The District of Columbia should relinquish control of its only public hospital to a not-for-profit corporation to reverse the facility's dismal financial performance, according to a plan drafted by a private consulting firm.
Kurron Shares of America, a New York-based healthcare management firm, drafted the plan for District of Columbia General Hospital under a contract with the city.
The firm recommended the hospital create a quasi-public governing board composed of private-sector executives appointed by the mayor. Under the plan, the city would ensure continued coverage of indigent patients and the prison population through contracts with the hospital but would no longer provide an outright appropriation for the facility or guarantee to fund its huge budget deficits.
In 1993, 435-bed D.C. General received a $59 million appropriation and lost more than $30 million. Under Kurron's proposed plan, the hospital could be $12 million in the black by 1998. With no changes, it will accumulate a $219 million deficit by that year, the report said.
But complying with the Kurron blueprint would require changes that are bound to meet political and grass-roots resistance, said Ronald Weitz, a principal in the company. These include rate increases; cutting 386 full-time employees through attrition and early retirement incentives; integrating 15 city-run clinics with D.C. General to create a delivery system with primary-care satellites; creating a faculty practice plan for physicians, who now are paid as full-time government workers, to give them an incentive to bill other payers for their services and reduce the hospitals' physician costs.
The Kurron proposal has been accepted by Mayor Sharon Pratt Kelly but still must be adopted by the city council. Approval could be stalled by this year's mayoral race.