Overview
Unity Health System
Unity Medical GroupGenesee St. Campus
Park Ridge Hospital
Map
ACM Medical Laboratory
Aging and Continuing Care Services Unity Health Foundation
• 208 acute care beds• Intensive Care Unit
– A Top 100 ICU• Emergency Department
– Full service with QuickCare unit• Surgical Services Center
– Inpatient and outpatient• Orthopaedics & Joint Replacement Center
– Highest volume in Rochester
Park Ridge Hospital
• Family Birth Place & Women’s Services• Behavioral Health & Psychiatry
– 40-bed inpatient psychiatric unit– 40-bed inpatient chemical dependency unit– Outpatient clinics and services– Community residences
• Cancer Center (opening Spring 2005)
Park Ridge Hospital (cont’d)
• Cardiology Services– Coronary angioplasty– Full-service outpatient testing & cardiac rehab
• Vascular Services• Child Care Center
Park Ridge Hospital (cont’d)
Changes in patient volume2000-2004
0
10
20
30
40
50
60
70
80
Medical Surgical OB E.D. visits
SMH
RGH
TGH
HH
PRH
TOTAL
• 33,000 square feet total• Expand treatment spaces from 24 to 40 • Upgraded facilities include four new operating rooms• Designed for 45,000
patient visits per year• Total cost $27 million• Opening January 2006
Emergency center expansion
Return to overview
• Walk In Care Center (24/7)– Psychiatric Emergency Unit
• Inpatient Psychiatric Unit– 40 beds
• Brain Injury Rehabilitation Unit– 33 beds, adults and children– Regional referral center
• Unity Living Center– 120-bed skilled nursing facility
Genesee Street Campus
• Outpatient Services– ACM Laboratory– Dialysis– Oncology– Full Service Pharmacy– Dental Practice– Family Medicine Practice – Pediatrics Practice– Outpatient Psychiatry
Genesee Street Campus (cont’d)
• Community Outreach Programs– Children's Clothes Closet– HealthReach, Healthy
Moms, Healthy Start– Health Care for the Homeless– McCree McCuller Wellness Center, HIV-AIDS
Services
Genesee Street Campus (cont’d)
• Affordable Senior Housing & Senior Services– Moore Park– Park Place SouthWest
• Leased Services– Family Resource Centers of Rochester– GRHC Hospice– Sector 4 CDC Office– Monroe County WIC Office
Genesee Street Campus (cont’d)
Return to overview
• Skilled Nursing Facilities (362 beds)– Park Ridge Living Center– Unity Living Center– Edna Tina Wilson Living Center
• Medical Adult Day Health Services (3 sites)• Social Adult Day Health Services (3 sites)• Home Care Services (325 patients)
– Unity at Home– Care at Home
Aging and Continuing Care Services
• Senior Housing (549 units)– The Village at Park Ridge (Greece)
– Woodland Village (Greece)
– The Hamlet (Greece)
– Park Ridge Commons (Greece)
– Resch Commons (Greece)
– Moore Park (Rochester)
– St. Bernard’s Park (Rochester)
– Hilton Project (2006)
Aging and Continuing Care Services (cont’d)
Return to overview
• For-profit business enterprise• Central reference laboratory• Testing services for:
– Physicians– Nursing homes– Hospitals– Pharmaceutical companies– Industry and occupational groups
ACM Medical Laboratory
• 29 patient service centers throughout Monroe County• Licensed for DOT/Non-DOT toxicology testing. Only
New York State lab (and one of six in the U.S.) with a SAMHSA license for drug testing
• Rapidly growing global clinical trials division– From $2.5 million in 2000 to $5.5 million in 2003
ACM Medical Laboratory (cont’d)
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• 23 practice sites throughout Monroe County• 39 MDs, 354,000 visits• Specialties:
– Internal Medicine– Family Medicine– Dentistry– Obstetrics & Gynecology– Geriatrics– Neurology– Cardiology– Pediatrics
Unity Medical Group
Return to overview
• Assets: $13.1 million• Revenues: $1.9 million• Grants Paid: $829,000• Funds raised through:
– Annual Appeal- PRISM Leadership Giving Society
– Memorials and Tributes– Planned Giving– Special Events *2003 numbers
Unity Health Foundation
Return to overview
Continuing financial success
0
50,000,000
100,000,000
150,000,000
200,000,000
250,000,000
300,000,000
350,000,000
Revenue
2001
2002
2003
2004
0
1,000,000
2,000,000
3,000,000
4,000,000
5,000,000
6,000,000
Surplus
• Medical staff
• 4,690 employees = 3,355 FTEs
Unity physicians and employees
461 ActiveMembers
174 CourtesyMembers
173 AlliedHealthProfessionals
• Direct impact: $414,213,000
Our economic impact
Payroll: $253,286,000
Supplies: $146,435,000
Capital Spending: $14,492,000
State income tax: $8,761,000
State sales tax: $4,744,000
Local sales tax: $4,772,000
• Taxes: $18,277,000
• Bad debt and charity care: $7,994,999
The mission of Unity Health System is to make a positive difference in the lives and health status of individuals in the city of Rochester and western Monroe County. We will educate our community, our providers, and future health care professionals in order to offer the highest quality care to all members of our community, especially those who are underserved and most vulnerable.
Our mission
• Employee turnover
A great place to work
24.8%22.0%
18.7%
14.9%
12.4%
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
1999 2000 2001 2002 2003
• Overall employee satisfaction
A great place to work
79%
67%
60%62%64%66%68%70%72%74%76%78%80%
Unity National Norm
Changing consumer needs
Labor shortages
Costs
Quality and safety
Health policy
Key issues in health care
• Aging of the population• Chronic illnesses• Patient expectations• Growth of uninsured and under-insured
Changing consumer needs
Obesity Trends* Among U.S. Adults1990, 1996, 2002
*BMI 30, or ~ 30 lbs overweight for 5’4” woman
Source: Behavioral Risk Factor Surveillance System, CDC.
No Data <10% 10%-14% 15%-19% 20%-24% 25%
1991 1996
2002
Health risks among the uninsured
*Among women 50–64. **Among adults 45–64.
Percent of Individuals Not Receiving Selected Recommended Preventive Care Services
Source: J. Ayanian, et al. “Unmet Health Needs of Uninsured Adults in the United States,” JAMA 284 no 16 (2000): pp 2061–2069.
11%
18%21%
24%
32%
41%
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
No Mammogram in Past 2 Years* No Cholesterol Check in Past 5 Years**
Insured Uninsured < 1 year Uninsured > 1 year
Increased spending on health care
10.9%
13.4%14.8%
16.4%17.7%
13.1%
0%
2%
4%
6%
8%
10%
12%
14%
16%
18%
20%
1988 1993 1996 2002* 2008* 2012*
*Projected
Source: Heffler et al., “Health Spending Projections for 2002–2012,” Health Affairs (February 7, 2003).
National Health Care Expenditures as a Percent of GDP1988-2012 Projected
Return to key issues
• Physician supply• Scarcity of nurses and other health professionals• Benefits costs• Workforce diversity
Labor shortages
• Shortages in certain specialties• Changing practice patterns• Malpractice costs• Physician-hospital relationships• Fees
Physician supply
• Recruit, develop, and retain high quality physicians• Increase physician involvement in decision-making• Support physician-to-physician networking• Employment vs. solo practice
Physician strategies
• Support of MCC nursing and radiologic technologist programs
• On-site classes for Keuka College nursing students
• Employee development: training pathways for existing employees to advance into clinical positions
Our commitment to training
Return to key issues
• Increasing costs of:– Labor– Technology– Benefits– Competition
• Limited access to needed capital• Rising importance of philanthropy
Costs
Rochester hospitals: inpatient trends
1990 2000 2002 2004
Med/Surg beds
1,736 1,617 1,347
Occupancy 92.1% 69.2% 81.9%
The majority of hospitals lose money on Medicare and Medicaid
Source: MedPAC and AHA Annual Survey Data
29%
55%
57%
Hospitals withNegative Total
Margins In 2002
Hospitals withNegative MedicaidMargins in 2002
Hospitals withNegative Total
Medicare MarginsIn 2002
Health care IT spending
$16.0
$18.9
$21.6 $25.8
$30.5
$0.0
$5.0
$10.0
$15.0
$20.0
$25.0
$30.0
$35.0
1998 2000 2002 2004 2006*
In Billions
Return to key issues
• Medical errors and patient safety• Consumer-driven health care• Hospital and provider report cards
Quality and safety
• Willingness to recommend
Unity patient satisfaction
97.8%
99.0%
98.1%
97.7%
99.3%99.0%
97.7%
100.0%
96.5%
97.0%
97.5%
98.0%
98.5%
99.0%
99.5%
100.0%E
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OB
Inpa
tient
JRC
Sur
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UA
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• Average patient satisfaction: 98.5%
Published reports:– ACM Laboratory– Behavioral Health– Cardiology– Emergency Services– Endoscopy (GI)– Housing– Joint Replacement Center– Obstetrics– Senior Services– Surgery
Care to compare
In process:– Diabetes Services– ICU– Primary Care– Patient Safety Initiative– Vascular Services
• Reimbursement• Medicaid – Medicare Reform• HIPAA• Public health and bioterrorism preparedness• Legislative outlook
Health policy
Return to key issues
Opportunities and challenges:• Capacity and throughput• Evolution away from community rating• Flat population growth• Healthy competition versus community-wide planning
(Centers of Excellence concept)
The local environment
• Specialty centers and services– Cardiology– Diabetes– Emergency Services – Gastroenterology – Geriatrics – Obstetrics
Strategic priorities
– Oncology– Stroke Care– Surgery:
- Orthopaedics- Spine-Neuro Surgery- Vascular
“Execution . . .
. . . is a discipline and integral to strategies.
. . . is the major job of the business leader.
. . . must be a core element of an organization’s culture.”