
Median Age: 36
POPULATION
Health Factor County MO US
Adult Smoking (% smoking >= 100 cigarettes) 24% 24% 14%
Adult Obesity (% with BMI >= 30) 33% 31% 25%
Physical Inactivity (% of 20+ pop. not active) 27% 28% 21%
Excessive/Binge Drinking 15% 17% 8%
Teen Birth Rate (per 1,000 females age 15-19) 68 44 22
Children in Poverty (% of children 0-17) 23% 21% 13%
Preventable Hospital Stays (per 1k Medicare) 74 75 49
COUNTY HEALTH RANKINGS
Jasper County Overall Health Rank = 41 (out of 115 counties) The lower the ranking, the healthier the community.
Below are some of the factors which attribute to the county’s health status compared to state and national benchmarks.
SERVICES & PHYSICIANS In FFY11, Mercy McCune-Brooks Hospital’s top inpatient service lines were orthopedics (19%) and pulmonary and neurology both at 13%.
The 13% of residents leaving the Carthage area for inpatient services primarily go to Mercy Hospital Springfield for neurology and orthopedic services.
There are approximately 390 physicians (30% primary care) located in the PSA, of which 15% are integrated with Mercy.
EDUCATION (based on population ages 25+)
11% Some High School 30% Some College 35% High School Diploma 18% Bachelor’s Degree/greater
44%
7%
3%
total outpatient volume in the Carthage PSA 2.3M
OUTPATIENT MARKET SHARE (hospital-based only)
Sources: Map – Mercy Locations Directory & AHD (other locations); Inpatient Patient Origin & Market Share – HIDI, FFY11 (does not include Normal Newborns); Outpatient Market Share – Data represents 187 procedure groups (categories of CPT and HCPCS codes). Hospitals include hospital-based outpatient services only. Physician Offices and Independent Laboratories represent procedures performed in a physician’s office and/or lab regardless of affiliation with a hospital or health system. Thomson Reuters Outpatient Market Profiles, 2010; Demographics – Thomson Reuters, 2011; Payer Mix – Thomson Reuters Insurance Estimates, 2011; County Health Rankings, 2012; Inpatient Services – HIDI, FFY11; Physicians – Buxton, April 2012
% Market Share FFY11
Discharges
50% FREEMAN HEALTH SYSTEM 12,137
25% MERCY HOSPITAL JOPLIN 6,137
7% MERCY MCCUNE-BROOKS HOSPITAL 1,700
5% FREEMAN NEOSHO HOSPITAL 1,161
2% MERCY HOSPITAL SPRINGFIELD 486
1% COX SOUTH 355
1% CHILDREN’S MERCY HOSP. & CLINICS 276
8% OTHER (including 0.1% Mercy) 2,038
total inpatient discharges in the Carthage PSA
24,290
5%
3%
2%
2%
2%
3%
5%
INPATIENT MARKET SHARE
MO
% Market Share 2010
OP Volume
46% PHYSICIAN OFFICES 119,890
14% MERCY HOSPITAL JOPLIN 35,515
11% INDEPENDENT LABS 28,566
10% FREEMAN HEALTH SYSTEM 25,167
9% MERCY MAUDE NORTON HOSPITAL 24,655
4% VIA CHRISTI HOSPITAL-PITTSBURG, KS 9,126
1% GIRARD MEDICAL CENTER 2,705
1% INTEGRIS BAPTIST-MIAMI, OK 1,854
5% OTHER (including 0.1% Mercy) 15,040
Community Snapshot COLUMBUS
HOUSEHOLD ECONOMICS
Total Households: 7,917 Average Income: $44,356 Annual Income <$15K: 19%
INSURANCE COVERAGE
52% Private 19% Medicare 12% Medicaid 18% Uninsured
Race: 90% White; 4% American Indian Ethnicity: 2% Hispanic (of any race)
Total Area Population: 20,162 5-Yr Growth: -4%
Age Cohorts: 24% Children (0-17) 18% Females (15-44) 17% Seniors (65+)
Median Age: 40
POPULATION
Health Factor County KS US
Adult Smoking (% smoking >= 100 cigarettes) 20% 18% 14%
Adult Obesity (% with BMI >= 30) 36% 30% 25%
Physical Inactivity (% of 20+ pop. not active) 27% 24% 21%
Excessive/Binge Drinking 12% 15% 8%
Teen Birth Rate (per 1,000 females age 15-19) 59 43 22
Children in Poverty (% of children 0-17) 28% 18% 13%
Preventable Hospital Stays (per 1k Medicare) 82 70 49
COUNTY HEALTH RANKINGS
Cherokee County Overall Health Rank = 96 (out of 100 counties) The lower the ranking, the healthier the community.
Below are some of the factors which attribute to the county’s health status compared to state and national benchmarks.
SERVICES & PHYSICIANS
In FFY11, Mercy Maude Norton Hospital’s top inpatient service lines were pulmonary (31%) and cardiovascular (18%).
The 96% of residents leaving the Columbus area for inpatient services primarily go to Freeman Health System for cardiovascular and OB services, and to Mercy Hospital Joplin for cardiovascular services.
There are approximately 14 physicians (36% primary care) located in the PSA, of which none are integrated with Mercy.
EDUCATION (based on population ages 25+)
10% Some High School 34% Some College 38% High School Diploma 13% Bachelor’s Degree/greater
Sources: Map – Mercy Locations Directory & AHD (other locations); Inpatient Patient Origin & Market Share – HIDI, FFY11 (does not include Normal Newborns); Outpatient Market Share – Data represents 187 procedure groups (categories of CPT and HCPCS codes). Hospitals include hospital-based outpatient services only. Physician Offices and Independent Laboratories represent procedures performed in a physician’s office and/or lab regardless of affiliation with a hospital or health system. Thomson Reuters Outpatient Market Profiles, 2010; Demographics – Thomson Reuters, 2011; Payer Mix – Thomson Reuters Insurance Estimates, 2011; County Health Rankings, 2012; Inpatient Services – HIDI, FFY11; Physicians – Buxton, April 2012
total outpatient volume in the Columbus PSA 260,664
OUTPATIENT MARKET SHARE (hospital-based only)
PRIMARY SERVICE AREA & PATIENT ORIGIN The majority (95%) of Mercy Hospital Columbus’s acute care patients reside in Cherokee County in southeast Kansas. Eight in ten patients share the same zip code (66725) as the hospital.
80%
6%
5%
2%
Mercy Hospital
Mercy Clinic
Mercy Urgent/Convenient Care Clinic
Mercy Patient Origin by Zip Codebased on inpatient volume(volumes 1% or less not shown)
Other hospital (non-Mercy)
%
total inpatient discharges in the Columbus PSA 2,796
% Market Share FFY11
Discharges
40% FREEMAN HEALTH SYSTEM 1,131
30% MERCY HOSPITAL JOPLIN 837
13% VIA CHRISTI HOSPITAL-PITTSBURG, KS 360
4% MERCY MAUDE NORTON HOSPITAL 105
2% MERCY MCCUNE-BROOKS HOSPITAL 60
2% UNIVERSITY OF KANSAS HOSPITAL 57
1% MERCY HOSPITAL SPRINGFIELD 36
8% OTHER (including 0.4% Mercy) 210
INPATIENT MARKET SHARE
KS
Springfield PRIMARY SERVICE AREA
The Springfield Primary Service Area (PSA)
comprises 13 counties in southwest Missouri
MO
DEMOGRAPHICS Springfield Service Area Missouri 2011
US 2011 2011 2016 % Growth
Total Population 698,393 735,387 5% 6,015,487 310,650,750
0-17 24% 24% 6% 24% 24%
18-44 Females 18% 17% 3% 18% 18%
18-44 Males 18% 17% 4% 18% 19%
45-64 25% 25% 2% 26% 26%
65+ 16% 17% 14% 14% 13%
Median Age 38 - - 38 37
White 92% 91% 4% 81% 64%
Black 2% 2% 22% 11% 12%
American Indian 1% 1% 5% 1% 1%
Asian/Pacific Islander 1% 1% 16% 2% 5%
Multiracial and Other 2% 2% 14% 2% 2%
Hispanic (of any race) 3% 4% 24% 4% 16%
Speak Spanish in Home 2% - - 3% 12%
Total No. of Households 281,267 297,484 6% 2,393,904 116,862,390
Households with Children 32% - - 33% 34%
HH Income Under $15K 16% - - 14% 13%
HH Income Over $75K 17% - - 25% 30%
Average HH Income $ 50,417 - - $ 58,797 $ 67,529
Some High School 10% - - 9% 9%
High School Graduate/GED 35% - - 33% 29%
Some College 30% - - 29% 28%
Bachelor’s Degree or greater 21% - - 25% 28%
Source: Springfield Business Development Corporation; Springfield, Missouri MSA – Greene, Christian, Webster, Polk and Dallas Counties Full Time Equivalent Employees as of summer 2011
Company Industry Staff
Mercy Health Health care 9,036
CoxHealth Systems Health care 7,560
Walmart Retail 4,000
Springfield Public Schools Education 2,911
US Government Government 2,500
Bass Pro Shops/Tracker Marine Retail 2,363
MAJOR EMPLOYERS
Largest employers in the greater Springfield area as listed by the Springfield Business Development Corporation:
Source: Thomson Reuters Insurance Coverage Estimates, 2011
Hypertension 30%
Arthritis 25%
Asthma 13%
Diabetes 8%
Coronary Heart Disease 5%
COPD 5%
Angina 3%
Congestive Heart Failure 2%
CHRONIC DISEASE
Within the thirteen-county Springfield Service Area, the following chronic conditions have been identified among the adult (18+) population:
In addition, 4% have had a heart attack 3% have had a stroke, and 7% are living with some type of cancer
Source: Thomson Reuters Continuum of Care, 2011
US MO
INSURANCE COVERAGE
Springfield DEMOGRAPHICS
Note: Springfield Service Area consists of 13 counties in Missouri; Education Level based on population age 25+ Source: Thomson Reuters, 2011
Rac
e &
Eth
nic
ity
Age
Gro
up
s H
ou
seh
old
s Ed
uca
tio
n
Health Factor Greene County Missouri
National Benchmark
Adult Smoking (% smoking >= 100 cigarettes) 23% 24% 14%
Adult Obesity (% with BMI >= 30) 30% 31% 25%
Physical Inactivity (% of adults age 20+ not active) 26% 28% 21%
Excessive/Binge Drinking 13% 17% 8%
Teen Birth Rate (per 1,000 females age 15-19) 44 44 22
Children in Poverty (% of children under 18 in poverty) 24% 21% 13%
Preventable Hospital Stays (per 1,000 Medicare enrollees) 54 75 49 Sources: (state) Overall Health Ranking – America’s Health Rankings, 2011, provided by United Health Foundation; (county) Overall Health Ranking and Health Factors table – 2012 County Health Rankings provided by the Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute
COMMUNITY HEALTH MEASURES
Overall Health Ranking: Missouri = 40 (/50 states); Greene County = 38 (/115 counties) Rankings are out of total number of states or reporting counties. The lower the number, the healthier the community.
Below are some of the factors which attribute to community health.
Private 51%
Medicare 18%
Uninsured 17%
Medicaid 14%
Private 57% 56% Medicare 16% 14% Medicaid 13% 14% Uninsured 15% 16%
7.0% 7.4% 8.2%
UNEMPLOYMENT RATE
Change over 12 months:
↓1.2% MSA*
↓1.3% Missouri
↓0.7% US
*Springfield, MO Metropolitan Statistical Area Note: US & State rates are seasonally adjusted; MSA, non-seasonally adjusted Source: US Dept. of Labor – Bureau of Labor Statistics
MARCH 2012
Springfield REGIONAL PROVIDER LANDSCAPE
The map below depicts all inpatient hospitals and freestanding general outpatient surgery centers in the Springfield Service Area.
1 7
12
2
3
4
5
6
8
9
11
10
KANSAS
OKLAHOMA
MISSOURI
ARKANSAS
FreestandingGeneral Outpatient
Surgery Center
Mercy
CoxHealth
Independent
Source: Buxton ASC database, 2012
1a
1b
Hospitals (*indicates on-site outpatient surgery center) Health System Affiliation
Mercy Hospital Springfield* Mercy
Mercy Children’s Hospital Springfield (renovations to be completed by spring 2013) Mercy
Mercy Orthopedic Hospital Springfield (new facility to open summer 2013) Mercy
Mercy Hospital Lebanon* Mercy
Mercy Hospital Aurora* Mercy
Mercy Hospital Berryville* Mercy
Mercy St. Francis Hospital Mercy
Mercy Hospital Cassville* Mercy
Cox South* CoxHealth
Cox Monett Hospital* CoxHealth
Skaggs Regional Medical Center* Independent
Ozarks Medical Center* Independent
Citizens Memorial Hospital* Independent
Ozarks Community Hospital Independent
1
3
2
5
4
6
8
9
10
11
12
7
Springfield REGIONAL PROVIDER LANDSCAPE
1a
1b
• Non-profit, private
• Two general acute care hospitals, a bone and joint center (Meyer Orthopedic Center), newly expanded Neuro Trauma ICU, a large multi-specialty physician group, 60 regional physician clinics and five Walmart clinic locations
• Integrated physician group consists of 250+ physicians and the Ferrell-Duncan Clinic which is a managed multi-specialty clinic with 100+ physicians
INPATIENT MARKET SHARE 36%
TOTAL ASSETS $1.0B
NET PATIENT REVENUE $793M
OPER. PROFIT MARGIN -3.2% www.coxhealth.com
Hospital FTEs Staffed
Beds Service Area IP Discharges
Total Hospital IP Discharges
Total Births
Cox South (includes North & Walnut Lawn) 6,256 626 28,067 31,480 3,373
Cox Monett 235 25 743 812 286
TOTAL 6,491 651 28,810 32,292 3,659
Source: IP discharges, market share (for PSA) – HIDI, FFY11 (does not include Normal Newborns); beds, births, FTEs – AHA Guide, 2010 data; total assets, NPR, OPM – AHD, 2010
www.mercy.net
Hospital FTEs Staffed
Beds Service Area IP Discharges
Total Hospital IP Discharges
Total Births
Total ED Visits
Mercy Hospital Springfield 4,816 774 26,740 31,988 2,957 92,322
Mercy Hospital Lebanon 490 62 1,890 2,467 420 27,370
Mercy Hospital Berryville* 136 25 797 797 100 9,380
Mercy Hospital Aurora 148 25 755 770 236 14,086
Mercy Hospital Cassville 95 18 289 300 0 10,163
Mercy St. Francis Hospital 113 25 239 523 0 8,338
TOTAL 5,798 929 30,710 36,845 3,713 161,659
• Non-profit, member of Mercy
• Two general acute and four critical access hospitals, a dedicated children’s hospital; Heart Institute; region’s only Level 1 trauma and burn center; nationally-certified stroke center; and 48-bed orthopedic specialty hospital to open in summer 2013
• Mercy Clinic includes 511 primary care, specialty and hospital-based physicians, 279 advanced practice providers and 1,945 co-workers. The clinic provides more than 1.5 million outpatient visits in over 70 specialty, multi-specialty clinics and eight urgent/convenient care sites in Southwest Missouri and Northwest Arkansas (physician counts as of April 2012)
INPATIENT MARKET SHARE *37%
TOTAL ASSETS $487M
NET PATIENT REVENUE $970M
OPER. PROFIT MARGIN 11.3%
*Berryville not included in market share; Berryville Service Area IP Discharges are total hospital discharges from Mercy Finance, FY11; Berryville births – AHD, 2010 Source: IP discharges, market share (for PSA) – HIDI, FFY11 (does not include Normal Newborns); beds, births, ED visits, total assets, NPR, OPM – Mercy Finance, FY11; Mercy FTEs & clinic co-workers – Mercy Pension & Comp, as of April 2012
Hospital Health System FTEs Staffed
Beds Service Area IP Discharges
Total Hospital IP Discharges
Total Births
Skaggs Regional Medical Center (Branson, MO) Independent 1,050 132 5,879 7,076 674
Ozarks Medical Center (West Plains, MO) Independent 1,092 114 4,174 6,228 686
Citizens Memorial Hospital (Bolivar, MO) Independent 829 62 2,316 3,263 537
Ozarks Community Hospital (Springfield, MO) Independent 586 35 1,020 1,099 0
Source: IP discharges – HIDI, FFY11 (does not include Normal Newborns); beds, births, FTEs – AHA Guide, 2010 data
Other Health Care Providers in the Springfield Service Area
Note: Hospitals only
Note: Hospitals only
Springfield REGIONAL PROVIDER STATISTICS
Service Area IP Discharges represent inpatient discharges within a specified service area, typically where 85%-95% of Mercy’s patients reside. Market share is calculated based on discharges within the service area. Total Hospital IP Discharges account for all discharges from a facility regardless of where patients reside.
In June 2012, Skaggs Regional Medical Center and CoxHealth signed a letter of intent to form a financial partnership. The two health systems will enter into a period of due diligence and should have a definitive agreement by fall 2012. As a part of the agreement, Skaggs would function as a subsidiary of CoxHealth but would keep its name, board, current employees, management and medical staff.
% Change
Select Clinical Service Categories
2011 Procedures
Adjusted and Trended*
5 Yr 10 Yr
Physical and Occ. Therapy 1,175,000 29% 45%
Cardiology 321,369 19% 29%
Hematology/Oncology 277,745 23% 35%
Nephrology 140,096 85% 132%
Orthopedics 114,464 31% 45%
OB/Gyn 95,536 54% 61%
Neurology 91,671 36% 50%
General Surgery 39,523 26% 39%
Gastroenterology 38,500 10% 15%
Advanced Practice
35%
Hospital-based 18%
Specialists 22% Primary Care
25%
36%
30%
41%
33%
36%
0 1,000 2,000 3,000 4,000
Pulm
Ortho
Neuro
OB
Cardio
FFY11 Discharges
Note: Primary Care = FP/GP, IM, OB/Gyn, Pediatrics Source: Thomson Reuters Physician Estimates, 2011
Mercy Clinic Physicians 87%
Springfield Nephrology Assoc. 2%
CMH Surgical Services 1%
Pediatrics Medical Group-Springfield 1%
Springfield OB/Gyn 1%
Cardiovascular Surgeons 1%
Andy J. Wright, MD (Rheumatology) 1%
Other Physicians 6%
Springfield MO US
Primary Care 99 121 116
Specialty 57 83 81
Total 156 204 197
Mercy Hospital Springfield
Note: Mercy service lines used; based on volumes within the PSA Source: HIDI, FFY11
Ranks 2nd in market share
Note: Total (n) = 790 integrated Mercy physicians and advanced practitioners serving the 13-county Springfield PSA Source: Mercy Hospital Medical Staff Services, April 2012
Of the region’s 3M hospital-based outpatient visits, 5% occurred outside the Springfield PSA (1% at Mercy hospitals)
*Physician Offices and Independent Laboratories represent procedures performed in a physician’s office and/or lab regardless of the provider’s affiliation with a hospital or health system Note: Data represents 187 procedure groups (categories of CPT and HCPCS codes); Hospitals include hospital-based outpatient services only Source: Thomson Reuters Outpatient Market Profiles, 2010
Medical Facility 2010
Physician's Offices* 53%
Cox South-Springfield, MO 9%
Independent Labs* 9%
Mercy Hospital Springfield-MO 8%
Skaggs Regional Medical Center-Branson, MO 4%
Ozarks Community Hospital-Springfield, MO 2%
Citizens Memorial Hospital-Bolivar, MO 2%
Ozarks Medical Center-West Plains, MO 1%
Mercy Hospital Lebanon-MO 1%
Cox Monett Hospital-MO 1%
Mercy Hospital Aurora-MO 0.6%
Mercy Hospital Cassville-MO 0.4%
Mercy St. Francis Hospital-Mountain View, MO 0.3%
Other Mercy hospitals 0.3%
Other (incl. hospitals and freestanding facilities) 8%
In FFY11, 10% of patients received inpatient care at hospitals located outside the Springfield 13-county PSA, including 1% at Mercy hospitals
Source: HIDI, FFY10-FFY11 (does not include Normal Newborns)
Hospital FFY10 FFY11
Cox South-Springfield, MO 35% 35%
Mercy Hospital Springfield-MO 33% 33%
Skaggs Regional Medical Center-Branson, MO 7% 7%
Ozarks Medical Center-West Plains, MO 5% 5%
Citizens Memorial Hospital-Bolivar, MO 3% 3%
Mercy Hospital Lebanon-MO 2% 2%
Ozarks Community Hospital-Springfield, MO 1% 1%
Missouri Residents/Arkansas Hospitals 1% 1%
Barnes-Jewish Hospital-St. Louis, MO 1% 1%
Mercy Hospital Aurora-MO 1% 1%
Cox Monett Hospital-MO 1% 1%
Other Mercy hospitals 2% 1%
Other hospitals 7% 8%
Ranks 1st in market share
Source: Epic data, FY11 inpatient discharges; Buxton physician database, April 2012
Note: Data is available for additional clinical service categories *Adjusted and Trended estimates take into account technology trends, health care reform, and changes in disease incidence and prevalence Source: Thomson Reuters Outpatient Estimates, 2011
Mercy Hospital Volume and Market Share
Springfield PATIENT CARE
INPATIENT MARKET SHARE TRENDS PHYSICIAN SUPPLY/100,000 POPULATION
INPATIENT DISCHARGES BY PHYSICIAN GROUP
MERCY INTEGRATED MEDICAL STAFF
INPATIENT PHYSICIANS OUTPATIENT
TOP INPATIENT SERVICE LINES
OUTPATIENT MARKET SHARE (Hospital-based)
OUTPATIENT UTILIZATION – MARKET ESTIMATES
Source: www.hospitalcompare.hhs.gov. Most current data available updated April 19, 2012 – results from patients who had overnight hospital stays during April 1, 2010 and March 31, 2011. More than 300 surveys were completed for each facility with an average response rate of 33%.
Percentage of patients who gave the hospital the highest rankings
Percentage of patients who gave the hospital the lowest rankings
Mercy Hospital
Cox South
MO US Mercy
Hospital Cox
South MO US
79% 73% 77% 76% 3% 5% 5% 5%
83% 79% 81% 80% 3% 4% 4% 4%
63% 59% 65% 64% 8% 12% 10% 10%
70% 67% 69% 70% 4% 7% 7% 7%
60% 56% 60% 61% 21% 24% 21% 21%
77% 68% 72% 72% 5% 10% 9% 9%
56% 51% 57% 58% 11% 13% 11% 11%
86% 83% 84% 82% 14% 17% 16% 18%
78% 65% 68% 68% 5% 9% 9% 9%
83% 70% 68% 70% 1% 5% 5% 5%
Springfield PATIENT SATISFACTION
1 How often did nurses communicate well with patients?
2 How often did doctors communicate well with patients?
Scale (Question 1 – 7): highest = “always”; lowest = “sometimes” or “never”
Scale (Question 8): highest = “yes/did”; lowest = “no/did not”
3 How often did patients receive help quickly from staff?
4 How often was patients’ pain well controlled?
5 How often did staff explain about medicines before giving them to patients?
6 How often were patients’ rooms & bathrooms kept clean?
7 How often was the area around patients’ rooms kept quiet at night?
8 Were patients given information about what to do during their recovery at home?
Scale (Question 9): highest = “9” or “10”; lowest = “6” or lower
9 How do patients rate the hospital overall?
Scale (Question 10): highest = “YES, definitely”; lowest = “No, probably/definitely not”
10 Would patients recommend the hospital to friends and family?
Mercy believes in listening to our communities and responding to their needs. As part of the People Promise key initiative, the Ministry is standardizing the survey tool and vendor used to obtain patient feedback – reinforcing our mission and culture of providing exceptional service, and to enhance the Mercy experience for our patients. Currently, we can look to HCAHPS survey results as a measure of patients’ perspectives of care.
Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a national survey developed by the Centers for Medicare & Medicaid Services (CMS) and the Agency for Healthcare Research and Quality (AHRQ). The data is publicly available to consumers.
Mercy’s HCAHPS results from patients who had overnight hospital stays during April 1, 2010 and March 31, 2011 are shown below, and are compared to other area providers as well as state and national averages for all reporting hospitals.
= indicates an equal or greater percentage of Mercy patients gave the hospital the highest rankings compared to competitors shown
Springfield CONSUMER PERCEPTIONS Another way Mercy listens to our customer is through syndicated opinion surveys. National Research Corporation (NRC) administers an annual consumer opinion survey related specifically to health care, providing historical and current data on more than 3,200 hospitals and health systems nationwide.
When asked about preferred providers for quality, image/reputation and select service lines, participating residents from the surveyed region provided feedback displayed here.
Last year, 50% of Springfield consumers who took the survey chose a Mercy Hospital for best overall quality and 52% selected Mercy as having the best image or reputation.
Source: NRC Healthcare Market Guide, 2011 (data collected Sep 2010 – Aug 2011); Springfield Community (13-county PSA: Dallas and Douglas Counties not surveyed)
BEST OVERALL QUALITY 2011
Total number of respondents: 609 Mercy Hospitals Cassville, Lebanon and St. Louis received less than 1% each
52% 50% 51% 48%
31% 32%35%
31%
0%
25%
50%
75%
2008 2009 2010 2011
Mercy Hospital Springfield Cox South
Average number of respondents (4 yrs trending): 569 %
re
spo
nd
en
ts
Heart Care
Average number of respondents (4 yrs trending): 525
% r
esp
on
de
nts
46%
38%
45% 42%
32%38% 37%
34%
0%
25%
50%
75%
2008 2009 2010 2011
Mercy Hospital Springfield Cox South
Maternity/OB
Average number of respondents (4 yrs trending): 544
% r
esp
on
de
nts
44%40%
44% 42%
31% 31% 33% 32%
0%
25%
50%
75%
2008 2009 2010 2011
Mercy Hospital Springfield Cox South
Cancer Treatment
Average number of respondents (4 yrs trending): 522
% r
esp
on
de
nts
45%39%
46% 43%
30%35% 34% 35%
0%
25%
50%
75%
2008 2009 2010 2011
Mercy Hospital Springfield Cox South
Pediatric Services
SELECT SERVICE LINE PREFERENCE TRENDS
47%
35%
4%4%
1%1%
1% 1% 7%
Mercy Hospital Springfield Cox SouthCox North Skaggs Regional Medical CenterMercy Hospital Aurora Ozarks Community HospitalMercy Hospital Joplin Cox Monett HospitalOther Facilities
Total number of respondents: 613 Mercy Hospitals Cassville, Lebanon and St. Louis received less than 1% each
BEST IMAGE/REPUTATION 2011
49%
32%
4%
4%
1%1%
1% 1% 7%
Mercy Hospital Springfield Cox SouthCox North Skaggs Regional Medical CenterOzarks Community Hospital Mercy Hospital AuroraMercy Hospital Joplin Cox Walnut LawnOther Facilities
% Market Share FFY11
Discharges
29% COX SOUTH 2,462
27% MERCY HOSPITAL SPRINGFIELD 2,237
9% COX MONETT 722
8% MERCY HOSPITAL AURORA 703
5% MO RESIDENTS/AR HOSPITALS 459
5% FREEMAN HOSPITAL WEST 379
3% MERCY HOSPITAL CASSVILLE 276
4% OTHER MERCY 292
10% OTHER 829
9%
38%
12%
2%
7%
8%
Community Snapshot AURORA
total outpatient volume in the Aurora PSA 967,710
INPATIENT MARKET SHARE OUTPATIENT MARKET SHARE (hospital-based only)
total inpatient discharges in the Aurora PSA
% Market Share 2010
OP Volume
47% PHYSICIAN OFFICES 458,584
9% COX MONETT 90,292
8% INDEPENDENT LABS 73,662
6% COX SOUTH 58,959
6% MERCY HOSPITAL AURORA 53,265
4% MERCY HOSPITAL CASSVILLE 41,371
4% MERCY HOSPITAL SPRINGFIELD 40,410
2% OTHER MERCY 22,481
13% OTHER 128,686
8,359
PRIMARY SERVICE AREA & PATIENT ORIGIN The majority (91%) of Mercy Hospital Aurora’s acute care patients reside in Barry and Lawrence Counties in southwest Missouri. Four in ten patients share the same zip code (65605) as the hospital.
Sources: Map – Mercy Locations Directory & AHD (other locations); Inpatient Patient Origin & Market Share – HIDI, FFY11 (does not include Normal Newborns); Outpatient Market Share – Data represents 187 procedure groups (categories of CPT and HCPCS codes). Hospitals include hospital-based outpatient services only. Physician Offices and Independent Laboratories represent procedures performed in a physician’s office and/or lab regardless of affiliation with a hospital or health system. Thomson Reuters Outpatient Market Profiles, 2010; Demographics – Thomson Reuters, 2011; Payer Mix – Thomson Reuters Insurance Estimates, 2011; County Health Rankings, 2012; Inpatient Services – HIDI, FFY11; Physicians – Buxton, April 2012
3%
3%
2%
2%
HOUSEHOLD ECONOMICS
Total Households: 29,880 Average Income: $44,930 Annual Income <$15K: 18%
INSURANCE COVERAGE
48% Private 18% Medicare 15% Medicaid 18% Uninsured
EDUCATION (based on population ages 25+)
13% Some High School 26% Some College 41% High School Diploma 13% Bachelor’s Degree/greater
Race: 89% White; 1% Multiracial Ethnicity: 8% Hispanic (of any race)
Total Area Population: 76,912 5-Yr Growth: +2%
Age Cohorts: 26% Children (0-17) 17% Females (15-44) 17% Seniors (65+)
Median Age: 39
POPULATION
SERVICES & PHYSICIANS
In FFY11, Mercy Hospital Aurora’s top inpatient service lines were OB (32%) and pulmonary (21%).
The 80% of patients leaving the Aurora area for inpatient services primarily go to Mercy Springfield for cardiovascular and orthopedic services, and to Cox South for cardiovascular, general surgery and neurology services.
There are approximately 72 physicians (65% primary care) located in the PSA, of which 29% are integrated with Mercy.
Health Factor County MO US
Adult Smoking (% smoking >= 100 cigarettes) 29% 24% 14%
Adult Obesity (% with BMI >= 30) 30% 31% 25%
Physical Inactivity (% of 20+ pop. not active) 30% 28% 21%
Excessive/Binge Drinking 10% 17% 8%
Teen Birth Rate (per 1,000 females age 15-19) 58 44 22
Children in Poverty (% of children 0-17) 26% 21% 13%
Preventable Hospital Stays (per 1,000 Medicare) 55 75 49
COUNTY HEALTH RANKINGS
Lawrence County Overall Health Rank = 57 (out of 115 counties) The lower the ranking, the healthier the community.
Below are some of the factors which attribute to the county’s health status compared to state and national benchmarks.
3%
Mercy Hospital
Mercy Clinic
Mercy Urgent/Convenient Care Clinic
Mercy Freestanding OP Surgery Center
Mercy Patient Origin by Zip Codebased on inpatient volume(volumes 1% or less not shown)
Other hospital (non-Mercy)
%
MO
Community Snapshot BERRYVILLE
OUTPATIENT MARKET SHARE (hospital-based only)
Sources: Map – Mercy Locations Directory, AHD (other locations); Inpatient Discharges Mercy Finance, FY10 (does not include Normal Newborns), Eureka Springs – AHA Guide 2010 data; Inpatient Patient Origin – Mercy Finance (Springfield Region), FY11; Outpatient Market Share – Data represents 187 procedure groups (categories of CPT and HCPCS codes). Hospitals include hospital-based outpatient services only. Physician Offices and Independent Laboratories represent procedures performed in a physician’s office and/or lab regardless of affiliation with a hospital or health system. Thomson Reuters Outpatient Market Profiles, 2010; Demographics – Thomson Reuters, 2011; Payer Mix – Thomson Reuters Insurance Estimates, 2011; County Health Rankings, 2012; Physicians – Buxton, April 2012
total outpatient volume in the Berryville PSA 402,236
% Market Share 2010
OP Volume
56% PHYSICIAN OFFICES 223,942
15% INDEPENDENT LABS 61,082
9% MERCY HOSPITAL BERRYVILLE 36,815
6% EUREKA SPRINGS HOSPITAL 25,684
1% WASHINGTON REG. MED. CTR. 5,302
1% NORTH AR REG. MED. CTR. 5,039
1% OTHER MERCY 4,040
10% OTHER 40,332
INPATIENT MARKET SHARE
PRIMARY SERVICE AREA & PATIENT ORIGIN The majority (74%) of Mercy Hospital Berryville’s acute care patients reside in Carroll County in northwest Arkansas. Four in ten patients share the same zip code (72616) as the hospital.
HOUSEHOLD ECONOMICS
Total Households: 11,813 Average Income: $43,737 Annual Income <$15K: 21%
INSURANCE COVERAGE
44% Private 19% Medicare 16% Medicaid 21% Uninsured
Race: 81% White; 1% Multiracial Ethnicity: 16% Hispanic (of any race)
Total Area Population: 29,471 5-Yr Growth: +4%
Age Cohorts: 22% Children (0-17) 17% Females (15-44) 18% Seniors (65+)
Median Age: 42
POPULATION
PHYSICIANS
There are approximately 28 physicians (54% primary care) located in the PSA, of which 39% are integrated with Mercy.
Health Factor County AR US
Adult Smoking (% smoking >= 100 cigarettes) 29% 23% 14%
Adult Obesity (% with BMI >= 30) 26% 32% 25%
Physical Inactivity (% of 20+ pop. not active) 28% 31% 21%
Excessive/Binge Drinking 12% 12% 8%
Teen Birth Rate (per 1,000 females age 15-19) 66 61 22
Children in Poverty (% of children 0-17) 27% 27% 13%
Preventable Hospital Stays (per 1,000 Medicare) 59 81 49
COUNTY HEALTH RANKINGS
Carroll County Overall Health Rank = 16 (out of 75 counties) The lower the ranking, the healthier the community.
Below are some of the factors which attribute to the county’s health status compared to state and national benchmarks.
EDUCATION (based on population ages 25+)
12% Some High School 26% Some College 36% High School Diploma 15% Bachelor’s Degree/greater
AR
Mercy Hospital
Mercy Clinic
Mercy Urgent/Convenient Care Clinic
Mercy Freestanding OP Surgery Center
Mercy Patient Origin by Zip Codebased on inpatient volume(volumes 1% or less not shown)
Other hospital (non-Mercy)
%
% Market Share 2010
Discharges
70% MERCY HOSPITAL BERRYVILLE 1,149
30% EUREKA SPRINGS HOSPITAL 488
1,637 total inpatient discharges within a 25-mile radius of Mercy Hospital Berryville
Note: Includes total inpatient discharges for hospitals located within a 25-mile radius of Mercy Hospital Berryville; does not account for outmigration
3%
4%
20% 42%
5%
% Market Share FFY11
Discharges
27% COX SOUTH 1,173
22% MERCY HOSPITAL SPRINGFIELD 920
11% COX MONETT 483
10% MO RESIDENTS/AR HOSPITALS 442
6% MERCY HOSPITAL CASSVILLE 269
5% FREEMAN HOSPITAL WEST 215
8% OTHER MERCY 338
10% OTHER 435
PRIMARY SERVICE AREA & PATIENT ORIGIN The majority (90%) of Mercy Hospital Cassville’s acute care patients reside in Barry County in southwest Missouri. Approximately five in ten patients share the same zip code (65625) as the hospital.
Community Snapshot CASSVILLE
Sources: Map – Mercy Locations Directory, AHD (other locations); Inpatient Patient Origin & Market Share – HIDI, FFY11 (does not include Normal Newborns); Outpatient Market Share – Data represents 187 procedure groups (categories of CPT and HCPCS codes). Hospitals include hospital-based outpatient services only. Physician Offices and Independent Laboratories represent procedures performed in a physician’s office and/or lab regardless of affiliation with a hospital or health system. Thomson Reuters Outpatient Market Profiles, 2010; Demographics – Thomson Reuters, 2011; Payer Mix – Thomson Reuters Insurance Estimates, 2011; County Health Rankings, 2012; Inpatient Services – HIDI, FFY11; Physicians – Buxton, April 2012
OUTPATIENT MARKET SHARE (hospital-based only)
total outpatient volume in the Cassville PSA 531,932
% Market Share 2010
OP Volume
47% PHYSICIAN OFFICES 251,253
13% COX MONETT 68,225
8% MERCY HOSPITAL CASSVILLE 40,755
7% INDEPENDENT LABS 36,835
5% COX SOUTH 26,153
3% MERCY HOSPITAL SPRINGFIELD 15,102
4% OTHER MERCY 23,209
13% OTHER 70,400
INPATIENT MARKET SHARE
48%
total inpatient discharges in the Cassville PSA 4,275
3%
HOUSEHOLD ECONOMICS
Total Households: 17,242 Average Income: $45,192 Annual Income <$15K: 17%
INSURANCE COVERAGE
48% Private 19% Medicare 16% Medicaid 17% Uninsured
Race:86% White; 1% Multiracial Ethnicity: 11% Hispanic (of any race)
Total Area Population: 44,147 5-Yr Growth: +2
Age Cohorts: 26% Children (0-17) 17% Females (15-44) 17% Seniors (65+)
Median Age: 40
POPULATION
4%
9%
8% 9% 2% 3%
6%
SERVICES & PHYSICIANS
In FFY11, Mercy Hospital Cassville’s top IP service lines were pulmonary (35%), cardiovascular (11%) and gastroenterology (11%).
The 82% of patients leaving the Cassville area for inpatient services primarily go to Mercy Springfield for cardiovascular and orthopedic services, and to Cox South for cardiovascular, general surgery and neurology services; 10% are leaving for Arkansas hospitals.
There are approximately 21 physicians (71% primary care) located in the PSA, of which 38% are integrated with Mercy.
Health Factor County MO US
Adult Smoking (% smoking >= 100 cigarettes) 27% 24% 14%
Adult Obesity (% with BMI >= 30) 30% 31% 25%
Physical Inactivity (% of 20+ pop. not active) 33% 28% 21%
Excessive/Binge Drinking 15% 17% 8%
Teen Birth Rate (per 1,000 females age 15-19) 72 44 22
Children in Poverty (% of children 0-17) 29% 21% 13%
Preventable Hospital Stays (per 1,000 Medicare) 56 75 49
COUNTY HEALTH RANKINGS
Barry County Overall Health Rank = 96 (out of 115 counties) The lower the ranking, the healthier the community.
Below are some of the factors which attribute to the county’s health status compared to state and national benchmarks.
EDUCATION (based on population ages 25+)
13% Some High School 26% Some College 41% High School Diploma 13% Bachelor’s Degree/greater
Mercy Hospital
Mercy Clinic
Mercy Urgent/Convenient Care Clinic
Mercy Freestanding OP Surgery Center
Mercy Patient Origin by Zip Codebased on inpatient volume(volumes 1% or less not shown)
Other hospital (non-Mercy)
%
MO
65584 St. Robert
Community Snapshot LEBANON
Sources: Map – Mercy Locations Directory, AHD (other locations); Inpatient Patient Origin & Market Share – HIDI, FFY11 (does not include Normal Newborns); Outpatient Market Share – Data represents 187 procedure groups (categories of CPT and HCPCS codes). Hospitals include hospital-based outpatient services only. Physician Offices and Independent Laboratories represent procedures performed in a physician’s office and/or lab regardless of affiliation with a hospital or health system. Thomson Reuters Outpatient Market Profiles, 2010; Demographics – Thomson Reuters, 2011; Payer Mix – Thomson Reuters Insurance Estimates, 2011; County Health Rankings, 2012; Inpatient Services – HIDI, FFY11; Physicians – Buxton, April 2012
OUTPATIENT MARKET SHARE (hospital-based only)
% Market Share 2010
OP Volume
51% PHYSICIAN OFFICES 452,866
17% MERCY HOSPITAL LEBANON 147,580
9% INDEPENDENT LABS 76,637
5% PHELPS CO. REG. MEDICAL CTR. 44,601
4% MERCY HOSPITAL SPRINGFIELD 31,653
2% LAKE REGIONAL HEALTH SYSTEM 21,919
2% COX SOUTH 16,224
10% OTHER (incl. 0.03% Mercy) 89,385
total outpatient volume in the Lebanon PSA 880,865
INPATIENT MARKET SHARE
PRIMARY SERVICE AREA & PATIENT ORIGIN The majority (87%) of Mercy Hospital Lebanon’s acute care patients reside in Laclede and Pulaski Counties in central Missouri. Six in ten patients share the same zip code (65536) as the hospital.
HOUSEHOLD ECONOMICS
Total Households: 30,323 Average Income: $47,994 Annual Income <$15K: 15%
INSURANCE COVERAGE
57% Private 15% Medicare 12% Medicaid 16% Uninsured
Race: 84% White; 6% Black Ethnicity: 6% Hispanic (of any race)
Total Area Population: 85,428 5-Yr Growth: +5%
Age Cohorts: 26% Children (0-17) 21% Females (15-44) 12% Seniors (65+)
Median Age: 34
POPULATION
% Market Share FFY11
Discharges
25% MERCY HOSPITAL LEBANON 2,144
20% MERCY HOSPITAL SPRINGFIELD 1,737
15% PHELPS CO. REG. MEDICAL CTR. 1,314
9% UNIVERSTY HOSPITALS & CLINICS 728
7% LAKE REGIONAL HEALTH SYSTEM 638
7% COX SOUTH 576
0.7% OTHER MERCY 62
16% OTHER 1,353
total inpatient discharges in the Lebanon PSA 8,552
60%
6% 6%
3%
2%
2%
2%
2%
2%
SERVICES & PHYSICIANS
In FFY11, Mercy Hospital Lebanon’s top inpatient service lines were pulmonary and OB, both at 18%.
The 75% of patients leaving the Lebanon area for inpatient services primarily go to Mercy Springfield for cardiovascular and neurology services, and to Phelps County Regional Medical Center in Rolla, MO, for behavioral health and OB services.
There are approximately 81 physicians (56% primary care) located in the PSA, of which 27% are integrated with Mercy.
Health Factor County MO US
Adult Smoking (% smoking >= 100 cigarettes) 30% 24% 14%
Adult Obesity (% with BMI >= 30) 32% 31% 25%
Physical Inactivity (% of 20+ pop. not active) 35% 28% 21%
Excessive/Binge Drinking 8% 17% 8%
Teen Birth Rate (per 1,000 females age 15-19) 72 44 22
Children in Poverty (% of children 0-17) 29% 21% 13%
Preventable Hospital Stays (per 1,000 Medicare) 74 75 49
COUNTY HEALTH RANKINGS
Laclede County Overall Health Rank = 68 (out of 115 counties) The lower the ranking, the healthier the community.
Below are some of the factors which attribute to the county’s health status compared to state and national benchmarks.
EDUCATION (based on population ages 25+)
11% Some High School 30% Some College 39% High School Diploma 15% Bachelor’s Degree/greater
MO
Mercy Hospital
Mercy Clinic
Mercy Freestanding OP Surgery Center
Mercy Patient Origin by Zip Codebased on inpatient volume(volumes 1% or less not shown)
Other hospital (non-Mercy)
%
Community Snapshot MOUNTAIN VIEW
Sources: Map – Mercy Locations Directory, AHD (other locations); Inpatient Patient Origin & Market Share – HIDI, FFY11 (does not include Normal Newborns); Outpatient Market Share – Data represents 187 procedure groups (categories of CPT and HCPCS codes). Hospitals include hospital-based outpatient services only. Physician Offices and Independent Laboratories represent procedures performed in a physician’s office and/or lab regardless of affiliation with a hospital or health system. Thomson Reuters Outpatient Market Profiles, 2010; Demographics – Thomson Reuters, 2011; Payer Mix – Thomson Reuters Insurance Estimates, 2011; County Health Rankings, 2012; Inpatient Services – HIDI, FFY11; Physicians – Buxton, April 2012
OUTPATIENT MARKET SHARE (hospital-based only)
total outpatient volume in the Mountain View PSA 670,677
% Market Share 2010
OP Volume
40% PHYSICIAN OFFICES 271,079
19% OZARKS MEDICAL CENTER 130,038
13% INDEPENDENT LABS 86,478
8% MERCY ST. FRANCIS HOSPITAL 53,671
2% COX SOUTH 16,264
2% MERCY HOSPITAL SPRINGFIELD 14,856
1% TEXAS COUNTY MEMORIAL 4,361
14% OTHER (incl. 0.01% Mercy) 93,930
INPATIENT MARKET SHARE
PRIMARY SERVICE AREA & PATIENT ORIGIN The majority (83%) of Mercy St. Francis Hospital’s acute care patients reside in Howell and Shannon Counties in southeast Missouri. Three in ten patients share the same zip code (65548) as the hospital.
% Market Share FFY11
Discharges
59% OZARKS MEDICAL CENTER 3,918
12% MERCY HOSPITAL SPRINGFIELD 806
8% COX SOUTH 524
7% MERCY ST. FRANCIS HOSPITAL 437
3% MO RESIDENTS/AR HOSPITALS 180
2% BARNES-JEWISH HOSPITAL 116
2% POPLAR BLUFF REG. MEDICAL CTR. 108
8% OTHER (incl. 0.3% Mercy) 582
total inpatient discharges in the Mountain View PSA 6,671
34%
17%
10%
9%
9%
6%
2%
2%
2%
HOUSEHOLD ECONOMICS
Total Households: 20,048 Average Income: $39,629 Annual Income <$15K: 23%
INSURANCE COVERAGE
35% Private 22% Medicare 19% Medicaid 23% Uninsured
Race: 94% White; 2% Multiracial Ethnicity: 2% Hispanic (of any race)
Total Area Population: 49,788 5-Yr Growth: +2%
Age Cohorts: 25% Children (0-17) 18% Females (15-44) 18% Seniors (65+)
Median Age: 40
POPULATION
34%
2%
9%
2%
6%
9%
2%
10%
Mercy Hospital
Mercy Clinic
Mercy Patient Origin by Zip Codebased on inpatient volume(volumes 1% or less not shown)
Other hospital (non-Mercy)
%
SERVICES & PHYSICIANS
In FFY11, Mercy St. Francis Hospital’s top inpatient service lines were pulmonary (43%) and gastroenterology (14%).
The 35% of patients leaving the Mountain View area for inpatient services primarily go to Mercy Hospital Springfield for cardiovascular and general surgery services.
There are approximately 82 physicians (41% primary care) located in the PSA area, of which 7% are integrated with Mercy.
Health Factor County MO US
Adult Smoking (% smoking >= 100 cigarettes) 27% 24% 14%
Adult Obesity (% with BMI >= 30) 30% 31% 25%
Physical Inactivity (% of 20+ pop. not active) 31% 28% 21%
Excessive/Binge Drinking 12% 17% 8%
Teen Birth Rate (per 1,000 females age 15-19) 68 44 22
Children in Poverty (% of children 0-17) 33% 21% 13%
Preventable Hospital Stays (per 1,000 Medicare) 62 75 49
COUNTY HEALTH RANKINGS
Howell County Overall Health Rank = 98 (out of 115 counties) The lower the ranking, the healthier the community.
Below are some of the factors which attribute to the county’s health status compared to state and national benchmarks.
17%
EDUCATION (based on population ages 25+)
12% Some High School 24% Some College 43% High School Diploma 13% Bachelor’s Degree/greater
MO
Oklahoma City PRIMARY SERVICE AREA
OK
The Oklahoma City Primary Service Area (PSA) comprises
six counties in central Oklahoma
Sayre, OK, Beckham County,
121 miles west of Oklahoma City
Private 56%
Medicare 13%
Uninsured 17% Medicaid
14%
DEMOGRAPHICS Oklahoma City Service Area Oklahoma 2011
US 2011 2011 2016 % Growth
Total Population 1,191,068 1,250,099 5% 3,771,943 310,650,750
0-17 25% 26% 7% 25% 24%
18-44 Females 19% 18% 1% 18% 18%
18-44 Males 19% 19% 2% 19% 19%
45-64 24% 24% 3% 25% 26%
65+ 12% 14% 16% 14% 13%
Median Age 35 - - 36 37
White 68% 66% 2% 70% 64%
Black 11% 11% 6% 8% 12%
American Indian 4% 4% 4% 8% 1%
Asian/Pacific Islander 3% 3% 11% 2% 5%
Multiracial and Other 3% 3% 0% 4% 2%
Hispanic (of any race) 11% 13% 22% 9% 16%
Speak Spanish in Home 7% - - 5% 12%
Total No. of Households 472,002 495,559 5% 1,478,071 116,862,390
Households with Children 33% - - 34% 34%
HH Income Under $15K 14% - - 16% 13%
HH Income Over $75K 25% - - 21% 30%
Average HH Income $ 59,116 - - $ 54,379 $ 67,529
Some High School 9% - - 10% 9%
High School Graduate/GED 28% - - 32% 29%
Some College 32% - - 30% 28%
Bachelor’s Degree or greater 28% - - 23% 28%
Company Industry Staff
State of Oklahoma Government 42,100
Tinker Air Force Base Military 27,000
OU – Norman Campus Education 11,650
FAA Mike Monroney Aeronautical Center Aerospace 7,500
Integris Health Health care 6,025
City of Oklahoma City Government 5,040
MAJOR EMPLOYERS
Largest employers in the greater Oklahoma City area provided by the Economic Development Division of the Greater Oklahoma City Chamber—Mercy is listed as ninth largest with 3,450 staff:
Oklahoma City DEMOGRAPHICS R
ace
& E
thn
icit
y A
ge G
rou
ps
Ho
use
ho
lds
Edu
cati
on
Health Factor Oklahoma
County Oklahoma National
Benchmark
Adult Smoking (% smoking >= 100 cigarettes) 24% 25% 14%
Adult Obesity (% with BMI >= 30) 30% 32% 25%
Physical Inactivity (% of adults age 20+ not active) 30% 31% 21%
Excessive/Binge Drinking 16% 14% 8%
Teen Birth Rate (per 1,000 females age 15-19) 69 58 22
Children in Poverty (% of children age 0-17 in poverty) 28% 24% 13%
Preventable Hospital Stays (per 1,000 Medicare enrollees) 62 82 49
Sources: (state) Overall Health Ranking – America’s Health Rankings, 2011, provided by United Health Foundation; (county) Overall Health Ranking and Health Factors table – 2012 County Health Rankings provided by the Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute
COMMUNITY HEALTH MEASURES
Overall Health Ranking: Oklahoma = 48 (/50 states); Oklahoma County = 32 (/77 counties) Rankings are out of total number of states or reporting counties. The lower the number, the healthier the community.
Below are some of the factors which attribute to community health.
Note: Oklahoma City Service Area consists of six counties in Oklahoma; Education Level based on population age 25+ Source: Thomson Reuters, 2011
Source: Greater Oklahoma City Economic Development, March 2012
CHRONIC DISEASE
Within the six-county Oklahoma City Service Area, the following chronic conditions have been identified among the adult (18+) population:
In addition, 3% have had a stroke 3% have had a heart attack, and 5% are living with some type of cancer
Source: Thomson Reuters Continuum of Care, 2011
Source: Thomson Reuters Insurance Coverage Estimates, 2011
OK US
INSURANCE COVERAGE
Hypertension 29%
Arthritis 22%
Asthma 13%
Diabetes 8%
COPD 4%
Coronary Heart Disease 4%
Angina 2%
Congestive Heart Failure 2%
Private 52% 56% Medicare 15% 14% Medicaid 15% 14% Uninsured 18% 16%
4.4% 5.4%
8.2%
UNEMPLOYMENT RATE
Change over 12 months
↓0.9% MSA*
↓0.5% Oklahoma
↓0.7% US
*Oklahoma City, OK Metropolitan Statistical Area Note: US & State rates are seasonally adjusted; MSA, non-seasonally adjusted Source: US Dept. of Labor – Bureau of Labor Statistics
MARCH 2012
24
1
4
11
12 14
5 7 6
9
19
20
18
26
25
10
21 17 15
16 3 13
2 22
The map below depicts all inpatient hospitals and freestanding general outpatient surgery centers in the Oklahoma City Service Area.
Oklahoma City REGIONAL PROVIDER LANDSCAPE
OKLAHOMA
Sayre, OK, Beckham County, 121 miles west of Oklahoma City 8
23
Integris Health
SSM Health Care of OK
HCA
HealthSouth
Physician Owned
Independent
Universal Health Svcs
Freestanding General Outpatient Surgery Center
Source: Buxton ASC database, 2012
Oklahoma City REGIONAL PROVIDER LANDSCAPE
8
16
2 3
4
1
5
6
7
9
10
11
12
14
13
15
18
16
17
19
20
21
22
24
Hospitals (*indicates on-site outpatient surgery center) Health System Affiliation
Mercy Hospital Oklahoma City* Mercy
Oklahoma Heart Hospital Mercy
Oklahoma Heart Hospital South Mercy
Mercy Hospital El Reno Mercy
Mercy Hospital Logan County Mercy
Mercy Hospital Watonga (Mercy-owned as of July 1, 2012) Mercy
Kingfisher Regional Hospital (managed facility) Mercy
Sayre Memorial Hospital (managed facility as of June 1, 2012) Mercy
Integris Baptist Medical Center* Integris Health
Integris Southwest Medical Center* Integris Health
Integris Canadian Valley Hospital Integris Health
Integris Edmond Integris Health
OU Medical Center* HCA
OU Medical Center Edmond* HCA
St. Anthony Hospital* SSM Health Care
Bone & Joint Hospital* SSM Health Care
Midwest Regional Medical Center* HMA
Norman Regional Hospital* Norman Regional Health System
Moore Medical Center* Norman Regional Health System
Healthplex* Norman Regional Health System
Deaconess Hospital* Community Health Systems
Oklahoma Spine Hospital Medical Facilities Corporation
Summit Medical Center* Physician Owned
Lakeside Women’s Hospital* Independent
McBride Clinic Orthopedic Hospital* Independent
Community Hospital* Independent
8
23
25
26
• Non-profit, member of Mercy
• Three general acute care hospitals: Mercy Hospital Oklahoma City, Mercy Hospital El Reno and Mercy Hospital Watonga (July 2012); one critical access facility - Mercy Hospital Logan County; two managed hospitals - Kingfisher Regional and Sayre Memorial
• Mercy broke ground on an $88 million medical complex in Edmond, OK to include a walk-in clinic, wellness and women’s centers, sports rehab , outpatient surgery and offices for 30 physicians
• Mercy, in partnership with Centerre Healthcare Corporation, broke ground on the $14 million, 50,000-sq.ft. Mercy Rehabilitation Hospital to be completed in fall 2012
• Oklahoma Heart Hospital; two campuses – North, a joint venture between Mercy and Oklahoma Heart Hospital Physicians; South, a joint venture between Mercy, Norman Regional and Oklahoma Heart Hospital Physicians
• Mercy Clinic includes 162 primary care, specialty and hospital-based physicians, 66 advanced practice providers and 534 clinic co-workers supporting over 475,000 outpatient visits to patients in 34 clinics and seven urgent/convenient care sites (physician counts as of April 2012)
Hospital FTEs Staffed
Beds Service Area IP Discharges
Total Hospital IP Discharges
Total Births
Total ED Visits
Mercy Hospital Oklahoma City 1,671 366 12,568 15,593 3,060 47,179
Oklahoma Heart Hospitals 1,523 145 6,164 11,933 0 19,524
Mercy Hospital Logan County 137 25 999 1,055 0 NA
Mercy Hospital El Reno 106 58 662 804 78 9,833
Mercy Hospital Watonga 70 25 12 381 0 NA
Managed Facilities
Kingfisher Regional Hospital 109 25 814 984 68 NA
Sayre Memorial Hospital 85 25 2 756 0 NA
TOTAL 3,701 669 21,221 31,506 3,206 76,536
INPATIENT MARKET SHARE (All except OHH)
13%
TOTAL ASSETS $208M
NET PATIENT REVENUE $327M
OPER. PROFIT MARGIN 5.3%
Note: Market share reflects a 6-county service area and includes all Mercy facilities except OHH; OHH market share uses a 24-county service area; OHH’s 24-county region represents 85% of their total discharges; OHH market share uses Mercy’s cardiology service line definition Source: IP discharges, market share (for PSA) – OK state data, 2010 (does not include Normal Newborns); OKC, El Reno – total assets, NPR, OPM, beds, births, ED visits – Mercy Finance, FY11; all other facilities: beds, births, ED visits, FTEs, total assets, NPR, OPM – AHA Guide/AHD, 2010; OHH statistics – OHH Finance, FY11; outpatient office-based clinic visits and clinic co-workers – Mercy MPO Office, FY12; Mercy FTEs – Mercy Pension & Comp, April 2012
• Non-profit, sponsored by Integris Health
• Four general acute care hospitals, an inpatient rehab hospital, a multi-specialty physician group operating 34 clinics
INPATIENT MARKET SHARE 23%
TOTAL ASSETS $1.2B
NET PATIENT REVENUE $966M
OPER. PROFIT MARGIN 3.9% www.integrisok.com
www.okheart.net
INPATIENT MARKET SHARE 26%
TOTAL ASSETS $310M
NET PATIENT REVENUE $295M
OPER. PROFIT MARGIN 12.8%
Hospital FTEs Staffed
Beds Service Area IP Discharges
Total Hospital IP Discharges
Total Births
Integris Baptist Medical Center 3,219 584 16,054 22,176 2,481
Integris Southwest Medical Center 1,229 358 11,273 13,301 1,173
Integris Canadian Valley Hospital 302 44 2,708 3,141 902
Integris Health Edmond (Oct. 2011) NA 40 NA NA NA
TOTAL 4,750 1,026 30,035 38,618 4,556
Source: IP discharges, market share (for PSA) – OK state data, 2010 (does not include Normal Newborns); beds, births, FTEs – AHA Guide, 2010 data; total assets, NPR, OPM – AHD, 2010
www.mercy.net
• For-profit, owned by Hospital Corporation of America (HCA) • Academic medical center affiliated with University of Oklahoma College
of Medicine, the only MD program in the state • One general acute care hospital, a children’s hospital and primary care physician clinics; more than 500 physicians (150 OU Children’s Physicians)
INPATIENT MARKET SHARE 14%
TOTAL ASSETS $332M
NET PATIENT REVENUE $701M
OPER. PROFIT MARGIN 1.9% www.hcahealthcare.com www.oumedicine.com
Hospital FTEs Staffed
Beds Service Area IP Discharges
Total Hospital IP Discharges
Total Births
OU Medical Center (includes OU Medical Center Edmond & Children’s Hospital of OK)
2,658 554 18,826 28,140 4,280
Note: In 2010, OU Medical Center Edmond began reporting under OU Medical Center Source: IP discharges, market share (for PSA) – OK state data, 2010 (does not include Normal Newborns); beds, births, FTEs – AHA Guide, 2010 data; total assets, NPR, OPM – AHD, 2010
Note: Hospitals only
Note: Hospitals only; Financials incl. owned facilities only
Note: Hospitals only
Note: Oklahoma Heart Hospital North and South
Oklahoma City REGIONAL PROVIDER STATISTICS
• For-profit, community-owned
• Two general acute care hospitals, six primary care clinics and The Healthplex, a state-of-the-art specialty hospital focusing on cardiology, orthopedic/spine and women’s/children’s services
• Affiliated in partnership with Mercy and Oklahoma Heart Hospital Physicians in Oklahoma Heart Hospital’s new south campus
INPATIENT MARKET SHARE 10%
TOTAL ASSETS $449M
NET PATIENT REVENUE $325M
OPER. PROFIT MARGIN -3.4%
Hospital FTEs Staffed
Beds Service Area IP Discharges
Total Hospital IP Discharges
Total Births
Norman Regional Health System - includes Norman Regional, Moore Medical
Center and The Healthplex
2,118 358 12,825 17,764 2,927 www.normanregional.com
Hospital Health System FTEs Staffed
Beds Service Area IP Discharges
Total Hospital IP Discharges
Total Births
Deaconess Hospital Community Health Systems 1,076 313 9,508 10,771 1,200
McBride Clinic Orthopedic Hospital Independent 286 78 1,343 2,678 0
Lakeside Women’s Hospital Independent 141 23 1,333 1,563 1,374
Oklahoma Spine Hospital Medical Facilities Corporation 192 23 1,047 2,176 0
Community Hospital Independent 315 37 1,027 1,769 0
Summit Medical Center Physician-owned 60 15 147 284 0
Source: IP discharges (for PSA) – OK state data, 2010 (does not include Normal Newborns); beds, births, FTEs – AHA Guide/AHD, 2010 data
Other Health Care Providers in the Oklahoma City Service Area
• Non-profit, sponsored by SSM Health Care of Oklahoma
• A general acute care hospital, orthopedic specialty hospital, network of primary care physician clinics, ambulatory sports medicine/rehabilitation facility, ambulatory surgery center, and home health agencies
• Saints Medical Group includes 60 primary and specialty physicians serving 30 locations
INPATIENT MARKET SHARE 11%
TOTAL ASSETS $240M
NET PATIENT REVENUE $346M
OPER. PROFIT MARGIN -2.6% www.ssmhc.com
Hospital FTEs Staffed
Beds Service Area IP Discharges
Total Hospital IP Discharges
Total Births
St. Anthony Hospital 1,873 463 14,035 18,758 1,303
Bone & Joint Hospital 168 33 Included above Included above 0
TOTAL 2,041 496 14,035 18,758 1,303 Source: IP discharges, market share (for PSA) – OK state data, 2010 (does not include Normal Newborns); beds, births, FTEs, total assets, NPR, OPM – AHD, 2010
Note: Hospitals only
Note: Hospitals only
Oklahoma City REGIONAL PROVIDER STATISTICS
Source: IP discharges, market share (for PSA) – OK state data, 2010 (does not include Normal Newborns); beds, births, FTEs – AHA Guide, 2010 data; total assets, NPR, OPM – AHD, 2010
Service Area IP Discharges represent inpatient discharges within a specified service area, typically where 85%-95% of Mercy’s patients reside. Market share is calculated based on discharges within the service area. Total Hospital IP Discharges account for all discharges from a facility regardless of where patients reside.
• For-profit, owned and operated by Health Management Associates (HMA)
• General acute care hospital, Renaissance Women’s Center of Midwest City on campus
INPATIENT MARKET SHARE 10%
TOTAL ASSETS $99M
NET PATIENT REVENUE $168M
OPER. PROFIT MARGIN 19.9%
Hospital FTEs Staffed
Beds Service Area IP Discharges
Total Hospital IP Discharges
Total Births
Midwest Regional Medical Center 1,059 255 12,648 14,303 947 www.midwestregional.com
Note: Hospital only
Source: IP discharges, market share (for PSA) – OK state data, 2010 (does not include Normal Newborns); beds, births, FTEs – AHA Guide, 2010 data; total assets, NPR, OPM – AHD, 2010
Advanced Practice
29% Hospital-based
9%
Specialists 22%
Primary Care 40%
Mercy Clinic Physicians 39%
Center for Women’s Health 5%
Oklahoma Spine & Sports Rehab 5%
Goff & Shanbour MDs & Assoc. (OB/Gyn) 5%
Mark G. Miles, MD (Internal Medicine) 3%
Neuroscience Specialists 3%
Parrington & Freeman (Pediatrics) 3%
Perinatal Center Oklahoma 2%
Funnell, Strebel and Hager, MDs (OB/Gyn) 2%
Northwest Pediatrics of Oklahoma City 1%
Pediatrics Medical Group 1%
Other 31%
0 1,000 2,000 3,000
Gastro
Pulm
Gen Surg
Neuro
OB
2010 Discharges
Note: Primary Care = FP/GP, IM, OB/Gyn, Pediatrics Source: Thomson Reuters Physician Estimates, 2011
In 2010, only 2% of patients received inpatient care at hospitals located outside the Oklahoma City PSA, including 0.1% at Mercy hospitals
Oklahoma City OK US
Primary Care 122 104 116
Specialty 100 63 81
Total 222 167 197
Mercy Hospital Oklahoma City
Note: Mercy service lines used; based on volumes within the PSA Source: Oklahoma State Data, 2010
Source: Oklahoma State Data, 2009-2010 (does not include Normal Newborns)
Hospital 2009 2010
OU Medical Center-Oklahoma City, OK 13% 14%
Integris Baptist Medical Center-Oklahoma City, OK 12% 12%
St. Anthony Hosp. (incl. Bone & Joint)-Oklahoma City, OK 11% 11%
Norman Regional Hospital-OK 10% 10%
Midwest Regional Medical Center-OK 10% 10%
Mercy Hospital Oklahoma City-OK 10% 10%
Integris Southwest Medical Center-Oklahoma City, OK 9% 9%
Deaconess Hospital-Oklahoma City, OK 7% 7%
Oklahoma Heart Hospital-Oklahoma City, OK 3% 4%
Integris Canadian Valley Regional Hospital-Yukon, OK 2% 2%
McBride Clinic Orthopedic Hospital-Oklahoma City, OK 1% 1%
Lakeside Women's Hospital-Oklahoma City, OK 1% 1%
Oklahoma Heart Hospital South-Oklahoma City, OK NA 1%
Oklahoma Spine Hospital-Oklahoma City, OK 1% 1%
Community Hospital-Oklahoma City, OK 1% 1%
Mercy Hospital Logan County-Guthrie, OK 1% 1%
Mercy Hospital Tishomingo-OK 1% 1%
Unity Health Center-Shawnee, OK 1% 1%
Mercy Hospital El Reno-OK 1% 1%
Other Mercy hospitals (owned and managed) 0.1% 0.1%
Other hospitals 5% 6% Note: Total (n) = 228 integrated Mercy physicians and advanced practitioners serving Oklahoma City and El Reno communities Source: Mercy Hospital Medical Staff Services, April 2012
Of the region’s 4M hospital-based outpatient visits, 4% occurred outside the Oklahoma City PSA (includes 0.1% Mercy hospitals)
Medical Facility 2010
Physician's Offices* 55%
Independent Labs* 16%
Norman Regional Hospital-OK 4%
Mercy Hospital Oklahoma City-OK 4%
Integris Baptist Medical Center-Oklahoma City, OK 2%
Integris SW Medical Center-Oklahoma City, OK 2%
OU Medical Center-Oklahoma City, OK 2%
St. Anthony Hospital-Oklahoma City, OK 2%
Midwest Regional Medical Center-OK 2%
Deaconess Hospital-Oklahoma City, OK 1%
Oklahoma Heart Hospital-Oklahoma City, OK 1%
OU Medical Center Edmond-OK 1%
Mercy Hospital Logan County-Guthrie, OK 1%
Integris Canadian Valley Hospital-Yukon, OK 1%
Other Mercy hospitals (owned and managed) 1%
Other (incl. hospitals and freestanding facilities) 6%
OHH ranks 1st in cardio
market share
Mercy Hospital Volume and Market Share
Oklahoma City PATIENT CARE
INPATIENT MARKET SHARE TRENDS PHYSICIAN SUPPLY/100,000 POPULATION
INPATIENT DISCHARGES BY PHYSICIAN GROUP
MERCY INTEGRATED MEDICAL STAFF
INPATIENT PHYSICIANS OUTPATIENT
TOP INPATIENT SERVICE LINES
OUTPATIENT MARKET SHARE (Hospital-based)
OUTPATIENT UTILIZATION – MARKET ESTIMATES
% Change
Select Clinical Service Categories
2011 Procedures
Adjusted and Trended*
5 Yr 10 Yr
Physical and Occ. Therapy 2,867,749 36% 51%
Hematology/Oncology 497,168 24% 37%
Cardiology 433,770 23% 34%
Orthopedics 182,918 32% 47%
OB/Gyn 174,123 45% 48%
Neurology 167,818 28% 41%
Nephrology 153,502 102% 160%
Gastroenterology 90,139 31% 41%
General Surgery 73,388 25% 37%
Note: Data is available for additional clinical service categories. *Adjusted and Trended estimates take into account technology trends, health care reform, and changes in disease incidence and prevalence. Source: Thomson Reuters Outpatient Estimates, 2011
*Physician Offices and Independent Laboratories represent procedures performed in a physician’s office and/or lab regardless of the provider’s affiliation with a hospital or health system Note: Data represents 187 procedure groups (categories of CPT and HCPCS codes); Hospitals include hospital-based outpatient services only Source: Thomson Reuters Outpatient Market Profiles, 2010
Source: Epic data, FY11 inpatient discharges; Buxton physician database, April 2012
14%
12%
11%
8%
11%
% Market Share
Mercy believes in listening to our communities and responding to their needs. As part of the People Promise key initiative, the Ministry is standardizing the survey tool and vendor used to obtain patient feedback – reinforcing our mission and culture of providing exceptional service, and to enhance the Mercy experience for our patients. Currently, we can look to HCAHPS survey results as a measure of patients’ perspectives of care.
Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a national survey developed by the Centers for Medicare & Medicaid Services (CMS) and the Agency for Healthcare Research and Quality (AHRQ). The data is publicly available to consumers.
Mercy’s HCAHPS results from patients who had overnight hospital stays during April 1, 2010 and March 31, 2011 are shown below, and are compared to other area providers as well as state and national averages for all reporting hospitals. Percentage of patients who gave the hospital
the highest rankings Percentage of patients who gave the hospital
the lowest rankings
Mercy Hospital
Integris Baptist
OU Med. Ctr.
OK US Mercy
Hospital Integris Baptist
OU Med. Ctr.
OK US
74% 75% 72% 77% 76% 4% 4% 7% 5% 5%
80% 82% 76% 83% 80% 5% 3% 5% 4% 4%
55% 64% 57% 68% 64% 12% 10% 13% 9% 10%
70% 69% 67% 71% 70% 5% 7% 8% 7% 7%
58% 56% 56% 63% 61% 25% 24% 25% 19% 21%
65% 72% 61% 73% 72% 10% 8% 15% 9% 9%
57% 61% 55% 65% 58% 11% 9% 13% 8% 11%
79% 83% 83% 82% 82% 21% 17% 17% 18% 18%
71% 74% 67% 69% 68% 6% 7% 9% 9% 9%
81% 77% 69% 69% 70% 3% 4% 6% 5% 5%
Oklahoma City PATIENT SATISFACTION
Scale (Question 1 – 7): highest = “always”; lowest = “sometimes” or “never”
Scale (Question 8): highest = “yes/did”; lowest = “no/did not”
Scale (Question 9): highest = “9” or “10”; lowest = “6” or lower
Scale (Question 10): highest = “YES, definitely”; lowest = “No, probably/definitely not”
1 How often did nurses communicate well with patients?
2 How often did doctors communicate well with patients?
3 How often did patients receive help quickly from staff?
4 How often was patients’ pain well controlled?
5 How often did staff explain about medicines before giving them to patients?
6 How often were patients’ rooms & bathrooms kept clean?
7 How often was the area around patients’ rooms kept quiet at night?
8 Were patients given information about what to do during their recovery at home?
9 How do patients rate the hospital overall?
10 Would patients recommend the hospital to friends and family?
Source: www.hospitalcompare.hhs.gov. Most current data available updated April 19, 2012 – results from patients who had overnight hospital stays during April 1, 2010 and March 31, 2011. More than 300 surveys were completed for each facility with an average response rate of 32%.
= indicates an equal or greater percentage of Mercy patients gave the hospital the highest rankings compared to competitors shown
Oklahoma City CONSUMER PERCEPTIONS Another way Mercy listens to our customer is through syndicated opinion surveys. National Research Corporation (NRC) administers an annual consumer opinion survey related specifically to health care, providing historical and current data on more than 3,200 hospitals and health systems nationwide.
When asked about preferred providers for quality, image/reputation and select service lines, participating residents from the surveyed region provided feedback displayed here.
Last year, 25% of Oklahoma City consumers who took the survey chose a Mercy facility for best overall quality as well as best image or reputation.
Source: NRC Healthcare Market Guide, 2011 (data collected Sep 2010 – Aug 2011); Oklahoma City, OK CBSA
BEST OVERALL QUALITY 2011
Total number of respondents: 1,069 Providers with 1% or less are included in “Other Facilities”; Mercy Hospital El Reno, 1%
27%
23%
11%
7%
7%
6%
3%2%2%
2%2% 8%
Integris Baptist Medical Center Mercy Hospital Oklahoma CityOU Medical Center Norman Regional HospitalSt. Anthony Hospital Deaconess HospitalIntegris Southwest Medical Center Midwest Regional Medical CenterOklahoma Heart Hospital Integris Canadian Valley Reg HospChildrens Hospital at OU Medical Center Other Facilities
BEST IMAGE/REPUTATION 2011
Total number of respondents: 1,062 Providers with 1% or less are included in “Other Facilities”; Mercy Hospital El Reno, 1%
31%
22%11%
7%
6%
4%
3%2%2%
2% 10%
Integris Baptist Medical Center Mercy Hospital Oklahoma CityOU Medical Center Norman Regional HospitalSt. Anthony Hospital Deaconess HospitalIntegris Southwest Medical Center Oklahoma Heart HospitalIntegris Canadian Valley Reg Hosp OU Medical Center EdmondOther Facilities
33%28% 29% 29%
21% 20% 20% 20%
13% 15%17% 17%
0%
10%
20%
30%
40%
2008 2009 2010 2011
Integris Baptist Medical CenterMercy Hospital Oklahoma CityOklahoma Heart HospitalOU Medical CenterNorman Regional HospitalSt. Anthony Hospital
Average number of respondents (4 yrs trending): 979
% r
esp
on
den
ts
Heart Care
21%
17% 18%
20%
17%
19% 19%
20%
0%
10%
20%
30%
2008 2009 2010 2011
Integris Baptist Medical CenterMercy Hospital Oklahoma CityNorman Regional HospitalDeaconess HospitalOU Medical CenterSt. Anthony Hospital
Average number of respondents (4 yrs trending): 869
% r
esp
on
den
ts
Maternity/OB
36%
28%31%
35%
0%
10%
20%
30%
40%
2008 2009 2010 2011
Integris Baptist Medical CenterOU Medical CenterMercy Hospital Oklahoma CityCTCA at Southwestern Regional Med CtrNorman Regional HospitalSt. Anthony Hospital
Average number of respondents (4 yrs trending): 926
% r
esp
on
den
ts
Cancer Treatment
23%
15% 16% 16%
15% 14% 14%14%
22%
27%
21%
11%
0%
10%
20%
30%
2008 2009 2010 2011
Integris Baptist Medical CenterMercy Hospital Oklahoma CityOU Medical CenterNorman Regional HospitalDeaconess HospitalSt. Anthony Hospital
Average number of respondents (4 yrs trending): 861 %
res
po
nd
ents
Pediatric Services
SELECT SERVICE LINE PREFERENCE TRENDS
Community Snapshot EL RENO
OUTPATIENT MARKET SHARE (hospital-based only)
Sources: Map – Mercy Locations Directory & AHD (other locations); Inpatient Patient Origin & Market Share – Oklahoma State Data, 2010 (does not include Normal Newborns); Outpatient Market Share – Data represents 187 procedure groups (categories of CPT and HCPCS codes). Hospitals include hospital-based outpatient services only. Physician Offices and Independent Laboratories represent procedures performed in a physician’s office and/or lab regardless of affiliation with a hospital or health system. Thomson Reuters Outpatient Market Profiles, 2010; Demographics – Thomson Reuters, 2011; Payer Mix – Thomson Reuters Insurance Estimates, 2011; County Health Rankings, 2012; Inpatient Services – Oklahoma State Data, 2010; Physicians – Buxton, April 2012
INPATIENT MARKET SHARE
total outpatient volume in the El Reno PSA 2.2M
% Market Share 2010
OP Volume
53% PHYSICIAN OFFICES 1,134,689
17% INDEPENDENT LABS 367,056
4% MERCY HOSPITAL OKLAHOMA CITY 77,403
4% INTEGRIS CANADIAN VALLEY 77,210
2% MERCY HOSPITAL EL RENO 43,318
2% INTEGRIS BAPTIST MEDICAL CTR. 41,716
1% OKEENE MUNICIPAL HOSPITAL 27,937
2% OTHER MERCY (owned and managed) 51,959
15% OTHER 332,208
PRIMARY SERVICE AREA & PATIENT ORIGIN The majority (88%) of Mercy Hospital El Reno’s acute care patients reside in Canadian, Blaine & Caddo Counties near central Oklahoma. Two out of every three patients share the same zip code (73036) as the hospital.
67%
5%
% Market Share 2010
Discharges
15% INTEGRIS CANADIAN VALLEY 2,443
14% INTEGRIS BAPTIST MEDICAL CTR. 2,348
11% MERCY HOSPITAL OKLAHOMA CITY 1,734
9% OU MEDICAL CENTER 1,444
6% DEACONESS HOSPITAL 1,039
6% ST. ANTHONY HOSPITAL 914
4% MERCY HOSPITAL EL RENO 707
8% OTHER MERCY (owned and managed) 1,317
26% OTHER 4,266
16,212 total inpatient discharges in the El Reno PSA
5%
3%
3%
HOUSEHOLD ECONOMICS
Total Households: 59,012 Average Income: $60,138 Annual Income <$15K: 12%
INSURANCE COVERAGE
62% Private 13% Medicare 12% Medicaid 12% Uninsured
EDUCATION (based on population ages 25+)
8% Some High School 33% Some College 34% High School Diploma 21% Bachelor’s Degree/greater
Race: 76% White; 8% American Indian Ethnicity: 7% Hispanic (of any race)
Total Area Population: 162,018 5-Yr Growth: +7%
Age Cohorts: 25% Children (0-17) 19% Females (15-44) 13% Seniors (65+)
Median Age: 37
POPULATION
Mercy Hospital
Mercy Clinic
Mercy Urgent/Convenient Care Clinic
Mercy Patient Origin by Zip Codebased on inpatient volume(volumes 1% or less not shown)
Managed hospital
Other hospital (non-Mercy)
%Health Factor County OK US
Adult Smoking (% smoking >= 100 cigarettes) 23% 25% 14%
Adult Obesity (% with BMI >= 30) 33% 32% 25%
Physical Inactivity (% of 20+ pop. not active) 30% 31% 21%
Excessive/Binge Drinking 15% 14% 8%
Teen Birth Rate (per 1,000 females age 15-19) 34 58 22
Children in Poverty (% of children 0-17) 13% 24% 13%
Preventable Hospital Stays (per 1,000 Medicare) 78 82 49
COUNTY HEALTH RANKINGS
Canadian County Overall Health Rank = 3 (out of 77 counties) The lower the ranking, the healthier the community.
Below are some of the factors which attribute to the county’s health status compared to state and national benchmarks.
SERVICES & PHYSICIANS
In 2010, Mercy Hospital El Reno’s top inpatient service lines were pulmonary (25%) and OB (14%).
The 74% of residents leaving the El Reno area for inpatient services primarily go to Integris Baptist for cardiovascular and general surgery services, and to Mercy Hospital Oklahoma City for OB and neurology services.
There are approximately 85 physicians (80% primary care) located in the PSA, of which 8% are integrated with Mercy.
OK
Kingfisher
Community Snapshot GUTHRIE
OUTPATIENT MARKET SHARE (hospital-based only)
Sources: Map – Mercy Locations Directory & AHD (other locations); Inpatient Patient Origin & Market Share – Oklahoma State Data, 2010 (does not include Normal Newborns); Outpatient Market Share – Data represents 187 procedure groups (categories of CPT and HCPCS codes). Hospitals include hospital-based outpatient services only. Physician Offices and Independent Laboratories represent procedures performed in a physician’s office and/or lab regardless of affiliation with a hospital or health system. Thomson Reuters Outpatient Market Profiles, 2010; Demographics – Thomson Reuters, 2011; Payer Mix – Thomson Reuters Insurance Estimates, 2011; County Health Rankings, 2012; Inpatient Services – Oklahoma State Data, 2010; Physicians – Buxton, April 2012
INPATIENT MARKET SHARE
total outpatient volume in the Guthrie PSA 330,477
% Market Share 2010
OP Volume
38% PHYSICIAN OFFICES 124,217
28% MERCY HOSPITAL LOGAN COUNTY 92,788
9% INDEPENDENT LABS 28,986
5% MERCY HOSPITAL OKLAHOMA CITY 17,626
2% OU MEDICAL CENTER EDMOND 8,187
2% OKLAHOMA HEART HOSPITAL 6,104
2% STILLWATER MEDICAL CENTER 5,312
1% OTHER MERCY (owned and managed) 1,731
14% OTHER 45,526
PRIMARY SERVICE AREA & PATIENT ORIGIN The majority (91%) of Mercy Hospital Logan County’s acute care patients reside in Logan County in north central Oklahoma. Three in four patients share the same zip code (73044) as the hospital.
HOUSEHOLD ECONOMICS
Total Households: 29,300 Average Income: $76,855 Annual Income <$15K: 13%
INSURANCE COVERAGE
62% Private 12% Medicare 12% Medicaid 14% Uninsured
Race: 80% White; 7% American Indian Ethnicity: 4% Hispanic (of any race)
Total Area Population: 78,897 5-Yr Growth: +7%
Age Cohorts: 24% Children (0-17) 20% Females (15-44) 12% Seniors (65+)
Median Age: 36
POPULATION
Mercy Hospital
Mercy Clinic
Mercy Urgent/Convenient Care Clinic
Mercy Patient Origin by Zip Codebased on inpatient volume(volumes 1% or less not shown)
Managed hospital
Other hospital (non-Mercy)
%
Health Factor County OK US
Adult Smoking (% smoking >= 100 cigarettes) 22% 25% 14%
Adult Obesity (% with BMI >= 30) 33% 32% 25%
Physical Inactivity (% of 20+ pop. not active) 30% 31% 21%
Excessive/Binge Drinking 10% 14% 8%
Teen Birth Rate (per 1,000 females age 15-19) 31 58 22
Children in Poverty (% of children 0-17) 19% 24% 13%
Preventable Hospital Stays (per 1,000 Medicare) 63 82 49
COUNTY HEALTH RANKINGS
Logan County Overall Health Rank = 12 (out of 77 counties) The lower the ranking, the healthier the community.
Below are some of the factors which attribute to the county’s health status compared to state and national benchmarks.
SERVICES & PHYSICIANS
In 2010, Mercy Hospital Logan County’s top inpatient service lines were rehabilitation (28%) and pulmonary (16%).
The 77% of residents leaving the Guthrie area for inpatient services primarily go to Mercy Hospital Oklahoma City for OB services and to OU Medical Center for general surgery, OB and cardiovascular services.
There are approximately 20 physicians (70% primary care) located in the PSA, of which 20% are integrated with Mercy.
EDUCATION (based on population ages 25+)
8% Some High School 28% Some College 24% High School Diploma 38% Bachelor’s Degree/greater
OK
total inpatient discharges in the Guthrie PSA 4,255
% Market Share 2010
Discharges
23% MERCY HOSPITAL LOGAN COUNTY 960
20% MERCY HOSPITAL OKLAHOMA CITY 850
14% OU MEDICAL CENTER 589
10% OKLAHOMA HEART HOSPITAL 407
8% INTEGRIS BAPTIST MEDICAL CTR. 347
6% ST. ANTHONY HOSPITAL 258
19% OTHER (incl. 0.01% Mercy) 844
9%
3%
74%
Community Snapshot WATONGA PRIMARY SERVICE AREA & PATIENT ORIGIN The majority (94%) of Mercy Hospital Watonga’s acute care patients reside in Blaine, Custer & Dewey Counties near central Oklahoma. Nearly two in three patients share the same zip code (73772) as the hospital.
64% 6%
2%
HOUSEHOLD ECONOMICS
Total Households: 16,827 Average Income: $48,537 Annual Income <$15K: 18%
INSURANCE COVERAGE
49% Private 16% Medicare 14% Medicaid 21% Uninsured
EDUCATION (based on population ages 25+)
10% Some High School 28% Some College 35% High School Diploma 20% Bachelor’s Degree/greater
Race: 72% White; 7% American Indian Ethnicity: 12% Hispanic (of any race)
Total Area Population: 44,800 5-Yr Growth: +1%
Age Cohorts: 23% Children (0-17) 19% Females (15-44) 15% Seniors (65+)
Median Age: 33
POPULATION
Mercy Hospital
Mercy Clinic
Mercy Urgent/Convenient Care Clinic
Mercy Patient Origin by Zip Codebased on inpatient volume(volumes 1% or less not shown)
Managed hospital
Other hospital (non-Mercy)
%
Health Factor County OK US
Adult Smoking (% smoking >= 100 cigarettes) 28% 25% 14%
Adult Obesity (% with BMI >= 30) 33% 32% 25%
Physical Inactivity (% of 20+ pop. not active) 31% 31% 21%
Excessive/Binge Drinking 16% 14% 8%
Teen Birth Rate (per 1,000 females age 15-19) 63 58 22
Children in Poverty (% of children 0-17) 25% 24% 13%
Preventable Hospital Stays (per 1,000 Medicare) 115 82 49
COUNTY HEALTH RANKINGS
Blaine County Overall Health Rank = 36 (out of 77 counties) The lower the ranking, the healthier the community.
Below are some of the factors which attribute to the county’s health status compared to state and national benchmarks.
OUTPATIENT MARKET SHARE (hospital-based only)
Sources: Map – Mercy Locations Directory & AHD (other locations); Inpatient Patient Origin & Market Share – Oklahoma State Data, 2010 (does not include Normal Newborns); Outpatient Market Share – Data represents 187 procedure groups (categories of CPT and HCPCS codes). Hospitals include hospital-based outpatient services only. Physician Offices and Independent Laboratories represent procedures performed in a physician’s office and/or lab regardless of affiliation with a hospital or health system. Thomson Reuters Outpatient Market Profiles, 2010; Demographics – Thomson Reuters, 2011; Payer Mix – Thomson Reuters Insurance Estimates, 2011; County Health Rankings, 2012; Inpatient Services – Oklahoma State Data, 2010; Physicians – Buxton, April 2012
INPATIENT MARKET SHARE
total outpatient volume in the Watonga PSA 577,997
% Market Share 2010
OP Volume
44% PHYSICIAN OFFICES 253,801
12% INDEPENDENT LABS 71,686
10% WEATHERFORD REG HOSPITAL 55,213
7% INTEGRIS CLINTON REG HOSPITAL 40,639
5% OKEENE MUNICIPAL HOSPITAL 29,136
4% MERCY HOSPITAL WATONGA 23,579
1% SEILING COMMUNITY HOSPITAL 7,818
2% OTHER MERCY (owned and managed) 12,137
15% OTHER 83,988
SERVICES & PHYSICIANS
In 2010, Mercy Hospital Watonga’s top inpatient service lines were pulmonary (20%) and cardiovascular and gastroenterology (16% each).
The 54% of residents leaving the Watonga PSA for inpatient services primarily go to Integris Baptist Medical Center for cardiovascular and general surgery services and to OU Medical Center for OB and neurology services.
There are approximately 42 physicians (74% primary care) located in the PSA, of which none are integrated with Mercy.
total inpatient discharges in the Watonga PSA 5,863
% Market Share 2010
Discharges
21% INTEGRIS CLINTON REG HOSPITAL 1,208
11% WEATHERFORD REG HOSPITAL 651
8% INTEGRIS BAPTIST MEDICAL CENTER 484
8% MERCY HOSPITAL WATONGA 451
5% OU MEDICAL CENTER 314
4% ST. ANTHONY HOSPITAL 233
9% OTHER MERCY (owned and managed) 550
34% OTHER 1,972
11%
2%
4%
OK
Ardmore PRIMARY SERVICE AREA
The Ardmore Primary Service Area (PSA) comprises six counties in south central Oklahoma
OK
Private 42%
Medicare 20%
Uninsured 20%
Medicaid 19%
DEMOGRAPHICS Ardmore Service Area Oklahoma 2011
US 2011 2011 2016 % Growth
Total Population 104,503 106,673 2% 3,771,943 310,650,750
0-17 25% 25% 3% 25% 24%
18-44 Females 16% 15% 0% 18% 18%
18-44 Males 16% 16% 2% 19% 19%
45-64 26% 25% -3% 25% 26%
65+ 17% 18% 10% 14% 13%
Median Age 39 - - 36 37
White 74% 72% -0.2% 70% 64%
Black 5% 5% 5% 8% 12%
American Indian 9% 9% 2% 8% 1%
Asian/Pacific Islander 1% 1% 14% 2% 5%
Multiracial and Other 5% 5% 7% 4% 2%
Hispanic (of any race) 7% 8% 20% 9% 16%
Speak Spanish in Home 4% - - 5% 12%
Total No. of Households 41,735 42,677 2% 1,478,071 116,862,390
Households with Children 34% - - 34% 34%
HH Income Under $15K 20% - - 16% 13%
HH Income Over $75K 17% - - 21% 30%
Average HH Income $ 47,061 - - $ 54,379 $ 67,529
Some High School 13% - - 10% 9%
High School Graduate/GED 40% - - 32% 29%
Some College 26% - - 30% 28%
Bachelor’s Degree or greater 15% - - 23% 28%
Company Industry Staff
Michelin North America Manufacturing 1,700
Mercy Hospital Health care 987
Dollar General Distribution 750
Walmart Retail 570
Ardmore City Schools Education 450
MAJOR EMPLOYERS
Largest employers in Ardmore as listed by the Ardmore Development Authority:
Ardmore DEMOGRAPHICS R
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Health Factor Carter County Oklahoma
National Benchmark
Adult Smoking (% smoking >= 100 cigarettes) 25% 25% 14%
Adult Obesity (% with BMI >= 30) 35% 32% 25%
Physical Inactivity (% of adults age 20+ not active) 36% 31% 21%
Excessive/Binge Drinking 10% 14% 8%
Teen Birth Rate (per 1,000 females age 15-19) 74 58 22
Children in Poverty (% of children age 0-17 in poverty) 27% 24% 13%
Preventable Hospital Stays (per 1,000 Medicare enrollees) 73 82 49 Sources: (state) Overall Health Ranking – America’s Health Rankings, 2011, provided by United Health Foundation; (county) Overall Health Ranking and Health Factors table – 2012 County Health Rankings provided by the Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute
COMMUNITY HEALTH MEASURES
Overall Health Ranking: Oklahoma = 48 (/50 states); Carter County = 59 (/77 counties) Rankings are out of total number of states or reporting counties. The lower the number, the healthier the community.
Below are some of the factors which attribute to community health.
Note: Ardmore Service Area consists of six counties in Oklahoma; Education Level based on population age 25+ Source: Thomson Reuters, 2011
Source: Ardmore Development Authority, 2012
CHRONIC DISEASE
Within the six-county Ardmore Service Area, the following chronic conditions have been identified among the adult (18+) population:
In addition, 3% have had a stroke 4% have had a heart attack, and 6% are living with some type of cancer
Source: Thomson Reuters Continuum of Care, 2011
Source: Thomson Reuters Insurance Coverage Estimates, 2011
OK US
INSURANCE COVERAGE
Private 52% 56% Medicare 15% 14% Medicaid 15% 14% Uninsured 18% 16%
Hypertension 32%
Arthritis 25%
Asthma 12%
Diabetes 9%
Coronary Heart Disease 5%
COPD 5%
Angina 3%
Congestive Heart Failure 2%
3.8% 5.4%
8.2%
UNEMPLOYMENT RATE
Change over 12 months
↓1.0% MSA*
↓0.5% Oklahoma
↓0.7% US
*Ardmore, OK Micropolitan Statistical Area Note: US & State rates are seasonally adjusted; MSA, non-seasonally adjusted Source: US Dept. of Labor – Bureau of Labor Statistics
MARCH 2012
The map below depicts all inpatient hospitals and freestanding general outpatient surgery centers in the Ardmore Service Area.
Hospitals (*indicates on-site outpatient surgery center) Health System Affiliation
Mercy Hospital Ardmore* Mercy
Mercy Hospital Healdton* Mercy
Mercy Hospital Tishomingo Mercy
Mercy Health Love County* (managed facility) Mercy
Arbuckle Memorial Hospital (managed facility) Mercy
Valley View Regional Hospital (managed facility) Mercy
Integris Marshall County Medical Center* (joint venture with HMA) Integris Health
Medical Center of Southeastern Oklahoma* Health Management Associates (HMA)
Duncan Regional Hospital* Independent
Jefferson County Hospital Independent
Ardmore REGIONAL PROVIDER LANDSCAPE
10
2
6
5
1 3
7
4 8
1
2
3
4
5
6
7
8
9
10
9
FreestandingGeneral Outpatient
Surgery Center
Physician Owned
Source: Buxton ASC database, 2012
OKLAHOMA
• OU Medical Center – 4% market share, 552 acute discharges
• Oklahoma Heart Hospital – 4%, 502
• Integris Baptist Medical Center – 2%, 310
• Norman Regional Hospital – 2%, 267
• Mercy Hospital OKC – 2%, 247
Hospital FTEs Staffed
Beds Service Area IP Discharges
Total Hospital IP Discharges
Total Births
Total ED Visits
Mercy Hospital Ardmore 666 151 6,977 7,667 918 34,720
Mercy Hospital Tishomingo 34 25 325 359 0 1,354
Mercy Hospital Healdton 35 22 174 185 0 3,485
Managed Facilities
Arbuckle Memorial Hospital 101 25 516 565 0 NA
Mercy Health Love County 123 25 420 454 0 NA
Valley View Regional Hospital 518 110 230 4,429 500 NA
TOTAL 1,477 358 8,642 13,659 1,418 39,559
• Non-profit, member of Mercy
• Three general acute care hospitals; new cancer treatment center opened in partnership with the Ardmore Chamber of Commerce Foundation
• Managed facilities include one general acute care (Valley View in Ada) and two critical access hospitals (Arbuckle Memorial in Sulphur and Mercy Health Love County in Marietta)
• Mercy Clinic consists of 35 primary care, specialty and hospital-based physicians, 15 advanced practice providers and 145 clinic co-workers supporting over 56,000 outpatient visits to patients in five clinics and one urgent/convenient care site (physician counts as of April 2012)
INPATIENT MARKET SHARE (all facilities)
62%
TOTAL ASSETS $111M
NET PATIENT REVENUE $113M
OPER. PROFIT MARGIN 0.2%
Note: Market share includes all facilities above; total assets, NPR and OPM are for Mercy owned facilities only Source: IP discharges, market share (for PSA) – OK state data, 2010 (does not include Normal Newborns); beds, births, ED visits – Mercy Finance, FY11; managed facilities beds, births, FTEs – AHD, 2010; outpatient office-based clinic visits and clinic co-workers – Mercy MPO Office, FY12; Mercy FTEs – Mercy Pension & Comp, April 2012
www.mymcso.com
Hospital FTEs Staffed
Beds Service Area IP Discharges
Total Hospital IP Discharges
Total Births
Medical Center of Southeastern Oklahoma 524 148 1,000 8,408 1,148
• For-profit, owned and operated by Health Management Associates (HMA)
• One general acute care hospital located in Durant, OK approximately 45 miles east of Ardmore
INPATIENT MARKET SHARE 7%
TOTAL ASSETS $42M
NET PATIENT REVENUE $89M
OPER. PROFIT MARGIN NA Source: IP discharges, market share (for PSA) – OK state data, 2010 (does not include Normal Newborns); beds, births, FTEs – AHA Guide, 2010 data; total assets, NPR, OPM – AHD, 2010
www.mercy.net
Note: Hospital only
www.integrisok.com
Hospital FTEs Staffed
Beds Service Area IP Discharges
Total Hospital IP Discharges
Total Births
Integris Marshall County Medical Center 93 21 695 750 0
• Non-profit, joint venture between Integris Health and Health Management Associates (HMA)
• Critical access hospital located in Madill, OK approximately 26 miles east of Ardmore
INPATIENT MARKET SHARE 5%
TOTAL ASSETS $1M
NET PATIENT REVENUE $12M
OPER. PROFIT MARGIN -5.4% Source: IP discharges, market share (for PSA) – OK state data, 2010 (does not include Normal Newborns); beds, births, FTEs – AHA Guide, 2010 data; total assets, NPR, OPM – AHD, 2010 Note: Hospital only
Hospital FTEs Staffed
Beds Service Area IP Discharges
Total Hospital IP Discharges
Total Births
Duncan Regional Hospital 730 124 285 4,920 506
Source: IP discharges, market share (for PSA) – OK state data, 2010 (does not include Normal Newborns); beds, births, FTEs – AHA Guide, 2010 data
Additionally, these Oklahoma City providers account for a portion of market share from Ardmore Region residents:
Note: Hospitals only; financials include only Mercy owned facilities
• Non-profit, independent hospital located in Duncan, OK approximately 70 miles from Ardmore
• One acute care hospital, eight physician clinics and 70 physicians on staff
www.duncanregional.com
Ardmore REGIONAL PROVIDER STATISTICS
Source: IP discharges, market share (for PSA) – OK state data, 2010 (does not include Normal Newborns)
Service Area IP Discharges represent inpatient discharges within a specified service area, typically where 85%-95% of Mercy’s patients reside. Market share is calculated based on discharges within the service area. Total Hospital IP Discharges account for all discharges from a facility regardless of where patients reside.
Advanced Practice
30%
Hospital-based 28%
Specialists 18%
Primary Care 24%
54%
62%
71%
48%
48%
0 500 1,000 1,500
Gastro
Ortho
OB
Pulm
Cardio
2010 Discharges
Note: Primary Care = FP/GP, IM, OB/Gyn, Pediatrics Source: Thomson Reuters Physician Estimates, 2011
In 2010, 33% of patients received inpatient care at hospitals located outside the Ardmore PSA, including 8% at Mercy hospitals
Mercy Clinic Physicians 33%
Nedley Clinic 5%
Bone and Joint Clinic of Oklahoma 5%
OSU Center for Health Sciences 5%
David Dean Rose, MD (Internal Medicine) 5%
Family Health Center of Ardmore 5%
Southern Oklahoma Women’s Health 4%
Life Cycle Women’s Care 4%
Pulmonary Medical Clinic 4%
Shockey Internal Medicine 3%
Doctors Clinic 2%
Cornerstone Family Healthcare 2%
Other 23%
Ardmore OK US
Primary Care 61 104 116
Specialty 33 63 81
Total 94 167 197
Mercy Hospital Ardmore
Hospital 2009 2010
Mercy Hospital Ardmore-OK 50% 50%
Medical Center of SE Oklahoma-Durant, OK 8% 7%
Integris Marshall County Med. Ctr.-Madill, OK 5% 5%
OU Medical Center-Oklahoma City, OK 4% 4%
Arbuckle Memorial Hospital-Sulphur, OK 3% 4%
Oklahoma Heart Hospitals-Oklahoma City, OK 3% 4%
Mercy Health Love County-Marietta, OK 3% 3%
Mercy Hospital Tishomingo-OK 2% 2%
Integris Baptist Med. Ctr.-Oklahoma City, OK 2% 2%
Duncan Regional Hospital-OK 2% 2%
Norman Regional Hospital-OK 2% 2%
Mercy Hospital Oklahoma City-OK 2% 2%
Valley View Regional Hospital-Ada, OK 2% 2%
Jefferson County Hospital-Waurika, OK 2% 2%
St. Anthony Hospital-Oklahoma City, OK 1% 1%
Mercy Hospital Healdton-OK 2% 1%
Other hospitals 8% 7%
Ranks 1st in market share
Medical Facility 2010
Physician’s Offices* 54%
Mercy Hospital Ardmore-OK 12%
Independent Labs* 10%
Arbuckle Memorial Hospital-Sulphur, OK 3%
Mercy Health Love County-Marietta, OK 2%
Integris Marshall County Med. Center-Madill, OK 2%
Carl Albert Indian Hospital-Ada, OK 1%
Duncan Regional Hospital-OK 1%
Medical Center of SE Oklahoma-Durant, OK 1%
Mercy Hospital Tishomingo-OK 1%
Jefferson County Hospital-Waurika, OK 1%
Mercy Hospital Healdton-OK 1%
Other Mercy hospitals (owned and managed) 1%
Other (incl. hospitals and freestanding facilities) 10%
Note: Total (n) = 50 integrated Mercy physicians and advanced practitioners serving Ardmore and Healdton communities Source: Mercy Hospital Medical Staff Services, April 2012
Of the region’s 408,161 hospital-based outpatient visits, 23% occurred outside the Ardmore PSA (1% at Mercy hospitals)
Mercy Hospital Volume and Market Share
Ardmore PATIENT CARE
INPATIENT MARKET SHARE TRENDS PHYSICIAN SUPPLY/100,000 POPULATION
INPATIENT DISCHARGES BY PHYSICIAN GROUP
MERCY INTEGRATED MEDICAL STAFF
INPATIENT PHYSICIANS OUTPATIENT
TOP INPATIENT SERVICE LINES
OUTPATIENT MARKET SHARE (Hospital-based)
OUTPATIENT UTILIZATION – MARKET ESTIMATES
% Change
Select Clinical Service Categories
2011 Procedures
Adjusted and Trended*
5 Yr 10 Yr
Physical and Occ. Therapy 130,596 37% 48%
Cardiology 47,910 17% 22%
Nephrology 31,371 63% 92%
Hematology/Oncology 25,880 20% 28%
Orthopedics 14,333 31% 42%
Neurology 12,483 31% 40%
OB/Gyn 11,800 54% 57%
General Surgery 7,782 23% 31%
Gastroenterology 6,659 14% 16%
Note: Data is available for additional clinical service categories. *Adjusted and Trended estimates take into account technology trends, health care reform, and changes in disease incidence and prevalence. Source: Thomson Reuters Outpatient Estimates, 2011
*Physician Offices and Independent Laboratories represent procedures performed in a physician’s office and/or lab regardless of the provider’s affiliation with a hospital or health system Note: Data represents 187 procedure groups (categories of CPT and HCPCS codes); Hospitals include hospital-based outpatient services only Source: Thomson Reuters Outpatient Market Profiles, 2010
Source: Epic data, FY11 inpatient discharges; Buxton physician database, April 2012
Note: Mercy service lines used; based on volumes within the PSA Source: Oklahoma State Data, 2010
Source: Oklahoma State Data, 2009-2010 (does not include Normal Newborns)
Mercy believes in listening to our communities and responding to their needs. As part of the People Promise key initiative, the Ministry is standardizing the survey tool and vendor used to obtain patient feedback – reinforcing our mission and culture of providing exceptional service, and to enhance the Mercy experience for our patients. Currently, we can look to HCAHPS survey results as a measure of patients’ perspectives of care.
Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a national survey developed by the Centers for Medicare & Medicaid Services (CMS) and the Agency for Healthcare Research and Quality (AHRQ). The data is publicly available to consumers.
Mercy’s HCAHPS results from patients who had overnight hospital stays during April 1, 2010 and March 31, 2011 are shown below, and are compared to other area providers as well as state and national averages for all reporting hospitals. Percentage of patients who gave the hospital
the highest rankings Percentage of patients who gave the hospital
the lowest rankings
Mercy Hospital
Med Ctr of SE OK
Integris Marshall Co
OK US Mercy
Hospital Med Ctr of SE OK
Integris Marshall Co
OK US
75% 71% 86% 77% 76% 6% 9% 3% 5% 5%
81% 80% 92% 83% 80% 4% 7% 2% 4% 4%
63% 55% 83% 68% 64% 12% 18% 5% 9% 10%
71% 63% 75% 71% 70% 7% 11% 10% 7% 7%
56% 59% 75% 63% 61% 23% 26% 17% 19% 21%
75% 67% 82% 73% 72% 7% 12% 7% 9% 9%
60% 57% 71% 65% 58% 13% 14% 8% 8% 11%
81% 78% 83% 82% 82% 19% 22% 17% 18% 18%
65% 59% 70% 69% 68% 10% 14% 7% 9% 9%
62% 60% 71% 69% 70% 5% 10% 7% 5% 5%
Ardmore PATIENT SATISFACTION
Scale (Question 1 – 7): highest = “always”; lowest = “sometimes” or “never”
Scale (Question 8): highest = “yes/did”; lowest = “no/did not”
Scale (Question 9): highest = “9” or “10”; lowest = “6” or lower
Scale (Question 10): highest = “YES, definitely”; lowest = “No, probably/definitely not”
1 How often did nurses communicate well with patients?
2 How often did doctors communicate well with patients?
3 How often did patients receive help quickly from staff?
4 How often was patients’ pain well controlled?
5 How often did staff explain about medicines before giving them to patients?
6 How often were patients’ rooms & bathrooms kept clean?
7 How often was the area around patients’ rooms kept quiet at night?
8 Were patients given information about what to do during their recovery at home?
9 How do patients rate the hospital overall?
10 Would patients recommend the hospital to friends and family?
Source: www.hospitalcompare.hhs.gov. Most current data available updated April 19, 2012 – results from patients who had overnight hospital stays during April 1, 2010 and March 31, 2011. More than 300 surveys were completed for each facility with an average response rate of 32%.
= indicates an equal or greater percentage of Mercy patients gave the hospital the highest rankings compared to competitors shown
Community Snapshot HEALDTON
OUTPATIENT MARKET SHARE (hospital-based only)
Sources: Mercy Locations Directory & AHD (other locations); Inpatient Patient Origin & Market Share – Oklahoma State Data, 2010 (does not include Normal Newborns); Hospitals include hospital-based outpatient services only. Physician Offices and Independent Laboratories represent procedures performed in a physician’s office and/or lab regardless of affiliation with a hospital or health system. Thomson Reuters Outpatient Market Profiles, 2010; Demographics – Thomson Reuters, 2011; Payer Mix – Thomson Reuters Insurance Estimates, 2011; County Health Rankings, 2012; Inpatient Services – Oklahoma State Data, 2010; Physicians – Buxton, April 2012
INPATIENT MARKET SHARE
total outpatient volume in the Healdton PSA 725,635
% Market Share 2010
OP Volume
60% PHYSICIAN OFFICES 438,393
17% MERCY HOSPITAL ARDMORE 121,946
9% INDEPENDENT LABS 63,772
2% DUNCAN REGIONAL HOSPITAL 14,597
2% MERCY HOSPITAL HEALDTON 10,677
1% JEFFERSON COUNTY HOSPITAL 10,249
1% CARL ALBERT INDIAN HOSPITAL 10,041
1% OTHER MERCY (owned and managed) 7,772
7% OTHER 48,188
PRIMARY SERVICE AREA & PATIENT ORIGIN The majority (94%) of Mercy Hospital Healdton’s acute care patients reside in Carter and Jefferson Counties in south central Oklahoma. About four in ten patients share the same zip code (73438) as the hospital.
% Market Share 2010
Discharges
68% MERCY HOSPITAL ARDMORE 5,147
4% OU MEDICAL CENTER 294
4% DUNCAN REGIONAL HOSPITAL 278
4% OKLAHOMA HEART HOSPITAL 269
3% JEFFERSON COUNTY HOSPITAL 230
2% MERCY HOSPITAL HEALDTON 173
3% OTHER MERCY (owned and managed) 249
12% OTHER 915
7,555 total inpatient discharges in the Healdton PSA
39% 9%
22%
16%
3%
2%
HOUSEHOLD ECONOMICS
Total Households: 22,417 Average Income: $47,171 Annual Income <$15K: 21%
INSURANCE COVERAGE
41% Private 20% Medicare 18% Medicaid 22% Uninsured
Race: 75% White; 8% American Indian Ethnicity: 5% Hispanic (of any race)
Total Area Population: 56,095 5-Yr Growth: +2%
Age Cohorts: 26% Children (0-17) 18% Females (15-44) 16% Seniors (65+)
Median Age: 38
POPULATION
Health Factor County OK US
Adult Smoking (% smoking >= 100 cigarettes) 25% 25% 14%
Adult Obesity (% with BMI >= 30) 35% 32% 25%
Physical Inactivity (% of 20+ pop. not active) 36% 31% 21%
Excessive/Binge Drinking 10% 14% 8%
Teen Birth Rate (per 1,000 females age 15-19) 74 58 22
Children in Poverty (% of children 0-17) 27% 24% 13%
Preventable Hospital Stays (per 1,000 Medicare) 73 82 49
COUNTY HEALTH RANKINGS
Carter County Overall Health Rank = 59 (out of 77 counties) The lower the ranking, the healthier the community.
Below are some of the factors which attribute to the county’s health status compared to state and national benchmarks.
SERVICES & PHYSICIANS
In 2010, Mercy Hospital Healdton’s top inpatient service lines were rehabilitation (31%) and pulmonary (25%).
The 27% of residents leaving the Healdton area for inpatient services primarily go to OU Medical Center for neurology and general surgery services, and to Duncan Regional for OB and orthopedic services.
There are approximately 99 physicians (26% primary care) located in the PSA, of which 21% are integrated with Mercy.
Mercy Hospital
Mercy Clinic
Mercy Urgent/Convenient Care Clinic
Mercy Patient Origin by Zip Codebased on inpatient volume(volumes 1% or less not shown)
Managed hospital
Other hospital (non-Mercy)
%
EDUCATION (based on population ages 25+)
12% Some High School 24% Some College 41% High School Diploma 17% Bachelor’s Degree/greater
OK
Community Snapshot TISHOMINGO
OUTPATIENT MARKET SHARE (hospital-based only)
Sources: Mercy Locations Directory & AHD (other locations); Inpatient Patient Origin & Market Share – Oklahoma State Data, 20010 (does not include Normal Newborns); Outpatient Market Share – Data represents 187 procedure groups (categories of CPT and HCPCS codes). Hospitals include hospital-based outpatient services only. Physician Offices and Independent Laboratories represent procedures performed in a physician’s office and/or lab regardless of affiliation with a hospital or health system. Thomson Reuters Outpatient Market Profiles, 2010; Demographics – Thomson Reuters, 2011; Payer Mix – Thomson Reuters Insurance Estimates, 2011; County Health Rankings, 2012; Inpatient Services – Oklahoma State Data, 2010; Physicians – Buxton, April 2012
INPATIENT MARKET SHARE
total outpatient volume in the Tishomingo PSA 327,148
% Market Share 2010
OP Volume
53% PHYSICIAN OFFICES 174,449
12% INDEPENDENT LABS 40,278
8% INTEGRIS MARSHALL COUNTY 26,183
5% MERCY HOSPITAL ARDMORE 16,936
3% MEDICAL CTR. OF SE OKLAHOMA 10,962
3% MERCY HOSPITAL TISHOMINGO 10,739
2% TEXOMA MEDICAL CENTER 7,170
2% OTHER MERCY (owned and managed) 5,207
11% OTHER 35,224
PRIMARY SERVICE AREA & PATIENT ORIGIN The majority (87%) of Mercy Hospital Tishomingo’s acute care patients reside in Johnston and Marshall Counties in south central Oklahoma. Two of every three patients share the same zip code (73460) as the hospital.
% Market Share 2010
Discharges
27% MEDICAL CTR. OF SE OKLAHOMA 964
23% MERCY HOSPITAL ARDMORE 820
19% INTEGRIS MARSHALL COUNTY 672
9% MERCY HOSPITAL TISHOMINGO 312
4% OU MEDICAL CENTER 143
7% OTHER MERCY (owned and managed) 261
11% OTHER 373
total inpatient discharges in the Tishomingo PSA 3,545
67% 6%
4%
4%
2%
HOUSEHOLD ECONOMICS
Total Households: 10,471 Average Income: $43,828 Annual Income <$15K: 22%
INSURANCE COVERAGE
36% Private 20% Medicare 24% Medicaid 20% Uninsured
Race: 71% White; 11% American Indian Ethnicity: 10% Hispanic (of any race)
Total Area Population: 26,173 5-Yr Growth: +3%
Age Cohorts: 25% Children (0-17) 17% Females (15-44) 18% Seniors (65+)
Median Age: 40
POPULATION
Health Factor County OK US
Adult Smoking (% smoking >= 100 cigarettes) 25% 25% 14%
Adult Obesity (% with BMI >= 30) 30% 32% 25%
Physical Inactivity (% of 20+ pop. not active) 34% 31% 21%
Excessive/Binge Drinking 12% 14% 8%
Teen Birth Rate (per 1,000 females age 15-19) 79 58 22
Children in Poverty (% of children 0-17) 34% 24% 13%
Preventable Hospital Stays (per 1,000 Medicare) 132 82 49
COUNTY HEALTH RANKINGS
Johnston County Overall Health Rank = 67 (out of 77 counties) The lower the ranking, the healthier the community.
Below are some of the factors which attribute to the county’s health status compared to state and national benchmarks.
SERVICES & PHYSICIANS
In 2010, Mercy Hospital Tishomingo’s top inpatient service lines were pulmonary (33%) and cardiovascular (16%).
The 72% of residents leaving the Tishomingo area for inpatient services primarily go to the Medical Ctr. Of SE OK for OB and cardiovascular services, and to Mercy Hospital Ardmore for orthopedic and cardiovascular services.
There are approximately 14 physicians (93% primary care) located in the PSA, of which none are integrated with Mercy.
Mercy Hospital
Mercy Clinic
Mercy Urgent/Convenient Care Clinic
Mercy Patient Origin by Zip Codebased on inpatient volume(volumes 1% or less not shown)
Managed hospital
Other hospital (non-Mercy)
%
EDUCATION (based on population ages 25+)
13% Some High School 27% Some College 38% High School Diploma 14% Bachelor’s Degree/greater
OK