Page 34 - SFHN March 2018

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A message from our President

Can We All Agree That Gun Violence Is ……………..?

We are overwhelmed by the attention focused on the unfortunate gun violence at 1,061 (almost 62 percent of the total) were either Medicaid or
Parkland’s Marjory Stoneman Douglas High School. The debate rages over who is at fault Self- or Non-Payment. When you look at the numbers for the
and fails to appropriately recognize the fact that, regardless of fault, seventeen younger first half of 2017, they are very consistent across principal
and older adults lost their lives; it is too late to nail this barn door shut, the horses have payer classes.
escaped, people are dead. In terms of charges, the bill for gun-related deaths in 2016
In the discussion about gun violence, where should the healthcare community stand? was a whopping $201,583,798. Of that amount, the charges
Well, let’s take a look and see what the numbers tell us. Using a very innovative software attributable to Medicare were $21,544,786, to Medicaid
program created by Bill Sampsel, HealthScope Innovative Solutions, that analyzes $81,167,263, and to Self- and Non-Pay $45,196,862. The
Florida’s hospital inpatient and emergency department records, I looked at some of the commercial insurance bill was $38,762,452. For the
numbers generated by Florida’s hospitals in their treatment of gun-related injuries. $97,753,929 bill for the first half of 2017, not much has
I will preface this review by saying that this is not a rigorous scientific study, rather, a changed in terms of who is and who isn’t paying for care.
20,000 foot look at the recent cost of gun-related violence from the perspective of Looking closer to home (Miami-Dade, Broward, Palm
Florida’s hospitals. In 2017, there were 1,532 emergency department visits with a pri- Beach), we had 740 gun-related admissions in 2016 and 341
mary code identifying the visit as relating to guns (we did not look at the total listing of in half of 2017. The charges for those admissions were Jaime Caldwell
codes to determine if gun-related codes appear in a secondary or later positions). We also $89,964,228 and $35,032,767 in 2016 and 2017, respec-
did not include any codes that specifically include the word “rifle.” And, also, codes tively. 65.4 percent, or $58,877,690, in 2016 and 61.5 percent, or $21,552,821, in
identifying “nail gun” were also excluded. I do feel safe saying that 1,532 is probably an 2017 were the calculated charges generated to Medicaid and Self- and Non-Pay!
underestimate of the total number in 2017. So, now that we have these numbers, what policy questions might we be able to
These 1,532 patients spent a total of 9,247 hours in the emergency department, ask? For instance, how much could we save in Medicaid if we reduced gun-related
amassed total charges of $14,396,330 (these are just emergency department charges), injuries by, something simple, 10 percent? If charges in 2016 for Medicaid in the tri-
with 930 having government insurance and 297 having commercial insurance. In addi- county area were $44,362,036 and we assume that Medicaid pays about 50 percent
tion, over 75 percent of those treated in the emergency department were between the of the actual cost of care (we can argue about this) then the cost to Medicaid was
ages of 18-64. about $ 22,181,018. Then with savings from less gun-related hospitalizations, you
As inpatients across the state, here is what this group looks like. There were 1,719 have a savings to Medicaid of $2.2 million! Even better, if hospitals can avoid those
inpatients in 2016 and through half of 2017, there were 866. In 2016, 218 patients were admissions, they also avoid the loss they take on the treatment of every Medicaid
Medicare or Medicare Advantage, 579 were Medicaid or Medicaid Managed Care, 308 patient.
had Commercial Insurance, 482 were self-pay or Non-Payment, and the remainder of the Therefore, can we agree above that the answer that the title asks for is, “Not Good
inpatients were spread across other payer sources. So, in 2016, of the 1,719 inpatients, Business?”

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2018 BOARD OF DIRECTORS SFHHA COMMITTEES

CHAIRMAN: David Wagner, Kindred South Florida Market CEO
VICE CHAIRMAN: Mark Doyle, Chief Executive Officer, Memorial Hospital Pembroke
SECRETARY: William "Bill" Duquette, Chief Executive Officer, Homestead Hospital, Baptist Health South Florida Education Committee
TREASURER: Charles Felix, Publisher, South Florida Hospital News and Healthcare Report
IMMEDIATE PAST CHAIR: Chantal Leconte, Chief Executive Officer, Joe DiMaggio Children’s Hospital
AT-LARGE: Ben Riestra, Chief Administrative Officer, UHealth’s Lennar Foundation Medical Center Healthcare Finance and Management Committee
AT-LARGE: Joel Wherley, Chief Operating Officer, VITAS
Doug Bartel, MBA Patricia Greenberg Patrick Taylor, MD
Sr. Director of Business Development, Media President Chief Executive Officer Health Information Technology Committee
and External Relations National Healthcare Associates Holy Cross Hospital
Florida Blue
Ralph A. Marrinson, NHA, FACHA Steven Ullmann Marketing and Public Relations Committee
Wael Barsoum, M.D. President Director
Chief Executive Officer Marrinson Group University of Miami Health Policy
Cleveland Clinic Hospital Management
Lincoln Mendez Membership Committee
Kevin Conn Chief Executive Officer Ana M. Viamonte Ros, M.D.
Regional Vice President of Operations South Miami Hospital Medical Director for Palliative Care
HEALTHSOUTH Corporation and Bioethics Quality and Patient Safety Committee
Charles Michelson Baptist Health South Florida
Darcy Davis Partner
Chief Executive Officer Saltz Michelson Architects Enrique Vicens-Rivera, JD, MHSA
Health Care District of Palm Beach County Chief Executive Officer Safety and Security Committee
Aristides (Ardy) Pallin HEALTHSOUTH Rehabilitation Hospital Miami
Michael Gittelman Chief Operating Officer
Chief Executive Officer Catholic Health Services
Bascom Palmer Eye Institute

34 March 2018 southfloridahospitalnews.com South Florida Hospital News