The Heat Is On And Is Near The Boiling Point

I attended a meeting with other Maryland hospital CEO's and Board Members yesterday.  During the meeting, the discussion got around to the expectations of individual hospitals and health systems in the communities that we serve as a result of the financial crisis facing Maryland and the rest of the country.  There was a clear consensus that hospitals have become a critical "go to" component for virtually everyone.  As the State of Maryland cuts funding of programs and services, health departments are now partnering to a much greater extent with hospitals to keep programs and services alive.  Other not-fo- profit organizations are seeking hospitals to make up for declines in charitable giving through requests for funding as well as assuming programs.  Cities and counties are asking hospitals for fees in lieu of taxes to keeping government services running.  Politicians are zeroing in on hospital executives and board members for personal political donations to keep their election / re-election campaigns going.  Physicians are asking to be employed by hospitals in record numbers or at least kept as whole as possible as they see their income continuing to shrink.  The list goes on.

Relying on hospitals for funding in lieu of the business community is going to come to a screeching halt very soon as all payers including Medicare, Medicaid, Blue Cross, other insurers and private payers continue to seek ways in reducing what they will pay hospitals for the care that has been delivered.  (In many cases, they do not pay.) Hospitals are altering the way that we do business, but as the State of Maryland attempts to balance their budget, they continue to reduce the rates that hospitals can charge as well as cut programs and services for the poor and disenfranchised.  Balancing the budget on the backs of hospitals has become a convenient approach for Maryland government over the past several years.  We continue to be hit with reductions in revenue to the tune of millions of dollars.  Considering that old adage, "no margin, no mission," hospitals can't continue to be all things to all people.