Every year is challenging when you’re a physician, staff member or leader at an essential hospital. But the good news is that in this ever-evolving health care environment, essential hospitals are better prepared for change than others: We have a long history of using limited resources to achieve good outcomes for complex patients who face many social and economic challenges. UTMB has truly demonstrated this since we began the Best Care initiative last June.
Yesterday, I was officially inducted as board chair of America’s Essential Hospitals (AEH), the nation’s leading association and champion for hospitals and health systems dedicated to high-quality care for all, including the most vulnerable. It is truly an honor to assist AEH in preserving and strengthening America’s safety net hospitals, and to assure that the health care needs of vulnerable populations are addressed for years to come.
The following are some examples of collective achievements of essential hospitals each year:
- We provide 16.9 percent of all uncompensated care.
- Half of the patients we serve are uninsured or Medicaid beneficiaries.
- We run approximately 34 percent of all Level I trauma centers, 42 percent of burn centers, and 25 percent of pediatric intensive care beds nationwide.
- We train nearly three times the number of physicians as other U.S. teaching hospitals – on average, that’s 228 residents per hospital versus 78 per hospital.
- We deliver approximately 395,000 newborns; nearly 39 percent of those births are paid for by Medicaid.
- We treat approximately 13.8 million patients in our emergency rooms.
- And we achieve all of this, spending slightly less per Medicare beneficiary than the average hospital.
Our margins are stretched thin by this work, and for some hospitals, there’s no margin at all. Overall, AEH members operate with only a 3.2 percent margin – that’s less than half of other hospitals. Essential hospitals would lose 3.6 percent of that margin without government funding provided to hospitals that treat indigent patients, known as Disproportionate Share Hospital payments.
It is this work, and our daily struggle to make ends meet, for which America’s Essential Hospitals advocates. The association gives essential hospitals like UTMB a strong, collective voice that’s hard to ignore. Standing alone we risk failure, but standing with one voice we have every chance to succeed. Most important, we give a voice to our vulnerable patients, who might otherwise be overlooked or left without care. We have a collective responsibility to work with our communities, within our states and our nation to be that voice for patients and create access to equitable care for all.
While the numbers speak for themselves, they come alive best through stories that speak to the complexity of care and to the needs of patients we manage every day. I am excited to share with our essential hospital peers the innovative work we are doing at UTMB in support of our mission. We all have stories that can help people who are not entrenched in health care understand the problems we juggle every day. I hope you will send me your experiences (protecting patient confidentiality, of course) so we can share the story of how, working together, we make a difference in the lives of so many!
Working together in concert not only helps us move more quickly; it changes the nature of what we can undertake. When we have the confidence that we can orchestrate the group effort required to realize them, we dare bigger dreams.
― Justin Rosenstein