Weathering the storm: Columbus healthcare providers fare well during tough economy, reform
Hospitals and health systems in Columbus say that despite the pressures of the economy and federal and state healthcare policies, they are faring well.
More diversified than other regions in Ohio, the state's capital has reported notable increases in population in the past decade, with the local population growing by 10%, yet concerns remain about Columbus' unemployment rate and the recession's impact on hospitals and health systems.
“We've seen a little increase in charity care. We've seen some softening in the volumes for elective surgery. We've seen employers adopt consumer-directed health plans, shifting some of the risk to the employees,” David Blom, president and CEO of Columbus-based OhioHealth, says about how the recession impacted the eight-hospital health system. “(But) Columbus has weathered the storm a little bit better than most.”
Blom adds that all hospitals in Columbus—the not-for-profit system owns three of the 11 hospitals in the city—have adopted similar charity-care policies. He notes that he noticed the increase in charity care in the past three years and that those charity-care policies have “helped us retain that relative proportionality.”
Jim Castle, president and CEO of the Ohio Hospital Association, says state hospitals consistently note the increase in charity care and uncompensated care. He says the state's charity-care spending has topped $1 billion.
“Historically, the economic challenges along the northern tier of Ohio—Toledo, Cleveland, Warren Youngstown, oftentimes referred to as the rust belt—has been a difficult economic struggle for about three decades now,” Castle says. “Whereas, Columbus, where there is more of a mixed economy, has not been hit as hard by the economic downturn as Cleveland.”
Blom says OhioHealth has been proactive in addressing costs and changes as a result of healthcare reform, despite pressures stemming from the economy, and at policy issues at the state and federal level.
“We're in the midst of moving from economic incentives for volume to economics incentives for value and that transition is difficult,” he says.
Part of that challenge is ensuring that the OhioHealth system's staff understands what is ahead. Even as the health system seeks to cut costs—Blom says it has cut $170 million in expenses in the past three years—OhioHealth is pushing ahead with plans to expand its ambulatory network, renovate and expand some inpatient facilities, and continue to invest in telemedicine and leadership training.
“Given all the healthcare changes coming down the pike, we found a need to do some additional training for our clinical leaders—training clinical people to really be leaders of processes of care that are becoming more consistent across our system and across hospitals even outside our system,” he adds.
Castle agrees, noting that workforce challenges for Columbus and statewide are a concern, in part because of the state's aging population.
“Our issue will be retaining those people that we educate in Ohio,” he says. “No question that nationally, as the economy gets better, those positions that are more mobile will be more and more challenged to keep them in Ohio … The pressure to change utilization patterns among consumers and to change how we utilized healthcare professionals within our healthcare systems represents an opportunity to mitigate the workforce challenges.”