San Diego & Imperial Counties Hospitals. Caring for Patients and Communities

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1 San Diego & Imperial Counties Hospitals Caring for Patients and Communities AUGUST 2012 Hospital Association of San Diego and Imperial ADVOCATES Counties FOR ACCESS TO HEALTHCARE FOR ALL CALIFORNIANS 1 P a g e

2 HOSPITALS REPRESENTED BY HOSPITAL ASSOCIATION OF SAN DIEGO AND IMPERIAL COUNTIES (HASD&IC) HASD&IC represents a broad spectrum of hospitals committed to providing quality care and meeting the health needs of our regional community. NOTE: City/County owned hospitals include El Centro Regional Medical Center (City), Edgemoor Hospital DPSNF (County), and Psychiatric Hospital of San Diego (County). SD and IC County Hospitals 3% 3% 3% 6% 1 Children's 1 Hospice 1 Veteran's 40% 14% 6% 8% 2 University 2 Naval 3 City/County Owned 5 District Owned 6 Investor Owned 17% 15 Non-Profit TYPES OF CARE AVAILABLE THROUGH HOSPITALS Hospitals provide several types and levels of care to meet the unique needs of patients. Our region s hospital system of care includes 8 trauma centers*, 21 emergency departments, and 14 certified Stroke Receiving Centers.** Services available through San Diego and Imperial Counties hospitals and health systems include: General acute care Emergency care including trauma services Skilled nursing facilities Inpatient rehabilitation facilities Cancer care General acute care Psychiatric care Alcohol/chemical dependency Long-term acute care Home health and hospice care Hospital-based clinics * (2) San Diego County trauma centers are Level I and (4) are Level II; (2) Imperial County trauma centers are Level IV. **Source: 2 P a g e

3 HOSPITAL ASSOCIATION OF SAN DIEGO AND IMPERIAL COUNTIES MEMBER HOSPITALS GAC = general acute care AP = acute psychiatric SNF = skilled nursing facilities TC = trauma center ED = emergency department Specialty: hospice, alcohol/chemical dependency Alvarado Hospital Medical Center GAC * ED Alvarado Parkway Institute/Behavioral Health System AP Aurora Behavioral Health Care / San Diego AP Bayview Behavioral Health Campus AP Edgemoor Hospital/DPSNF SNF El Centro Regional Medical Center GAC * ED Fallbrook Hospital GAC * ED Kaiser Permanente San Diego GAC * ED Kindred Hospital San Diego GAC Naval Hospital Camp Pendleton GAC Naval Medical Center San Diego GAC * ED Palomar Medical Center GAC * TC * ED Paradise Valley Hospital GAC * ED Pioneers Memorial Healthcare District GAC * ED Pomerado Hospital GAC * ED Promise Hospital of San Diego GAC Rady Children's Hospital San Diego GAC * TC * ED San Diego County Psychiatric Hospital AP San Diego Hospice and The Institute for Palliative Medicine hospice Scripps Green Hospital GAC Scripps Memorial Hospital Encinitas GAC * ED Scripps Memorial Hospital La Jolla GAC * TC * ED Scripps Mercy Hospital GAC * TC * ED Scripps Mercy Hospital Chula Vista GAC * ED Sharp Chula Vista Medical Center GAC * ED Sharp Coronado Hospital and Healthcare Center GAC * ED Sharp Grossmont Hospital GAC * ED Sharp Mary Birch Hospital for Women & Newborns GAC Sharp McDonald Center alcohol/chemical dependency Sharp Memorial Hospital GAC * TC * ED Sharp Mesa Vista Hospital AP Tri-City Medical Center GAC * ED UC San Diego Medical Center GAC * TC * ED UC San Diego Thornton Hospital GAC * ED VA San Diego Healthcare System GAC Vibra Hospital of San Diego GAC 3 P a g e

4 SAN DIEGO COUNTY HOSPITALS BY THE NUMBERS, Inpatient Licensed Beds 7,605 Admissions 332,949 Patient Days 1,671,233 Occupancy Rate 65.1% Surgeries 73,259 Births 37,359 Hospital Discharges 300,694 Outpatient Emergency Visits 663,514 Surgeries 98,508 Births (Alternate Birthing Centers) 4,441 Medical Evaluations 6,695,274 Lab Tests 2,983,115 Radiology Visits 2,447,502 Trauma Centers EMS Visits Level I 83,248 Level II 239,533 IMPERIAL COUNTY HOSPITALS BY THE NUMBERS, Inpatient Licensed Beds 272 Admissions 15,993 Patient Days 47,864 Occupancy Rate 43.3% Surgeries 3,190 Births 3,106 Hospital Discharges 14,178 Outpatient Emergency Visits 78,704 Surgeries 6,017 Visits 240,562 Lab Tests 450,549 Radiology Visits 71,997 Trauma Centers EMS Visits Level IV 91,154 Source: California Healthcare Foundation; OSHPD Hospital Annual Utilization Data and Hospital Annual Financial Data, 2010; California Hospital Association Summary Report. 4 P a g e

5 JOB CREATION & ECONOMIC DEVELOPMENT IN SAN DIEGO COUNTY HOSPITALS Beyond providing vital health care services to their communities, hospitals are fueling our local economy with high paying jobs, large construction projects, and the purchase of large amounts of goods and services. 140 Total Healthcare & Social Services Employment in San Diego County (in thousands) (f) (f) *(f) = Forecast Source: The Kyser Center for Economic Research, Economic Forecast and Industry Outlook: TOP EMPLOYING HOSPITALS & HEALTH SYSTEMS Hospitals in San Diego and Imperial Counties directly employ 36,336 full-time workers (9% of California hospital total) with a wage and benefits package totaling over $3 billion dollars (8% of California hospital total).* The following hospitals are in the top (50) list of largest employers in San Diego County, based on their reporting of all local hospital employees.** Organization Total Employees % of Top 50 Employers Sharp HealthCare 14, % Scripps Health 13, % Kaiser Foundation Hospital, San Diego 8, % UC San Diego Medical Center 5, % Rady Children s Hospital - San Diego 4, % Palomar Health 3, % VA San Diego Healthcare System 3, % Tri-City Medical Center 2, % Alvarado Hospital Medical Center 1, % Top Hospitals & Health Systems Subtotal 58, % All other companies in the Top , % *Source: OSHPD Financial Data, **Source: San Diego Business Journal, 2012 Book of Lists Largest Employers (2010 data) 5 P a g e

6 JOBS BY INDUSTRY SECTOR San Diego County % Administrative Services 18.6% All Others 18.6% 10.4% Construction Government Health Care Services 6.1% 10.8% 10.0% 7.6% 13.2% Hospitality Manufacturing Professional Services Retail Trade Source: Economic Forecast and Industry Outlook, Los Angeles Economic Development Corporation. HOSPITALS & HEALTH SYSTEMS JOBS BY CATEGORY San Diego County % 7.7% 7.4% Management Technical Registered Nurse 15.0% 6.2% 25.6% Licensed Vocational Nurse Aides & Orderlies Clerical Staff 1.7% 31.6% Enviromental and Food Service All Others Source: OSHPD Annual Hospital Financial Disclosure Reporting, , Hours by Job Natural Classification (OSHPD data excludes Kaiser Permanente). 6 P a g e

7 HOSPITALS & HEALTH SYSTEMS JOBS BY VOCATION 0.2% San Diego County % 25.6% Physicians and Surgeons Physician Assistant Respiratory Care Practitioner 56.7% 1.3% 3.3% Registered Nurse Vocational Nurse Psychiatric Technician Source: Supply of Healthcare Providers by Geographical Area, OSHPD: HOSPITALS & HEALTH SYSTEMS AVERAGE WAGE TREND The average wage and salary for the hospital and health system industry in San Diego County is higher than the average of all other industries by nearly 30%. $70,000 $65,000 $60,000 $55,000 $50,000 $45,000 $40,000 San Diego County Average Annual Salary, Hospitals & Health Systems $64,923 $48,699 All Industries $50,200 $44, Source: OSHPD Annual Hospital Financial Reporting (data excludes Kaiser Permanente); US Bureau of Labor Statistics CPI, OES Occupational Wage Estimates. 7 P a g e

8 CURRENT SUPPLY OF PHYSICIANS AND SURGEONS BY PRIMARY PRACTICE, 2012 California is facing a critical shortage of physicians at a time when the demand for their services is anticipated to grow as the population ages and coverage expands under health care reform. Cuts to Medicare payments for medical education included in several federal deficit-reduction proposals would only exacerbate the shortage. California s ban on the corporate practice of medicine, an obsolete law that denies physicians the right to choose where and how they care for patients, presents an additional challenge in meeting patients needs. HASD&IC supports changing this law to give physicians the option to be employed by hospitals. SAN DIEGO COUNTY 10,190 IMPERIAL COUNTY 138 Source: California Department of Consumer Affairs, Medical Board of California Public Master File, May 2012 (data set only includes physicians and surgeons licensed by the Medical Board of California). 8 P a g e

9 MAJOR HOSPITAL & HEALTH SYSTEM IMPROVEMENT PROJECTS San Diego County, 2011 Imperial County, remodeling and renovation projects 7 emergency system upgrades 5 medical technology upgrades 3 fire alarm upgrades 3 nurse call system upgrades 3 new facilities 1 sustainable energy project 1 conversion of SNF to psychiatric hospital 1 new project to build a freestanding SNF 3 remodeling & renovation projects 1 staff system upgrade 1 medical technology upgrade Source: OSHPD County-Wide Project Status Report, 2011 HOSPITALS & HEALTH SYSTEMS CONSTRUCTION-IN-PROGRESS, 10-YEAR TREND $1,000 $900 $800 $700 $600 $500 $400 $300 $200 $100 $0 San Diego County by Total Projects Costs (Cost in Millions) Imperial County by Total Projects Costs $2,000,000 $1,800, $1,600, $1,400,000 $1,200, $1,000,000 $800, K $600, K $400, K 124K $200,000 10K 15K $0 Source: OSHPD County-wide Project Status Report, P a g e

10 HOSPITALS & HEALTH SYSTEMS THE COST OF CARE Medicare and Medicaid Payments are Vital to Preserve Access to Care California hospitals continue to face challenges due to payment shortfalls; shortages in key areas of the workforce; unfunded state mandates; an increasing regulatory burden; and the continued escalation of technology costs, including health information technology. With Medicare and Medicaid payments not fully covering the cost of care, hospitals are concerned about the future sustainability of services required by an American public that is aging and experiencing a higher rate of chronic disease. An increased demand for services is also expected as more individuals obtain health insurance and seek access to care as a result of health care reform. Total Uncompensated Cost of Providing Care in San Diego and Imperial Counties in 2010: Over $828 million dollars $0 Medicare Shortfall Medi-Cal Shortfall Charity Care & Bad Debt ($378,308,620) ($163,617,916) ($287,051,116) Source: OSHPD Annual Financial Data, 2010 calendar year. 10 P a g e

11 NATIONAL OUTLOOK FOR HEALTH CARE SPENDING National spending on health care is expected to increase over the next 8 years, reflecting significant spending growth across all areas of the health care sector. $5,000 $4,500 $4,000 $3,500 $3,000 $2,500 $2,000 $1,500 $1,000 $500 $0 Health Care Spending (Dollars in Billions) 1,410 1,320 1,239 1,173 1,111 1, , ,098 1, ,037 1,102 1,172 1,245 1,330 1,424 Hospital Care Professional Services Medical Products All Others Source: Centers for Medicare and Medicaid Services, Office of the Actuary: Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/downloads/proj2010.pdf. Note: Professional Services = physician and clinical services, other professional services, dental services; Medical Products = retail outlet sales of medical products such as prescription drugs, durable medical equipment, and other non-durable medical products; All Others = other health, residential, and personal care (excludes personal care and professional services), home health care, nursing care facilities and continuing care retirement communities, government administration, net cost of private health insurance, government public health activities, and investment (includes research and structures & equipment). Hospital Association of San Diego and Imperial Counties 5575 Ruffin Road, Suite 225 San Diego, CA Tel: Advancing Patient Safety and Quality throughout California 11 P a g e