A new report says the New Orleans region might be able to support an even larger teaching hospital than the 484-bed facility suggested by a state consultant, and that a $1.2 billion cost estimate for the proposed hospital might be low. The ultimate success of the venture, however, will largely depend on the ability of Louisiana State University to transform from a charity operation that serves mainly the indigent into an academic medical center focused on high-end specialty care. The report, commissioned by the Downtown Development District, said it remains an open question whether LSU can make that transition.