Hosted by: Overview of Hospitals and Healthcare in Virginia Tracey van Marcke Executive Director, VHREF June 8, 2017 2 Contents • Virginia Healthcare Landscape • Virginia Healthcare Statistics • Virginia Hospital & Healthcare Association • VHHA Member Health Systems 3 Virginia Healthcare Landscape • Virginia has a growing and increasingly diverse population • Low unemployment and higher family incomes than the U.S. population overall – 4% unemployment rate in March 2017 – $65,015 median income in 2015 • Virginia’s GDP grew by 0.6% in 2016, compared to the national average of 1.5% • Population health ranking – 19th – is slightly above the national average • Disparities in health and healthcare access exist in Virginia • Virginia’s uninsured rate – 10.4% in 2015, ranked 28th nationally Sources: BEA, Census Bureau, Kaiser Family Foundation, United Health Foundation, VHDA 4 Virginia Healthcare Landscape • Similar to the national picture, the majority of Medicaid enrollees are children, but the elderly and individuals with disabilities account for most Medicaid spending – 52% of enrollees are children; account for 22% of spending – 26% of enrollees are aged, blind or disabled; account for 67% of spending • Most Medicaid beneficiaries - 69% - are enrolled in managed care • Virginia currently has limited Medicaid eligibility for adults – Pregnant women with income up to 148% FPL – Elderly and disabled with income up to 80% FPL – Parents of dependent children with income up to 52% FPL – Adults without dependent children are ineligible • 191,000 currently uninsured adults remain in the coverage gap – The ACA expands coverage to nonelderly with incomes up to 138% FPL and provides premium tax credits for individuals with incomes between 100-400% FPL – Because Virginia has not expanded Medicaid, those nonelderly adults with incomes below 100% do no qualify for Medicaid or the tax credits Source: Kaiser Family Foundation, Medicaid in Virginia 5 Virginia Healthcare Landscape • Virginia is implementing new quality and performance measures to improve primary and preventative care and care coordination • Virginia is seeking to better coordinate care and control costs for its dual eligible beneficiaries • Virginia is one of 27 states in which the federal government has set up and is running the Health Insurance Marketplace • Virginia hospitals and health systems continue to play a safety-net role – $584.9 million in financial assistance or charity care – $333.5 million Medicaid shortfall – $133 million in subsidized health services • Despite Virginia’s health care safety-net, the state has Health Professional Shortage Areas (HPSAs) and unmet need for care – 90 HPSAs and only 72% of primary health care need met – 50 mental health HPSAs and 83 dental HPSAs, with 61% and 47% of need met respectively Source: Kaiser Family Foundation, 2017 Annual Report on Community Benefit 6 Virginia Healthcare Statistics Virginia Population: 8.4 million Emergency Department Visits: 3,636,082 Inpatient Admissions: 789,171 Babies Delivered: 94,273 Hospitals’ Community Benefit: $1.43 billion 2015 Data 7 Virginia Healthcare Statistics **Wellmont Health System, Other, Sheltering Arms Corporation, Diamond Healthcare, and Vibra Healthcare each represent <1% 8 Virginia Healthcare Statistics Virginia Nonelderly Uninsured Rate by County Source: RWJ Foundation and the University of Wisconsin Population Health Institute 9 Virginia Healthcare Statistics Source: RWJ Foundation and the University of Wisconsin Population Health Institute 10 Virginia Hospital & Healthcare Association • 29 member health systems • 38 VHHA staff, headquartered in Glen Allen • Affiliates: – VHHA Shared Services – Virginia Hospital Research and Education Foundation – Virginia Business Coalition on Health – Virginia Health Care Waste Management Cooperative – Health Providers Insurance Alliance – ASPR Hospital Preparation Program 11 VHHA Strategic Plan Vision Through the power of collaboration, the association will be the recognized driving force behind making Virginia the healthiest state in the nation by 2020. Mission Working with our members and other stakeholders, the association will transform Virginia’s health care system to achieve top tier performance in safety, quality, value, service and population health. The association’s leadership is focused on: principled, innovative and effective advocacy; promoting initiatives that improve health care safety, quality, value and service; and, aligning forces among health care and business entities to advance health and economic opportunity for all Virginians. 12 VHHA Strategic Plan Focus Areas 1. Principled, Innovative and Effective Advocacy 2. Improving Safety, Quality, Value and Service 3. Transforming Data and Analytics Tools 4. Cutting Edge Education and Communication 5. Broadening Membership and Members Impact 13 About Virginia Hospitals • 107 community, psychiatric, rehabilitation and specialty hospitals • 18,881 hospital beds • 17 designated trauma centers • 49 percent are rural hospitals • 51 percent are urban hospitals • 77 percent of Virginia hospitals are not-for-profit 14 Virginia Hospitals 15 Augusta Health Care Headquarters: Fishersville, VA Leadership: Mary N. Mannix, President and CEO VHHA Board Member: Mary N. Mannix, Past Chair Hospital: Augusta Medical Center 16 Bath Community Hospital Headquarters: Hot Springs, VA Leadership: Kathy S. Landreth, CEO VHHA Board Member: Kathy S. Landreth 17 Bon Secours Virginia Headquarters: Richmond, VA Leadership: Toni R. Ardabell, CEO VHHA Board Member: Toni R. Ardabell Hospitals: − Bon Secours Depaul − Bon Secours Maryview − Bon Secours Memorial Regional − Bon Secours Richmond Community − Bon Secours St. Francis − Bon Secours St. Mary’s − Bon Secours Mary Immaculate − Rappahannock General 18 Buchanan General Headquarters: Grundy, VA Leadership: Robert D. Ruchti, CEO 19 Carilion Clinic Headquarters: Roanoke, VA Leadership: Nancy Howell Agee, President and CEO VHHA Board Member: Steven C. Arner Hospitals: − Carilion Franklin Memorial − Carilion Giles Community − Carilion Roanoke Community − Carilion Roanoke Memorial − Carilion New River Valley − Carilion Stonewall Jackson − Carilion Tazewell Community 20 Centra Health Headquarters: Lynchburg, VA Leadership: E.W. Tibbs, President and CEO VHHA Board Member: E.W. Tibbs Hospitals: − Bedford Memorial Hospital − Lynchburg General Hospital − Southside Community Hospital − Virginia Baptist Hospital 21 Chesapeake Regional Healthcare Headquarters: Chesapeake, VA Leadership: Reese Jackson, President and CEO VHHA Board Member: Kenneth R. Deans, Jr. Hospitals: − Chesapeake Regional Medical Center 22 Children’s Hospital of The King’s Daughters Headquarters: Norfolk, VA Leadership: James D. Dahling, President and CEO VHHA Board Member: James D. Dahling 23 Children’s National Health System Headquarters: Washington, DC Leadership: Kurt Newman, MD, President and CEO VHHA Board Member: Kurt Newman, MD Hospitals: − Children’s National Medical Center 24 Community Health Systems Headquarters: Franklin, TN Leadership: Wayne T. Smith, Chairman and CEO VHHA Board Member: Trent Nobles Hospitals: − Southampton Memorial Hospital − Southern Virginia Regional − Southside Regional Medical Center 25 HCA Virginia Headquarters: Richmond, VA Leadership: Tim McManus, President VHHA Board Member: Tim McManus Hospitals: − CJW Medical Center – Chippenham − CJW – Johnston-Willis − Dominion Hospital − Henrico Doctors’ Hospital − John Randolph Medical Center − Parham Doctors’ Hospital − Lewis-Gale Medical Center − Lewis-Gale – Alleghany − Lewis-Gale – Montgomery − Lewis-Gale – Pulaski − Reston Medical Center − Retreat Doctors’ Hospital − Spotsylvania Regional − StoneSprings Hospital Center 26 HealthSouth Headquarters: Birmingham, AL Leadership: Jay Grinney, President and CEO VHHA Board Member: Thomas J. Cook Hospitals: − HealthSouth Rehabilitation Hospital of Virginia − HealthSouth Rehabilitation Hospital of Petersburg − The Rehabilitation Hospital of Southwest VA − HealthSouth Rehabilitation Hospital of Federicksburg − HealthSouth Rehabilitation Hospital of Northern Virginia 27 Inova Health System Headquarters: Falls Church, VA Leadership: J. Knox Singleton, CEO VHHA Board Member: John L. Fitzgerald Hospitals: − Inova Alexandria − Inova Fair Oaks − Inova Fairfax − Inova Loudoun − Inova Mount Vernon 28 Lake Taylor Transitional Care Hospital Headquarters: Norfolk, VA Leadership: Thomas J. Orsini, President and CEO VHHA Board Member: Thomas J. Orsini 29 LifePoint Health Headquarters: Brentwood, TN Leadership: William F. Carpenter, III, Chairman and CEO VHHA Board Member: Peter M. Mulkey Hospitals: − Clinch Valley Medical Center − Danville Regional Medical Center − Fauquier Hospital − Memorial Hospital of Martinsville and Henry County − Twin County Regional Healthcare (a Duke Lifepoint Hospital) − Wythe County Community Hospital 30 Mary Washington Healthcare Headquarters: Fredericksburg, VA Leadership: Michael P. McDermott, MD, President and CEO VHHA Board Member: Michael P. McDermott, MD, Secretary- Treasurer Hospitals: − Mary Washington Hospital − Stafford Hospital 31 Mountain States Health Alliance Headquarters: Johnson City, TN Leadership: Alan Levine, President and CEO VHHA Board Member: Anthony E. Keck Hospitals: − Dickenson Community Hospital − Johnston Memorial Hospital − Norton Community Hospital − Russell County Medical Center − Smyth County Community Hospital 32 Novant Health Headquarters: Winston-Salem, NC Leadership: Carl S. Armato, President and CEO VHHA Board Member: Melissa