Under proposed rules set down by the federal government for accountable care organizations, providers won't know who their patients are until they're through the first year of the new care delivery model. In addition, those anonymous ACO patients may seek healthcare anywhere they want. If they run up a healthcare bill somewhere else, their ACO is still responsible for the cost.
And those downside risks could be considerable when ACOs enter the "two-sided model" in their third year of operations. A report from PricewaterhouseCoopers shows that two-sided ACOs with 5,000 beneficiaries could earn as much as $1.3 million for generating savings of 5%, but could also be penalized $420,000 for cost increases of 5%. For ACOs with 60,000 beneficiaries, that incentive payment for 5% savings would be around $15.6 million, while the penalty for a 5% increase in costs would be $5 million.
With those kinds of numbers in play, some healthcare executives are openly skeptical about the benefits of joining a highly complex, untested, and potentially punitive healthcare model that prevents them from controlling – or even identifying – their patients.
"I think they are going to have to modify the rules. That's what we're hoping for," Dan Wolterman, president/CEO of Houston-based Memorial Hermann Healthcare System, told HealthLeaders Media. "Most entities out there in the U.S. are not a Mayo Clinic or Geisinger (Health System), where you have large groups and hospitals integrated for years. Most of them are like us, community hospitals, teaching hospitals, dealing with a lot of private practice physicians trying to move this thing forward."
Wolterman calls the proposed retrospective assignment of ACO beneficiaries "a difficult sell" that could discourage many providers from taking up the new model. "First and foremost they have to assign the Medicare beneficiaries ahead of time. You have to know who your patients are to be able to work with them to modify their lifestyle and manage their chronic diseases, and navigate that patient through the complex healthcare system," he said.
Wolterman says he was told that the federal government doesn't want to identify ACO beneficiaries ahead of time, because they don't want providers to skimp on care to keep costs down, a justification that he says doesn't hold water. "The whole concept that they aren't going to assign them to us because we are going to skimp on care -- that just says you don't trust the system," he says. "I don't believe that skimping will happen. You have these people for three years. If you skimp in the first or second year on a hypertensive patient they may come back with a stroke or a (myocardial infarction)and cost a lot more the third year."
Benjamin Isgur, director of PwC's Health Research Institute, told HealthLeaders Media that Wolterman and other healthcare executives are raising legitimate concerns. "That's why we're saying don't underestimate the infrastructure that is going to be required for a successful ACO model," he says. "If you look at the rules, if you aren't already a fairly integrated organization, there are some pretty daunting things there. You have to have EMR working well so you can analyze the data. You are going to have to meet more quality requirements than any other CMS program. You have to manage a population that might be difficult to manage because you might not know exactly who is in your ACO until after the first full year. There are a lot of infrastructure and sophistication issues that organizations should not underestimate."
Isgur identified several "huge barriers" for many fledgling ACOs. In addition to not knowing who their beneficiaries are until after the first year, ACOs also are not closed networks, and beneficiaries are free to seek treatment wherever they'd like. When beneficiaries get care out of network, that accrued cost is assigned to the ACO, even though they didn't provide the care, and probably had no say in the decision making. "You wake up one morning and a significant portion of your population is in Florida for the winter," he says. "When you are dealing with a Medicare population, especially in the upper incomes, you are dealing with a retiree population that may be living in more than one geographic place in one year."
Finally, Isgur says, demonstration projects have shown that Medicare beneficiary populations have significant "churn" -- about 25% turnover each year, further straining an ACO's ability to control costs.
Isgur says he would not be surprised to see "substantial changes" to the final ACO rules after the comment period ends on June 6. "Most people looking at these draft rules believe there are going to be at least some attempt to alleviate some of the burden," he says. "To be frank, there is negativity in the market place. When these were released, there were 500 pages of rules a lot of organizations threw up their hands and said 'we aren't ready to tackle this.' The government is going to have to revisit these and we can expect to see some change."
Because the federal government is pushing patient choice, Isgur says any change in the rules to help ACOs would more likely involve "a more prospective understanding of the beneficiary population so you can have more accuracy in beginning to manage that population off the bat." That could include some contingencies for ACOs whose patients get a certain percentage of care from outside the service area, perhaps not accruing those costs toward the ACOs average costs.
Wolterman says that even though the risk is capped in the two-sided model, healthcare providers are still on the hook for significant costs. "And the ability to collect that money from private physicians -- and they are proposing to do that with a 25% withhold off their current fee for service -- that is a pretty hard sell to doctors," he says. "Hopefully, they will come out with some more well thought out final regulations this summer. Right now there is a lot of pause out there. We may be willing to take the risk and use it as a three-year teaching demonstration project for our doctors and our system, or we may not if our doctors aren't happy with the terms."
If the federal government wants to grow the ACO model, Wolterman says it will have to return the concept to a shared savings program for all three years and reconfigure other financial incentives and risks. "Those who are far enough along and want to go at risk for three years, fine, let them. I have no problem with that. But allow the rest of America to use this as an opportunity to begin the change of working with their doctors. That is what this was supposed to be," he says.
The ability of patients in accountable care organizations to restrict access to their personal health information is one of several hurdles that could hinder the success of the new healthcare delivery models, the College of Healthcare Information Management Executives said this week.
In a letter Tuesday to Donald Berwick, MD, administrator of the Centers for Medicare & Medicaid Services, CHIME called for a re-examination of several sections of the proposed rules that it said would create significant pressures on ACOs.
“If beneficiary claims data are withheld, the ACO’s ability to improve individual beneficiary health, as well as achieve the desired shared savings, could be compromised,” CHIME said in the letter, its public comments on the Notice of Proposed Rulemaking for governing ACOs.
“We believe that allowing ACO patients to opt out of data sharing, while maintaining their ability to see the primary care physician participating in an ACO, contraindicates efforts to provide accountable care.”
CHIME told CMS that patients who want to opt out of sharing claims data should be required to see a primary care physician not affiliated with an ACO, or that healthcare expenditures for these patients should not be counted against an ACO under shared savings payments.
“Technology will no doubt play a prominent role in the success of any ACO. The amount of data and information exchange between ACO participants will be enormous,” Bill Spooner, senior vice president/CIO at San Diego-based Sharp HealthCare, said in a CHIME media release. “But as the person responsible for lining up those data points, CIOs are really worried about patient data opt-out provisions. We think the simplest answer is to remove patients from ACO participation if they refuse to share their data.”
CHIME, in its comments to CMS, also objected to a requirement that 50% of an ACO’s primary care physicians meet all meaningful use standards for electronic health records by the beginning of the second year of the ACO’s agreement with CMS. “From both patient management and business perspectives, CHIME feels it would not be necessary for an ACO’s PCPs to meet all MU requirements. Similarly, CHIME sees no need for CMS to specify some minimum level of EHR MU performance for the hospitals participating in an ACO,” CHIME said.
Pam McNutt, senior vice president/CIO of Methodist Health System in Dallas, and chair of CHIME’s Policy Steering Committee, said concerns raised in the letter to Berwick “speak to the complex technical implications of CMS’s Shared Savings Program. As hospitals look to participate, they will depend on CIOs to understand how ACOs meet the data collection and reporting requirements. We urged CMS in our comments to avoid prescribing technology, such as requiring meaningful use, instead allowing ACOs to make determinations based off their business needs and patient populations.”
CHIME also asked CMS to:
Reconsider the proposed use of 65 performance measures in the first year of the ACO program. “CHIME also believes that CMS is underestimating the difficulty of the proposed data validation process,” the letter to CMS said.
Align performance measures across similar or related programs and outline a more consistent approach for measuring quality improvement for other programs that overlap. David Muntz, senior vice president/CIO at Dallas-based Baylor Health Care System and chair of CHIME’s Advocacy Leadership Team, said that healthcare organizations want to develop and monitor “the right performance measures” to improve healthcare delivery, “but some of the proposed performance measures for ACOs seem to be duplicative or unrelated to broader ACO tenets.”
Scale back expectations for health information exchange to give healthcare organizations more time to gain experience with the use of exchanged patient data in care delivery. “These proposed regulations portend a level of functional health information exchange and technology adoption that may be too aggressive for deployments in January 2012 and not yet ready for effective deployment,” CHIME said in its comments to CMS. “We believe this issue could be better handled by allowing ACOs to determine their own technology needs, given their market and their patient population.”
The letter was signed by CHIME CEO/President Richard A. Correll, and CHIME Board Chairman Lynn Vogel, MD, who is also vice president/CIO at the University of Texas, M.D. Anderson Cancer Center.
Because the U.S. population is aging, gaining weight, and thus requiring more healthcare services, conventional wisdom has it that the demand for healthcare workers will remain strong. To an extent, that has been true.
In April, for example, for the second consecutive month, job growth in the healthcare sector showed impressive gains, Bureau of Labor Statistics preliminary data shows. Healthcare sector consistently has been one of the few job-creating sectors in the recovery. And, The Conference Board monthly review of online job postings consistently shows that there are three jobs available for every skilled healthcare provider.
What's puzzling, though, is another report from The Conference Board this month which shows that post-recession job growth in the healthcare sector today is the slowest it's been during an economic recovery since 1960.
Healthcare sector job growth was 6.9% in the months after the recession of 1991, and 4.5% following the 2001 recession, but only 3.5% in the 21 months since the recession ended in June, 2009, The Conference Board research shows.
What's going on?
"If you look at the 21 months since the recession, the recovery in healthcare jobs is the weakest among all recoveries in healthcare jobs," Gad Levanon, associate director of macroeconomic research at The Conference Board, tells HealthLeaders Media. "It's one of the fastest growing industries, but it is always one of the fastest growing industries. But in relative terms healthcare is recovering more slowly than in any other recovery."
"It's a mystery to me," Lavanon says. "You would think that as the U.S. population is getting older the demand for healthcare services is going to get stronger as well. What we see is that in this decade, the increase in the number of healthcare workers is much slower.
"In many cases, the explanation could be outsourcing or productivity growth, but I don't think that is a good explanation for healthcare, where things can't be outsourced and it is labor intensive," Lavanon says.
Is the healthcare sector -- which already employs more than 14 million people -- becoming more efficient and productive, and thus not in need of as many workers? Or, is job growth slowing because there aren't enough people to fill the positions? Or, is job growth slowing because the healthcare sector can't afford to add to the labor force, nor can consumers continue to support that added cost? I suspect that the answer involves all three questions.
Slow job growth does have its upsides. It would appear that this halving of the rate of job growth in the healthcare sector has slowed the growth of healthcare inflation, at least in the short-term. Labor costs constitute about 60% to 70% of the budgets at many healthcare organizations.
As I reported a couple of weeks ago, Standard & Poor's Healthcare Economic Indices shows that the average per capita cost of healthcare services covered by commercial insurance and Medicare grew 6.19% over the 12 months ending in February. (The Consumer Price Index showed that overall inflation grew by 2.1% for the same period.)
That's high -- unsustainable, actually -- but the rate of growth in healthcare inflation has been steadily decelerating since it hit a high water mark of 8.74% for the 12-month period ending May 2010. S&P analysts have noted that hospital employment growth has correspondingly slowed significantly, falling from 2%-3% increases between 2008 and early 2009, to 1% since the middle of 2009. S&P analysts believe that slowing rate of inflation in healthcare is also tied to high unemployment in the overall economy, but they also warn that the slowing trend could quickly reverse.
So what's next? If we accept that labor costs are the biggest driver in healthcare inflation, does that mean that healthcare employment growth will slow even more? Will healthcare workers be expected to do more, with less help? Can healthcare workers expect to see their salaries and other compensation stagnate, as it has in most other sectors of the economy?
Once again, I suspect the answer lies in the questions. We're already seeing compensation costs decline for healthcare workers, a trend that has been around for the last 20 years or so, and hospital layoffs have become a daily event.
It's worth remember, however, that the healthcare sector grew 466,400 jobs in the 21 months since the recession ended, as the entire economy -- including healthcare -- grew 1.3 million jobs. Since June 2009, the financial, construction, and state and local government sectors lost 1.1 million jobs.
So, healthcare sector job growth is at record low levels in a post-recession recovery, but it is still growth.
Grossman Burn Center said it will open a burn center at St. Luke’s Medical Center in Phoenix this summer. It’s the fifth such center for West Hills, CA-based GBC, and its second outside California, GBC said in a media release.
“As both population and demand for additional burn care resources in Arizona continue to grow, there is a demonstrated need for another burn unit in the metropolitan Phoenix area,” GBC medical director Peter H. Grossman, MD, said in a media release. “We believe, based on our experience in Southern California where there are no fewer than eight operating burn centers, that we can address that need by complementing the existing burn center in Phoenix which is currently the only burn center in the state of Arizona.”
GBC will provide acute and reconstructive burn care, rehabilitation, and post-treatment emotional and psychological support. The collaborative center will be managed on a day-to-day basis by physicians on the medical staff at St. Luke’s Medical Center trained in restorative burn care.
“Partnering with the Grossman Burn Center gives St. Luke’s the unique opportunity to expand access to exceptional burn care in Arizona,” St. Luke’s Medical Center CEO Ed Myers in the media release. “We look forward to collaborating with GBC and with local fire departments, as well as community physicians and organizations, to bring additional burn care treatment and prevention education resources to our community.”
GBC is the largest plastic surgery-based burn practice in the western United States, and has had partnerships with IASIS Healthcare, Adventist Health, the Franciscan Missionaries of Our Lady Health System, HCA, and Integrated Healthcare Holdings, Inc. In addition to the agreement with St. Luke’s Medical Center, the GBC said it is also in talks to open a burn center in Texas.
For the second consecutive month, job growth in the healthcare sector showed impressive gains, Bureau of Labor Statistics preliminary data show.
Hospitals created 10,100 new jobs in April, after posting 10,200 new jobs in March. So far in 2011, hospitals have created 31,500 new jobs, compared with 8,900 new jobs in the first four months of 2010, BLS data and preliminary data show.
The healthcare sector – everything from hospitals to podiatrists' offices to kidney dialysis centers – created 37,290 new jobs in April, after posting 34,400 new jobs in March, and 112,100 new jobs in 2011. Healthcare created 80,500 new jobs in the first four months of 2010, BLS preliminary data and preliminary show.
Healthcare sector employment nudged over the 14 million jobs threshold in April, with more than 4.7 million jobs at hospitals, more than 6.1 million jobs in ambulatory services, and more than 2.3 million in physicians’ offices, BLS preliminary data show.
Ambulatory services accounted for more than half of the new jobs created in the healthcare sector in 2011, with 21,500 new jobs in April, and 59,800 new jobs in the last four months. Ambulatory services created more than 57,000 new jobs in the first four months of 2010, BLS data and preliminary data show.
Physicians' offices reported another strong month of job growth, with 6,600 new payroll additions reported in April, after posting 8,700 new jobs in March, and 31,500 new jobs in 2011. That compares with 8,900 new jobs in the first four months of 2010.
BLS data from March and April are preliminary and may be considerably revised in the coming months.
The healthcare sector continues to be one of the few areas of job growth in the sputtering economy. Since the start of the recession in December 2007, healthcare employment has grown by 931,000 jobs, while total nonfarm employment has fallen by about 7.2 million, BLS data show.
The larger U.S. economy gained 244,000 jobs in April but the nation's jobless rate edged up to 9%, up from 8.8% in March, with 13.7 million people unemployed. The number of long-term unemployed -- people jobless for 27 weeks or longer – was 5.8 million in April, a decrease of 280,000 from March, and their ranks decreased from 43.9% to 43.4% of the unemployed, BLS preliminary data show.
Health Management Associates, Inc., the University of Florida, and Shands HealthCare on Thursday jointly announced an alliance that they said will improve cardiac and stroke emergency services at three regional hospitals in central Florida.
The alliance brings the UF physicians, resources, and protocols to HMA's regional hospitals through the Heart and Stroke Emergency Specialists program. It will provide teleconferencing consultations between physicians, continuing education, and other hands-on exchanges. And patients requiring tertiary care will be transferred to Shands at UF, an academic medical center in Gainesville, FL, a media release said.
"By teaming up with UF and Shands, we further our mission to enable America's best local healthcare," Gary D. Newsome, president/CEO of Naples, FL-based HMA said in a statement. "We do this by providing the people, processes, capital and expertise necessary for our hospital and physician partners to fulfill their local missions of delivering superior healthcare services. The Heart and Stroke Emergency Specialists program will result in even better care, and an even better overall experience for our patients."
"We have been looking to extend our programs beyond Gainesville, and all three Health Management hospitals are highly-ranked facilities with accredited chest pain and/or certified primary stroke centers," said Tim Goldfarb, CEO of Shands HealthCare. "For us, it means working with a larger network of doctors on the front lines of Citrus and Hernando counties. For the regional hospitals it means quick access to our doctors and resources if they need us."
More than three of four hospitals in the National Hospital Preparedness Program met 90% or more of measures for all-hazards preparedness in 2009, according to a report from the U.S. Department of Health and Human Services.
All states, eight U.S. territories and four large metropolitan areas participate in the cooperative agreement grant program, which provides federal funds, technical assistance, and guidelines for hospital preparedness. Of the more than 6,300 hospitals across the nation, more than 85% use the program, HHS says.
Hospitals meeting preparedness performance measures have dedicated redundant, interoperable systems to communicate between hospitals, public health agencies and emergency managers. These hospitals can report the number of available beds to a state, territory or city emergency operations center within 60 minutes of a request during a disaster.
These hospitals also have plans to handle a surge in demand for hospital services during a disaster, as well as plans for hospital evacuation, sheltering patients and staff in place during a disaster, and to respond to mass fatalities, HHS said.
Hospitals meeting program measures demonstrate their response capability during emergency exercises, including statewide or regional exercises, or actual incidents. The hospitals develop improvement plans based on after-action reports from these events. During a disaster, they use the incident command system, and have adopted the National Incident Management System through the hospital organization. These systems standardize response terminology and command-and-control structure across the emergency response, HHS said.
To meet some of these performance measures and enhance the response capability, states, territories, cities, and participating hospitals also use HPP funding to purchase emergency equipment, such as mobile medical units to bring medical care to survivors during disaster response and back-up generators to keep participating hospitals running when power is otherwise unavailable, HHS said.
The report suggests that hospitals focus on building coalitions within communities so that hospitals, government agencies, nongovernment organizations, businesses, and community residents work as a team to prepare for disasters. The report recommends that the coalitions involve all populations within communities, including children, pregnant women, the elderly, and other vulnerable people, HHS said.
In July 2010, states, territories, and large metropolitan areas received HPP grants totaling $390.5 million to help hospitals and other healthcare organizations strengthen the medical surge capability across the nation. HPP funding focuses on enhancing planning, increasing integration between public and private sector medical planning and assets, and improving infrastructure, HHS said.
HHS established the program in 2002 as the National Bioterrorism Hospital Preparedness Program to enhance hospitals' ability to respond to a biological attack by increasing stockpiles of equipment, supplies, and pharmaceuticals that would not have been purchased by financially strained institutions without the program. Since that time, the program evolved to support preparedness for all hazards, HHS said.
Two South Florida companies entered guilty pleas this week in a Miami federal court for what prosecutors called a "staggering in scope" fraud scheme that falsely billed Medicare for more than $200 million and collected $80 million of the bogus claims, the Departments of Justice and Health and Human Services announced in a joint statement.
The companies were identified as American Therapeutic Corp., the Miami-based operators of seven partial hospitalization programs for the severely mentally ill in South Florida, and Medlink Professional Management Group Inc., which was described by prosecutors as a shell company that abetted ATC's efforts to hide its ill-gained profits, federal prosecutors said.
"The fraud scheme was staggering in scope, and those who concocted the scheme exhibited a complete disregard for the elderly, infirm, and disabled victims who were used to commit it," Assistant Attorney General Lanny A. Breuer of the Justice Department's Criminal Division said in a statement. "These guilty pleas mark an important step forward in our effort to hold accountable everyone -- and every entity -- involved in the scheme, and to recover the maximum amount possible on behalf of American taxpayers."
ATC and Medlink were each charged with conspiracy to commit healthcare fraud in an indictment unsealed on Feb. 15. ATC was also charged with healthcare fraud and conspiracy to defraud the federal government, and to pay and receive illegal healthcare kickbacks, federal prosecutors said.
"The defendants altered patient files, diagnoses, and medication types and levels to make it appear that patients being treated qualified for PHP treatments," said U.S. Attorney Wifredo Ferrer for the Southern District of Florida, in a media release. "This was done so that the defendants could fraudulently bill Medicare for more than $200 million in medically unnecessary services. We are pleased to have put these unscrupulous operators out of business."
ATC President Marianella Valera, and Medlink President Lawrence S. Duran pleaded on behalf of the two corporations before a federal magistrate judge in Miami on Tuesday. On April 14, Valera and Duran each pleaded guilty individually to dozens of felony counts, including conspiracy to commit healthcare fraud, healthcare fraud, conspiracy to pay and receive illegal healthcare kickbacks, conspiracy to commit money laundering, money laundering and structuring to avoid reporting requirements, federal prosecutors said.
With this week's plea, Duran and Valera admitted that their companies together, and with other coconspirators defrauded Medicare beginning in 2002 and until their arrest in October 2010. Duran and Valera also admitted that they used American Sleep Institute, identified as another shell company, to submit fraudulent Medicare claims, federal prosecutors said.
Duran, Valera and their coconspirators falsely altered patient files and therapist notes to make it appear that ATC patients qualified for PHP treatments. Duran and Valera also told employees and doctors to alter diagnoses and medication types and levels to make it falsely appear that ATC patients qualified for PHP services, federal prosecutor said.
Duran, Valera and others paid kickbacks to owners and operators of assisted living facilities and halfway houses, and to patient brokers in exchange for delivering ineligible patients to ATC and ASI. Some patients were paid kickbacks.
Duran, Valera and their coconspirators used Medlink to hide the fraud and kickbacks from Medicare and law enforcement. Once Medicare paid ATC and ASI for the bogus services, Duran, Valera, and others transferred millions of dollars to Medlink. Duran and Valera used Medlink to distribute those millions of dollars to shell corporations and people to launder the money into cash to pay kickbacks.
Sentencing for the two corporations is scheduled for July 13. Both corporations, which have been out of business since the arrests of their owners in October 2010, face financial penalties of more than $80 million, the amount paid by Medicare from the scheme. The corporations' assets were frozen in October 2010 through civil forfeitures.
Coconspirator Margarita Acevedo, also charged in the February 2011 superseding indictment, pleaded guilty on April 7. A fourth person charged in the indictment, Judith Negron, will be tried on Aug. 1.
Online job ads for healthcare practitioners, technical workers, and support staff fell off sharply in April, but there were still nearly three jobs available for every highly skilled healthcare professional looking for work, according to The Conference Board Help Wanted Onlinereport.
Labor demand for healthcare practitioners and technical occupations fell by 28,600 listings in April to 568,500. Healthcare support positions fell by 11,400 new listings to 129,100 in April, The Conference Board reports.
The board's Help Wanted Online Data Series tracks more than 1,000 online job boards across the United States.
Online job listings in healthcare continue to yo-yo from month to month. In March, healthcare practitioners and technical occupations grew by 3,700, and healthcare support positions posted 4,400 new listings, with the primary demand coming for physical therapist assistants, home health aides, nursing aides, and medical assistants.
In January, The Conference Board reported 78,500 new listings for healthcare practitioners and technicians, and 16,600 new ads for healthcare support jobs, as healthcare jobs led a strong first month of 2011. However, February saw online job ads for practitioners and technical occupations drop by 4,300 owing largely to decreases in advertised vacancies for registered nurses and occupational and physical therapists, while support positions posted a decrease of 4,200.
Even with April's decline in on-line job listings, there were nearly three jobs for every healthcare technician and practitioner job seeker, with the average salary of $33.51 an hour. Conversely, there were 1.7 healthcare support workers for every online job listing, with pay averaging $12.84 an hour, The Conference Board reports.
In the overall economy, online advertised vacancies fell 123,800 to slightly more than 4.3 million. "Labor demand has risen to levels we last saw just before the official start of the recession four years ago," said June Shelp, vice president at The Conference Board, in a media release. "At the same time, the number of unemployed has doubled and now stands at 13.5 million, and some professions have clearly fared better than others in job opportunities. At this stage, there are occupations where the supply/demand rate has fallen significantly and there are two or less unemployed for every advertised vacancy. However, other occupations are still experiencing relatively high supply/demand rates above 4.0, reflecting the fact that there are over four unemployed for every advertised vacancy."
HCA on Monday announced that it has finalized its previously announced purchase of Mercy Hospital in Miami. Financial terms of the sale were not disclosed.
Mercy is now a campus of Plantation General Hospital, an HCA affiliate in Plantation, FL, and has been renamed Mercy Hospital – A campus of Plantation General Hospital. The 473-bed hospital will continue to serve as a Catholic acute care hospital, owned and operated by HCA and will continue to operate under the Ethical and Religious Directives for Catholic Health Care Services, HCA said in a media release.
"The addition of Mercy strengthens our presence in South Florida, enhancing our ability to meet this area's healthcare needs," Michael G. Joseph, president of HCA's East Florida Division said in a prepared statement. "The hospital has a long tradition of providing quality patient care, and we welcome Mercy to the HCA East Florida family."
With the addition of Mercy, HCA's East Florida Division now includes 13 hospitals, 12 outpatient surgery centers, an integrated regional laboratory and numerous imaging facilities, physician practices and medical education and training programs serving South Florida and the Treasure Coast, HCA said.
