Summit Medical CenterSummit Medical Center

““Top Performer” Award from The Top Performer” Award from The Joint CommissionJoint Commission

Emergency Room Expansion – July Emergency Room Expansion – July 20112011

Emergency Room Expansion – July Emergency Room Expansion – July 20112011

Robotic Surgery: Robotic Surgery: Urology and Gynecology Urology and Gynecology (2011) – Thoracic Surgery and General Surgery (2012)(2011) – Thoracic Surgery and General Surgery (2012)

Airstrip TechnologiesAirstrip Technologies

Community Benefit 2011Community Benefit 2011

Charitable contributions: $170,000Uncompensated Care: $46 millionTaxes: $15.7 millionEmployees: 910Salaries, Wages, and Benefits: $54 millionCapital Expenditures: $12 million

What are some of the top What are some of the top “headlines” that you think of on “headlines” that you think of on the topic of Healthcare in the the topic of Healthcare in the U.S.?U.S.?

Infant Mortality – Deaths per 1,000 Live Infant Mortality – Deaths per 1,000 Live Births - 2007Births - 2007

Average Life Expectancy at Birth - 2007Average Life Expectancy at Birth - 2007

Healthcare Costs as a % of GDP - 2007Healthcare Costs as a % of GDP - 2007

Arguments in Favor of the U.S. as Arguments in Favor of the U.S. as a Very High Quality Healthcare a Very High Quality Healthcare ProviderProvider

High Healthcare Tourism: about 250,000 foreign citizens come to the U.S. annually for healthcare

World’s Best Medical EducationInnovationThe U.S. likely reports the most accurate

data – this could contribute to us looking worse by comparison

Lifestyle affects health status

Obesity Trends*Obesity Trends* Among U.S. AdultsAmong U.S. AdultsBRFSS, 1985BRFSS, 1985

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14%

Obesity Trends* Among U.S. AdultsObesity Trends* Among U.S. AdultsBRFSS, 2006BRFSS, 2006

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

Health Concerns of ObesityHealth Concerns of Obesity Endocrine:  Diabetes, Lipid Management Cardiovascular:  Coronary Artery Disease, Heart Failure,

Peripheral Vascular Disease (Amputations, By-Pass grafts), Hypertension

Neuro:  Stroke Ophthalmologic:  Retinal Proliferative Disease GI:  Bariatric Surgery, Fatty Liver Disease, Steatohepatitis

(complications to liver disease, pancreatic disease) GU:  Male: ED  Female:  Fertility, Polycystic Ovary Disease Orthopedic:  Arthritis, Hip & Knee Prosthetics, Spinal Disease Preventive Services: Exercise, Nutrition, Weight Management Pulmonary: Obstructive Sleep Apnea, Complications to asthma,

COPD Psychosocial: Depression Infectious Disease:  Skin Disease, Complex infection with

Diabetes Other:  Complex surgical / anesthetic management, Cancer

(Thyroid, Upper GI, colon, pancreas, GB, kidney, uterine, & post-menopausal breast)

Tobacco Consumption – Percentage of Tobacco Consumption – Percentage of Population - 2007Population - 2007

Pharmaceutical % of Total Healthcare Pharmaceutical % of Total Healthcare CostsCosts

Percentage of Total Healthcare Expenditures Percentage of Total Healthcare Expenditures that are Out-of-Pocket - 2007that are Out-of-Pocket - 2007

Primary Care Physicians per 1,000 Primary Care Physicians per 1,000 PopulationPopulation

What’s Next With the Affordable What’s Next With the Affordable Care Act?Care Act?

Supreme Court Ruling – June ??2014: DSH Cuts, Insurance Exchanges, Adult

No Pre-Existing, Medicaid 133% FPL, Tax on Insurance Companies

2016: Individual Penalty for no insurance of $695, or 2.5 % of taxable income

2017: Businesses with > 100 FTEs can buy from exchanges

2018: 40 % excise tax on “cadillac plans” > $10,200 for individuals, > $27,500 for families

Where Should Healthcare in the Where Should Healthcare in the U.S. Be Headed?U.S. Be Headed?

Greater use of technology for information exchange and data collection

Improved quality – reduction of varianceTransparencyGreater proliferation of non-physician primary

providersIncrease in wellness and prevention in the

outpatient settingGreater individual ownership of healthcare costs

and decision-making

Questions?Questions?