BOSTON MEDICAL CENTER Academic Medical Center 2018 Hospital Profile Metro Boston

Boston, MA BOSTON MEDICAL CENTER Academic Medical Center 2018 Hospital Profile Metro Boston

Boston Medical Center (BMC) is a large, non-profit academic medical center (AMC) located in the Metro Boston region. BMC is a teaching hospital of Boston University School of Medicine. It also qualifies as a High Public Payer (HPP) hospital. It is the state’s seventh-largest hospital, and one of nine organ transplant centers in Massachusetts. In FY18, BMC reported a profit of $49.4M and a total margin of 3.3% compared to its peer cohort median of 5.0%.

Overview / Size Payer Mix Hospital System Affiliation: Boston Medical Center Health System Public Payer Mix: 75.6% HPP Hospital Hospital System Surplus (Loss) in FY18: $25,666,000 CY17 Commercial Statewide Relative Price: 1.15 Change in Ownership (FY14-18): Not Applicable Top 3 Commercial Payers: Blue Cross Blue Shield of Massachusetts Total Staffed Beds: 441, 7th largest acute hospital Harvard Pilgrim Health Care % Occupancy: 78.7%, lowest in cohort avg. (86%) AllWays Health Partners, Inc. Special Public Funding: HCIIη Trauma Center Designation: Adult: Level 1, Pedi: Level 2 Utilization Case Mix Index: 1.25, < cohort avg. (1.54); > statewide (1.14) Inpatient Discharges in FY18: 26,408

Glance Change FY17-FY18: 2.7%

At a a At Financial Emergency Department Visits in FY18: 130,163 Inpatient NPSR per CMAD: $13,749 Change FY17-FY18: -2.5% Change FY17-FY18: -4.2% Outpatient Visits in FY18: 1,581,337 Inpatient:Outpatient Revenue in FY18: 28%:72% Change FY17-FY18: -6.5% Outpatient Revenue in FY18: $781,570,362 Quality Change FY17-FY18: 28.5% Readmission Rate in FY18: 15.6% Total Revenue in FY18: $1,492,616,000 ` Change FY14-FY18 (percentage points): 0.1 Total Surplus (Loss) in FY18: $49,421,000 Early Elective Deliveries Rate: 1.7%

What were the most common inpatient cases (DRGs) treated at the Where did most of the hospital's inpatients reside? What proportion of hospital in FY18? What proportion of the region’s cases did this hospital each community's total discharges was attributed to this hospital? treat for each service? Discharges by DRG Discharges by Community Normal Neonate Birth (2351) 10% of regional discharges were treated Boston MA (4,599) 25% of community discharges Vaginal Delivery (1693) 9% at this hospital in FY18 Dorchester MA (3,503) 37% were treated at this hospital Cesarean Delivery (980) 11% Dorchester Center MA (1,934) 30% in FY18 Heart Failure (840) 12% Roxbury MA (1,507) 39%

Septicemia Infections (763) 10% Mattapan MA (1,085) 33% Services Bacterial Skin Infections (454) 14% Chelsea MA (820) 18% Procedures For Obesity (426) 18% Brockton MA (791) 5% Sickle Cell Anemia Crisis (425) 42% Revere MA (779) 12% Other Pneumonia (376) 9% Quincy MA (715) 7% COPD (367) 13% Hyde Park MA (659) 16% 0% 20% 40% 60% 80% 100% 0% 20% 40% 60% 80% 100% - - - Hospital (26,408) = 9% of total regional discharges

What proportion of adult patient discharges from this hospital resulted in How many central line-associated blood stream infections (CLABSI), a readmission at any hospital within 30 days, and how does this catheter-associated urinary tract infections (CAUTI), and surgical site compare to the state average? infections (SSI) after colon surgery did patients get at this hospital 25% compared to what was expected based on the hospital's characteristics and case mix? 20% CLABSI CAUTI SSI: Colon Surgery 5 15.6% 15.6% 15% 4 State Average 15.4%

Quality 14.7% 3 10% 2 Lower is Better 5% 1 Lower is Better 0% 0 2014 2018

For descriptions of the metrics, please see the technical appendix.

A2 2018 HOSPITAL PROFILE: BOSTON MEDICAL CENTER Key: Hospital Cohort: Academic Medical Center Peer Cohort

How has the volume of the hospital's inpatient discharges changed How has the volume of the hospital's outpatient visits changed compared to FY14, and how does this compare to the hospital's peer compared to FY14, and how does this compare to the hospital's peer cohort median? (FY14=100) cohort median? (FY14=100)

FY18 Inpatient Discharges = 26,408 150 FY18 Outpatient Visits = 1,581,337 150

+2.7% +1.3% +0.6%

Utilization 100 100 -2.2%

50 50 2014 2015 2016 2017 2018 2014 2015 2016 2017 2018

What was the hospital's net inpatient service revenue per case mix How has the hospital's total outpatient revenue changed compared to adjusted discharge between FY14 and FY18, and how does this FY14, and how does this compare to the hospital's peer cohort median? compare to the hospital's peer cohort median? (FY14=100)

$24,000 150 FY18 Outpatient Revenue = $782 M $20,000 +23.4%

$16,000 Hospital +11.2% Cohort Median 100 $12,000

Patient RevenueTrendsPatient $8,000

$4,000 50 2014 2015 2016 2017 2018 2014 2015 2016 2017 2018

How have the hospital's total revenue and costs changed between FY14 What were the hospital's total margin and operating margins between and FY18? FY14 and FY18, and how do these compare to the hospital's peer cohort medians? Revenue, Cost, & Profit/Loss (in millions) 12% FY 2014 2015 2016 2017 2018 3.0% 2.8% 2.6% 2.6%

Operating Revenue $ 1,087 $ 1,137 $ 1,243 $ 1,326 $ 1,481 0% Operating Non-Operating $ 22 $ 22 $ (9) $ 16 $ 11 Revenue -12% 12% Total Revenue $ 1,109 $ 1,159 $ 1,233 $ 1,342 $ 1,493 5.0% 5.0% 4.7% 3.3%

Financial PerformanceFinancial 0% Total Costs $ 1,053 $ 1,130 $ 1,241 $ 1,313 $ 1,443 Total

-12% Total Profit (Loss) $ 55.5 $ 29.3 $ (7.6) $ 28.6 $ 49.4 2014 2015 2016 2017 2018

For descriptions of the metrics, please see the technical appendix. * High Public Payer Hospitals (HPP) receive a minimum of 63% of gross patient service revenue from public payers.

η For more information on Health Care Innovation Investment Program (HCII) special funding, please contact the Health Policy Commission (HPC).