Carolinas HealthCare System

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1 Overview NC Institute of Medicine March 8, 2006

2 Before CMC

3 CHS was created in 1943 under the Hospital Authorities Act History CHS is authorized to: - Construct and operate healthcare and hospital facilities - Borrow money through issuance of bonds - Secure bonds by a pledge of revenues CHS Board Members are nominated by the Board and appointed by the Chairperson of the Board of Commissioners of Mecklenburg County

4 New 1 Million Hospital 1940

5 The CHS Mission The mission of the is to create and operate a comprehensive system to provide health care and related services, including education and research opportunities, for the benefit of the people it serves.

6

7

8 Facility Group Snapshot Total Licensed Beds Level of care: Acute/ Tertiary 2,903 Specialty 273 Long-term care 1,073 4,249 Financial Reporting: Combined/Obligated Group 1,949 Component Units 917 Managed Facilities 1,383 4,249

9 CHS Size and Scope Graham Cherokee Clay Swain Macon Haywood Jackson Oconee Madison Transylvania Pickens Buncombe Anderson Henderson Greenville Abbeville McDowell Polk Rutherford Ashe Burke Cleveland Cherokee Union Alleghany Wilkes Watauga Mitchell Avery Caldwell Yancey Alexander McCormick Spartanburg Laurens Greenwood Newberry Saluda Catawba Lincoln Gaston York Chester Fairfield Lexington Iredell Mecklenburg Richland Surry Yadkin Davie Rowan Lancaster Cabarrus Union Kershaw Sumter Stokes Forsyth Davidson Stanly Anson Chesterfield Lee Rockingham Guilford Randolph Montgomery Darlington Richmond Florence Marlboro Caswell Orange Alamance Durham Moore Scotland Chatham Dillon Marion Lee Hoke Robeson Person Harnett Granville Vance Wake Cumberland Horry Franklin Johnston Bladen Columbus Sampson Warren Brunswick Nash Wilson Wayne Duplin Halifax Greene Pender New Hanover Lenoir Northampton Edgecombe Pitt Jones Onslow Martin Craven Camden Gates Currituck Pasquotank Hertford Perquimans Chowan Bertie Beaufort Carteret Washington Pamlico Terrell Hyde Dare Edgefield Aiken Calhoun Clarendon Williamsburg Orangeburg Georgetown Barnwell Bamberg Dorchester Berkeley Allendale Hampton Colleton Charleston Service Area Legend Charlotte MSA: Jasper Beaufort Absolute Population Change, 1990 to 2000: 305,805 Absolute Population Change, 2000 to 2010: 332, ,689 Counties with Integrated Hospitals Counties with Physician/Ambulatory Sites

10 CMC Tertiary/Quaternary Volume Inpatient Discharges Tertiary and Quaternary Inpatient Discharges Selected N.C. Hospitals ,000 14,574 14,387 11,588 10,000 9,216 8,504 8,440 5,000 4,061 3,792 3,457 0 CMC Duke University WFU/Baptist Medical Pitt County Memorial UNC Hospitals Presbyterian Hospital NorthEast Medical Frye Regional Gaston Memorial Source: Solucient, Inc. Note: (1) Based on calendar year 2004.

11 CHS- Safety Net System The funding formula used by Mecklenburg County states that each health system s indigent care should be at least 3 percent of net patient revenue (NPR) before it is eligible for any County indigent care funds. $120,000 $105,000 $90,000 $75,000 $60,000 $45,000 $30,000 $15,000 $0 $31,148 $105,757 3% of NPR $13,647 $14, $32 million self-pay and indigent physician charges CHS Novant Threshold for Funding Indigent Care Costs

12 Cannon Research Center Regional Education & Outreach Carolinas College of Health Sciences Division of Education & Research Postgraduate Medical Education Service to Underserved Clinical Practice

13 Carolinas College of Health Sciences A regionally-accredited 2-year college on the campus of CMC. Mission: To meet the nursing and allied health workforce needs of Carolinas HealthCare System and the greater Charlotte area. Enrollment: 450 Management Contracts: o Mercy School of Nursing o Nurse Anesthesia Program (CMC/UNCC)

14 School For- Credit Programs Length Enrollment Grads per yr. CMC-M (MSON) Nursing (Diploma) 1 ½ Yr CRNA Nurse Anesthesia (Masters Degree) Offered by UNCC/CMC 2 ½ Yr CCHS Nursing (Associate Degree) 2 Yr CCHS Radiologic Technology (Associate Degree) 2 Yr CCHS Surgical Technology (Diploma) 1 Yr 12 9 CCHS Medical Technology (Diploma) 1 Yr CCHS Paramedic (Diploma) 1 Yr CCHS Non-Credit Programs: Phlebotomy, Nurse Aide, Health Care Transport, PALS, ACLS, BLS, Instructor Courses.

15 Cannon Research Center Cannon Research Center Opened stories; 58,000 square ft 275 FTEs; 15 PhDs IRB (686 open studies) IACUC (55 open studies) RRC and IBC Focus: Translational research with the goal of moving new technologies into practice. External Funding Expenditures 2005 Mission: To improve the quality and costeffectiveness of health care to patients through Research & Development Research Laboratories General Surgery, Urology Emergency Medicine, Oral Medicine Orthopaedic Biology/Engineering OB/GYN, Internal Medicine Pediatrics, Blumenthal Cancer Ctr Heineman Medical Research Core Laboratories & Admin Offices Clinical Studies: $2,348,410 Federal Revenue: $3,560,584 Consortium Agreement: $ 746,922 Misc. Grant Revenue: $2,023,899 Patents Issued/Pending: 64 Biostatistics, Electron Microscopy Comparative Medicine Molecular Biology Research Microarray Facility Research Administration Grants & Contracts Management Clinical Research Office

16 Regional Education & Outreach Linking Healthcare and Education AHEC Continuing Education Continuing Medical Education (CME) CORPCE (Regional Primary Care Education) Dental Allied Health Diversity/ Spanish Health Careers Leadership Management Mental Health Nursing Public Health Medical Media Services Medical Arts Audio Visual Services Medical Photography Teleconferencing Information Resource Center/ AHEC Medical Library AHEC Digital Library (ADL) Provides print and online resources Literature Searches Document delivery Interlibrary loans Pharmacotherapy Education Ongoing Continuing Education Precept & Educate NC Pharmacy Students UNC Pharmacy Faculty Charlotte AHEC is a division of and is part of the North Carolina Area Health Education System

17 Cannon Research Center Regional Education & Outreach Carolinas College of Health Sciences Division of Education & Research Postgraduate Medical Education Service to Underserved Clinical Practice

18 Faculty & Resident Overview Faculty Physicians Resident Physicians Pediatrics Emer Med Intern Med General Surgery ObGyn Family Med PM&R Orthopedics Dental Vascular/CTS Neurology N=181 N=212 Cap = 187

19 Primary Care Residency Fill Rates: 2005 Specialty Family Practice Internal Medicine Pediatrics Ob-Gyn National Match Results* 41% 56% 74% 67% CMC Match Results* 100% 100% 100% 100% *% positions filled by US Senior students Source: National Resident Matching Program Data: available at

20 Current NC Physicians: Training Location 30% 25% 20% 1 in 4 practicing physicians in NC trained at a major NC teaching hospital CMC trained 11% of these physicians 15% 10% 5% 0% CMC ECU UNC WFU Duke

21 CHS Affiliated Physicians: Training Location 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% MMG/Charlotte Med Clinic CPN CMC All others

22 Service to Underserved Community Sites and Indigent Population Impact

23 CMC Community Clinics CMC Myers Park Internal Medicine OB/Gyn Pediatrics Surgery Orthopaedics CMC NorthPark Family Practice OB/Gyn Teen Health Connection Pediatric After Hours CMC Biddle Point Family Practice Pediatric Dental Clinic CMC Eastland Family Practice CMC Dentistry

24 CMC Community Sites Hispanic/Latino Visit Growth 250, , , ,000 50,000 21% Visit Growth Overall 57% Hispanic Visit Growth Total Visits Hispanic Visits

25 Emerging Trends and Issues Expansion of training programs to other facilities Development of fellowship programs Capacity to substantially expand GME programs (~30%) Organizational preference for new state dollars to support GME

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