Hospitals recognized for high-quality cardiac care are more likely to be penalized under value-based programs than other hospitals.
No good work goes unpunished.
Hospitals that are recognized for high-quality cardiac care are also more likely to be penalized under value-based payment models, according to a new study inJAMA Cardiology.
Researchers at Beth Israel Deaconess Medical Center in Boston found that hospitals awarded by the American Heart Association and American College of Cardiology for their high-quality care for acute myocardial infarction and heart failure were more likely to be financially penalized under value-based programs than other hospitals.
"Our findings highlight that evaluations of hospital quality for acute myocardial infarction and heart failure care differ between AHA/ACC national quality improvement initiatives and federal value-based programs," said study lead author Rishi Wadhera, MD, an investigator at BIDMC's Smith Center for Outcomes Research.
"Hospitals recognized by the AHA/ACC for high quality care were more likely to be financially penalized by federal value-based programs than other hospitals, despite achieving similar and/or better outcomes," Wadhera said.
The findings show that federal incentives are not aligned with prevailing medical consensus on what constitutes appropriate cardiovascular care.
The Hospital Readmissions Reduction Program slaps financial penalties on hospitals with high 30-day readmission rates, while the Hospital Value-Based Purchasing Program rewards or penalizes hospitals based on their performance on multiple domains of care, including 30-day mortality.
Both programs have focused on heart failure and AMI because their clinical and financial burden.
The BIDMC researchers looked at some award-winning hospitals and found they were also more to be penalized by the HRRP and VBP compared with other hospitals. The award hospitals were also less likely to see reimbursement increases by the VBP and saw higher median payment reductions and lower payment increases under the VBP than other hospitals.
The researchers suggested that the award hospitals are being penalized by the value-based programs for factors unrelated to the quality of care. The award hospitals were larger, urban, teaching hospitals with a poorer, sicker, more complex patient mix.
That fragile patient mix not taken into consideration by risk-adjustment models used for value-based programs, which means that award hospitals could be getting penalized for the populations they serve rather than for the quality of the care delivered.
"As the shift to value-based care continues in the United States and as multiple bodies simultaneously assess hospital systems, we need to prioritize efforts to promote fair, equitable and standardized measurement of cardiovascular care quality," Wadhera said.
Study finds nonprofit hospitals with thicker bottom lines gave disproportionately lower levels of charity care.
The nation's top-earning nonprofit hospitals doled out less charity care than lower-earning hospitals did, relative to their respective profits, according to a new study from Johns Hopkins University.
In the research letter, published this week in JAMA Internal Medicine, Ge Bai, an associate professor at Johns Hopkins Carey Business School, examined 2017 Medicare cost reports from the Centers for Medicare and Medicaid Services for 2, 563 acute-care hospitals.
For every $100 of net income, hospitals in the top-earning quartile gave $11.5 of charity care to uninsured patients and $5.1 to insured patients.
Hospitals in the lower, third quartile of income gave considerably more – $72.3 to the uninsured and $40.9 to the insured.
"For both insured and uninsured patients, non-profit hospitals with superior financial performance provided disproportionately low levels of charity care," the researchers concluded.
"Nonprofit hospitals with substantial financial strength should consider more generous financial assistance eligibility criteria to reduce the financial risk exposure of disadvantaged uninsured and underinsured patients."
The top 1% of high-earning hospitals generated 23% of the net income of all nonprofit hospitals and provided 7% (to the uninsured) and 5% (insured) of the charity care at all nonprofit hospitals.
"The highest-earning hospitals have done very well financially," Bai said in comments accompanying the study. "The top 1% made more than $10 billion profit, and the top 5% more than $25 billion. Yes, they take certain measures to help financially disadvantaged patients, but they’re positioned to do more."
The 640 top-earning hospitals generated nearly $48 billion in net income in 2017 – or slightly over 100% of all net income reported by the 2,563 hospitals. The bottom three quartiles of hospitals reported negative net income.
Study co-author Gerard Anderson, of the Johns Hopkins Bloomberg School of Public Health, said the research letter breaks new ground by examining charity care across hospitals' financial state, and detailing distinctions between charity care for insured and uninsured patients.
"Congress and state legislatures need to take a careful look at the proper balance between the hospitals' profits and their level of charity care. Too many very profitable nonprofit hospitals are providing little charity care," Anderson said.
The study also found that hospitals in states that expanded Medicaid under the Affordable Care Act gave less charity care than hospitals in other states did – $12 versus $37.8 for uninsured patients, and $8.7 versus $11 for insured patients, measured against every $100 of net income.
"Nonprofit hospitals have full discretion in designing their financial assistance policy," Bai said.
"The top-earning hospitals, which have substantial financial strength, should design more generous eligibility criteria to help uninsured and underinsured patients. The hospitals' nonprofit status and tax exemptions require such action," she said.
The appellate court ruled that HHS Secretary Alex Azar's approval of a Section 1115 waiver for Arkansas was "arbitrary and capricious."
A key healthcare policy initiative of the Trump administration suffered a major setback on Friday when a federal appeals court slapped down the administration's efforts to allow Arkansas to impose work requirements on "able-bodied adult" Medicaid beneficiaries.
The three-judge panel at the U.S. Court of Appeals for the District of Columbia upheld a lower court when they ruled unanimously for the plaintiffs in Gresham v. Azar.
The appeals court said that the Department of Health and Human Services granted Arkansas' Section 1115 waiver for work requirements without considering its full effect on the Medicaid program and beneficiaries, a violation of the federal Administrative Procedure Act.
In a 19-page ruling, Judge David Sentelle, a Reagan appointee, called HHS Secretary Alex Azar's waiver approval process "arbitrary and capricious" and said HHS ignored concerns raised by stakeholders and beneficiaries about the potentially negative impact the waiver would have on coverage.
"In total, the Secretary's analysis of the substantial and important problem is to note the concerns of others and dismiss those concerns in a handful of conclusory sentences," Sentelle wrote. "Nodding to concerns raised by commenters only to dismiss them in a conclusory manner is not a hallmark of reasoned decision making."
It is not clear if the federal government intends to appeal the ruling, which could eventually be heard in the U.S. Supreme Court. Calls to the Centers for Medicare & Medicaid Services were not returned on Friday afternoon.
Stewart v. Azar consolidated suits from Arkansas and Kentucky that challenged waiver approvals for Medicaid beneficiaries. The court dismissed the Kentucky complaint after newly elected Democratic Gov. Andy Beshear ended the work requirement program in that state.
Jane Perkins, legal director of the National Health Law Program, a co-counsel for the plaintiffs, said she was "gratified" by the ruling.
"It means that thousands of low-income people in Arkansas will maintain their health insurance coverage — coverage that enables them to live, work, and participate as fully as they can in their communities," she said.
"Section 1115 of the Social Security Act only allows the Secretary to approve experimental projects that further the Medicaid Act's purpose," she said. "As Judge Sentelle's opinion repeatedly notes, the text of the Medicaid Act is clear as to this purpose – to provide health care coverage. The agency was bound by the purpose Congress selected and could not change it as it attempted to do. Only Congress can do that."
Allowing states to impose work requirements for "able-bodied adults" on Medicaid has been a key, but contentious, policy initiative by the Trump administration.
CMS Administrator Seema Vermahas repeatedly defended the "dignity and pride that is derived from work—for paying one's own way—and I believe it is the desire of nearly every American to achieve financial independence."
"Our default position must always be to help and encourage those who are able to lift themselves up and find their footing again," she said.
However, critics of the work requirements dismiss them largely as either a stunt or a back doorway to pare the Medicaid rolls.
The Centers on Budget and Policy Priorities has said the work requirements would kick many low-income adults off Medicaid "including people who are working or are unable to work due to mental illness, opioid or other substance use disorders, or serious chronic physical conditions, but who cannot overcome various bureaucratic hurdles to document that they either meet work requirements or qualify for an exemption from them."
Roth, who previously served in executive roles at Northwest Hospital & Medical Center in Seattle and Ochsner Health System in New Orleans before arriving at St. Luke's in 2007, spoke with HealthLeaders about the challenges and opportunities he foresees in his role as top executive.
The following is a lightly edited transcript of Roth's comments.
HealthLeaders: Why do you want to be a CEO?
Chris Roth: First of all, I am firmly rooted in this community. I've got family that goes way back relative to Idaho roots. My kids are here. I believe in the community and making a difference, and St. Luke's has a large footprint in southern Idaho where Boise is.
It is personal work, for sure. I believe in our mission and the course that we've been on for the past few years and the people that wake up every day to provide care. I want to make a difference in the community that I'm a part of and one in which I plan to be here, hopefully, until I retire.
The opportunity to influence the organization and make a difference in the community relative to healthcare, and dealing with some of the challenges we face, that's why I want to do it.
HL: You've been in senior leadership for a long time. How do you see your role changing as CEO?
Roth: I believe the CEO needs to serve as the chief culture officer. Culture is a team sport and leaders shape that. As a CEO, it's my responsibility to set the tone from the top. We are a caring organization, and that is the product that we deliver, so I look forward to doing that and setting the example.
Where I'll be spending my time will change. Any senior leader needs to have a balance of being both inwardly focused, but also externally focused. Community relationships are incredibly important. St. Luke's is an organization that can have an influence on public policy. I'll be spending more of my time shaping those aspects of regional healthcare and policy.
And, I'll be leading the strategy that our board has adopted and approved and driving the organization forward to achieve our vision.
The day-to-day work will change, but I'm fortunate that I have the experience and the background in the organization to know where our challenges are and where our opportunities lie. I'm going into this with eyes wide open, but it's going to be a change.
HL: Going into this first year, what do you anticipate being your areas of focus?
Roth: We have a very solid mission and a vision. As an organization, we are committed to improving outcomes, addressing affordability, improving access, and we aim to be and remain a national leader in quality and safety.
We have a solid plan and a strategy going forward. With that as background, I expect that in the next many months, I'm going to be engaged with our employees, our community, our physicians, our legislators, all individuals throughout southern Idaho, to listen and hear how we can become the best partners in the state as it relates to providing healthcare.
HL: How does your commitment to the community affect any movement toward social determinants of health?
Roth: We have two key foundations that help build our strategy. One speaks specifically to population health. We define population health in the way that St. Luke's improves the health of people in our communities by taking accountability for outcomes in the total cost of care. We're taking financial and clinical account accountability. In fact, we have about 36% of our total revenues at full risk right now.
Secondly, we know that most healthcare outcomes are determined outside of a hospital or clinic or a health system setting. They're determined socially. We need to play a part as a key leader in addressing social determinants, but we can't do it alone. We're committed to partnering with others to help achieve those needs.
HL: What does it say about St. Luke's that they hired a new CEO from within?
Roth: Our board in the process was looking for the right leader at the right time. And I mentioned before the solid strategy and the success we've had as an organization. Anytime an organization makes a decision to go within, what they're saying is, 'We're on a strong path. We've got a good culture. We're looking for a leader to continue the great work and take us to the next level.'
HL: What do you see as some of the biggest challenges and opportunities in the broader healthcare delivery universe in the months and years ahead?
Roth: Our biggest challenge is tackling the issue of access and affordability. When I talk about access, it's meeting people where they want to be met relative to healthcare, the right place, the right time, the right care, and to do so in a way that's affordable and transparent.
We've got a healthcare system that has a lot of work to do. We have incentives that are misaligned. We have payment models and fee schedules and chargemasters and hospitals and insurance companies and the federal government that are part of this big ball of twine that needs to be unwound in a meaningful way for consumers.
Our challenge is achieving better outcomes at a lower cost, and I haven't seen many organizations in healthcare able to achieve that, but that's our aim, and that's our No. 1 challenge ahead.
HL: What role model did Dr. Pate provide for you heading into this job?
Roth: As a CEO, I have never seen anybody that was more committed to the organizational vision and in such a consistent way. He led by example. He talked about it relentlessly.
Seeing him do that over and over again, internally, externally, showed me the importance of consistency as a leader—in particular, CEO. He took some arrows along the way. There were people that doubted the vision he was laying out for the organization, and I saw him with an unwavering commitment to that. That was a good example for me.
HL: At the end of your tenure as CEO, what do you hope your legacy will be?
Roth: Two things: One, I hope and I expect that we will have made a meaningful improvement as it relates to the delivery of healthcare in the region that we serve that's high quality, including strong safety, accessibility, and affordability, and that we can look back to say we've solved some of the greatest healthcare challenges in Idaho.
Second, would be a strong, positive, thriving culture of caring individuals that is functioning as a highly aligned team and has fun in the process.
15 Arkansas hospitals are the latest of hundreds of other hospitals across the country challenging opioid makers and distributors.
A handful of Arkansas hospitals, strapped by opioid-related care costs, are filing suit against the drug makers, distributors and retailers who peddle the addictive drug.
In a suit filed in Washington County Circuit Court, the 15 plaintiff hospitals allege negligence, fraud and civil conspiracy by the defendants, which include Purdue Pharma, Johnson & Johnson, Abbott Laboratories and more than 40 other companies and individuals involved in the manufacturing, distribution, and sales of prescription opioids.
"The manufacturers' deceptive marketing techniques and the active evasion of effective controls over the distribution of opioids by retailers and distributors have caused this ongoing crisis," said plaintiffs' attorney Thomas Thrash, of Thrash Law Firm P.A. in Little Rock.
"Other than the patients who have experienced devastating and often lethal consequences, hospitals were the most direct victims of this conspiracy," Thrash said. "Hospitals continue to provide desperately needed care, much of which is uncompensated, to effectively treat opioid-addicted patients and have saved countless lives."
The Arkansas hospitals are the latest of hundreds of other hospitals across the country that have filed suits against opioid makers and distributors.
Arkansas ranks eighth in the United States for its opioid use rate, according to the state officials.
Between 2000 and 2016, the drug overdose rate in the state rose from 5.4 per 100,000 people to 14 per 100,000. These increases came, the plaintiff hospitals allege, while the opioid makers, distributors and retailers "engineered a dramatic shift in how and when opioids were prescribed and used."
"They organized a complex scheme to overstate the benefits and trivialize the risk of long-term opioid use and minimized the risk of dependence among patients who used opioids to treat chronic pain," the suit alleges.
The plaintiff hospitals cited a study in the Journal of Managed Care Pharmacy that showed opioid-related hospitalizations costs eight times more than the cost of treating patients without opioid use disorders.
A 2012 study in the journal Health Affairs found that the average opioid-related hospital stay for cost about $28,000, with 20% of those stays were covered by private insurance. The same study found the cost of that stay rocketed to an average of $107,000 if there was an associated infection, with only 14% of such patients covered by insurance.
"For more than 20 years, virtually every hospital in the United States has provided and continues to provide some amount of totally uncompensated patient care as a direct result of the opioid crisis. This is not a sustainable trend," said plaintiffs' co-counsel Don Barrett.
"America's hospitals can lead us out of the man-made health care disaster created by the defendants, but hospitals must receive new resources to help address two decades of financial loss," he said.
For U.S. hospitals, an outbreak of the coronavirus would increase demand for services, but also increase costs.
The corona virus outbreak that has killed more than 1,100 people in China and infected more than 45,000 people globally could disrupt supply lines for U.S. medical device and drug makers that rely on products and manufacturing in that country, Moody's Investors Service says.
At the same time, Moody's says, the outbreak could increase demand for hospital services, medical products and drugs to fight the contagion.
"While the primary impact is on human health, the risk of contagion is affecting economic activity and financial markets," said Moody's associate managing director, Jessica Gladstone.
"The immediate and most significant economic impact is in China but will reverberate globally, given the importance of China in global growth as well as in global company revenue."
For hospitals, if the coronavirus were to spread widely in the U.S., Moody's says that would increase demand for services. However, costs likely would rise as well, as hospitals would need to add staff, possibly through expensive temporary laborers, and cancel more lucrative elective procedures such as orthopedic surgeries.
And if the outbreak is not contained in China, it could create shortages of medical device part and disrupt the medical supply chain as demand begins to spike, Moody's said.
For drug makers in the U.S. and Europe, China is a big customer and a big supplier of active ingredients. If China's economy slows or diverts healthcare-associated resources because of the coronavirus, it could have a pronounced impact on drug supplies.
For example, if manufacturing plants in China are adversely affected, that would negatively impact the bottom line for drug companies internationally, Moody's says.
A study found that 20.5% of elective surgeries came with an out-of-network bill with an average charge of $2,011.
About one-in-five patients undergoing elective surgeries at in-network hospitals is slapped with an out-of-network bill, new research shows.
A study published this week in JAMA looked at one large commercial insurer's claims data on nearly 350,000 adult beneficiaries who underwent elective surgeries for common procedures with in-network surgeons and hospitals between 2012 and 2017.
The study found that 20.5% of the cases came with an out-of-network bill, averaging $2,011, with most of the out-of-network billing attributed to surgical assistants or anesthesiologists.
Beneficiaries in health insurance exchange plans had a significantly higher risk of out-of-network bills (27%) when compared to beneficiaries in non-exchange plans (20%).
Of the 83,021 surgeries performed at ambulatory surgery centers with in-network primary surgeons, 6.7% included an out-of-network facility bill and 17.2% included an out-of-network professional bill.
Surgical complications were associated with a significantly higher risk of out-of-network bills (28%), compared with episodes with no complications (20%).
For the most part, the public discussion around out-of-network billing has focused on emergency care. A study published in November in JAMA Internal Medicine found that the percentage of emergency department visits that included a surprise bill grew from 32% in 2010 to 43% in 2016.
in an editorial accompanying the study, Melinda Buntin, chair of the Department of Health Policy at Vanderbilt University School of Medicine, said the findings "add to the widespread sense that surprise billing is prevalent and unfair and illustrate that it is not isolated to a limited set of private equity–backed medical groups."
"What they unfortunately cannot shed light on is which of the policy solutions on the table will best solve the problem," she said.
The study comes as Congress debates out-of-network bills that can leave insured patients on the hook for financially crippling medical debts. Buntin said Congress should take note of these latest findings.
"Hopefully, a compromise will be reached between those in Congress who favor setting a benchmark rate for compensating out-of-network providers in these situations and those who favor arbitration between insurers and out-of-network providers," Buntin said.
"What is not the subject of debate among lawmakers is that patients should not be left paying these bills in full—and yet that is exactly what will happen if Congress is not able to agree on a path forward."
The $4.8 trillion proposed budget is not expected to get much traction in Congress. However, critics say it demonstrates the administrations efforts to shred the safety net.
President Donald Trump's proposal to cut nearly $1 trillion from Medicaid, the Affordable Care Act and other safety net programs over the next decade was greeted with a chorus of boos from the nation's hospital lobby.
The proposal, put forward Monday in Trump's $4.8 trillion 2021 budget, is not expected to get much traction in Congress. However, critics say it demonstrates the administrations ongoing efforts to shred the safety net.
"Every year, the Administration aims to gut our nation's healthcare infrastructure," American Hospital Association President and CEO Rick Pollack said in prepared remarks.
"The proposals in this budget would result in hundreds of billions of dollars in cuts that sacrifice the health of seniors, the uninsured and low-income individuals. This includes the one in five Americans who depend on Medicaid, of which 43% of enrollees are children," he said.
Russ Vought, acting director of the White House Office of Management and Budget, defended the budget Monday at a press briefing, and said spending for Medicare and Medicaid will go up 6% and 3% annually, respectively.
"We have reforms, as it pertains to on the payment side, where you’re buying and reimbursing for healthcare costs. That has to be allocated and it shows a savings in a budget," he said.
Vought said the proposal to impose site-neutral payments for hospital outpatient services could save about $266 billion.
"I’ve talked about site neutrality to make sure that a CAT scan that costs $118 in a physician's location and costs $230 at an outpatient hospital costs the same thing to taxpayers and, in the Medicare program, doesn’t lead to people choosing where they refer a patient for the purposes of reimbursement," Vought said.
Pollack says the site-neutral payments "fail to recognize the crucial role hospitals serve for their communities, such as providing 24/7 emergency services."
"Post-acute cuts threaten care for patients with the most medically complex conditions," he said. "The cuts also undermine medical advances and the availability of around-the-clock services exclusive to teaching hospitals, and the training they provide to those who will become our nation’s future physicians."
The proposal cuts $3 billion in funding for National Institutes of Health, the Health Resources and Services Administration), and other health agencies, along with cuts to Medicare funding for graduate medical education public service loan forgiveness, and the 340B Drug Pricing Program.
"The arbitrary cuts to healthcare programs envisioned in the budget will make the job of America’s caregivers much more difficult," Kahn said. "This proposal combined with already issued regulations will result in a reduction in coverage, putting the healthcare of millions of patients at risk."
The Catholic Hospital Association said it was "deeply disappointed" with the budget.
"CHA believes that our nation's spending priorities should reflect our moral commitment to assisting the least among us," CHA said in a statement.
"For the millions of Americans who rely on Medicaid and other healthcare programs, as well as housing and nutrition programs that promote healthier lives, cuts to these programs will have devastating consequences."
CHA noted that adding "burdensome" work requirements to Medicaid "will further restrict access to affordable healthcare."
"While we do commend the Administration's proposal to expand the mental health services available under Medicaid, that effort would only be negated by the budget’s cuts and other harmful program requirements," CHA said.
Association of American Medical Colleges President and CEO David J. Skorton, MD, said the cuts to Medicaid would disproportionately hurt AAMC-member hospitals, which represent only 5% of all hospitals, but account for 26% of all Medicaid hospitalizations.
Skorton noted that much of the research performed by NIH takes place at medical schools and teaching hospitals, and that the $3 billion in cuts proposed to NIH-funded research "would thwart scientific progress on strategies to prevent, diagnose, treat, and cure medical conditions that affect countless patients nationwide."
"Likewise, the president's proposal to reduce and consolidate Medicare, Medicaid, and Children’s Hospital GME into a single grant program would exacerbate the projected physician shortage by forcing teaching hospitals to absorb $52 billion in untenable cuts," he said.
An new analysis estimates what savings states will need to generate in aggregate and per capita Medicaid models.
States participating in the optional block grant proposal for their expanded Medicaid populations would have to generate up to 8% of the total savings to keep below the aggregate cap over the five-year span of the model, a new study from Avalere suggests.
"Under this option, if states are successful in achieving spending below the cap they will be eligible to share those savings with the federal government," Avalere said.
Reductions in total federal Medicaid funding over the life of the model vary from 0.1% in Nebraska to 8.1% in California, with 13 states seeing reductions of less than 2% over five years, and 10 states seeing reductions of more than 5%.
The Healthy Adult Opportunity, unveiled January 30 by the Centers for Medicare & Medicaid Services and created under a Section 1115 demonstration waiver, allows states to opt for capped aggregate model, also known as a block grant, or a per capita model for their expanded, non-mandatory Medicaid populations, under age 65.
The HAO models would give states the flexibility to reduce costs below the caps for the expanded populations through changes in eligibility and benefits, prescription drug formularies, provider reimbursements and managed care oversight. Any savings generated by the models would be shared with the federal government.
By comparison, states using a per capita cap model under the HAO proposal may need to generate up to 6% in savings over 5 years, a lower level of savings than under an aggregate cap, Avalere said.
"The analysis demonstrates that participation in an aggregate cap demonstration will generally create a lower federal funding cap for states than per capita caps; however, the variation between the funding approaches differs by state," Avalere said.
Per capital caps would also better protect federal Medicaid reimbursements during a recession, the analysis noted.
That's because the total reimbursement to states would rise with increased in enrollment, while aggregate caps, by comparison, do not rise during a recession, nor increase Medicaid enrollment.
The analysis also found that states that expanded Medicaid under the Affordable Care Act would need to generate the greatest savings under the proposal, because of the larger number of non-mandatory adults enrolled in each state.
However, the analysis noted that the expansion states, such as California, are also the least likely to pursue the HAO demonstration.
Conversely, Avalere found that several states that didn't expand their Medicaid populations – and are most likely to pursue the HAO model – don't cover enough non-mandatory adult beneficiaries to model the effects on federal funding.
"For these states, the HAO may provide an opportunity to expand coverage with additional flexibilities," Avalere said.
As part of the three-year management agreement, Adventist will bring in a senior management team led by CEO Anita L. A. Jenkins.
Adventist Healthcare will take over operations at the financially troubled Howard University Hospital in Washington, D.C., on February 17 under a management agreement signed by the two providers.
As part of the three-year "partnership," Adventist HealthCare will bring in a senior management team to the private, not-for-profit Howard University Hospital, led by new CEO Anita L. A. Jenkins, the former president of Sycamore Medical Center near Dayton, Ohio.
In addition, Adventist will work with Howard University to build a replacement hospital as part of the overall strategy to continue serving the community, the two providers said in a joint media release.
"We want Howard to continue to be a vital healthcare provider to meet the growing needs of the community, the region and the country now and in the future," said Adventist HealthCare President and CEO Terry Forde.
The affiliation will bring Howard University medical residents, medical students, pre-med students and graduates into the Adventist network for training. Howard University is the No. 1 producer of black applicants to U.S. medical schools.
"This is a historic day for Howard University because this union with Adventist HealthCare signifies a stronger foundation for building our academic programs and it enhances our ability to train the next generation of healthcare professionals," said Howard University President Wayne A. I. Frederick, MD, MBA.
Washington, D.C., Mayor Muriel E. Bowser applauded the agreement, saying it "solidifies the rich tradition of providing high-quality health care services on Georgia Avenue and to the surrounding community."
"In addition, we can all be proud that the District of Columbia will remain home to the largest producer of African American doctors in the country — the Howard University College of Medicine," she said.
Last month, Moody's Investors Service gave Howard University's bond rating a negative outlook, after noting that "weak operating performance when combined with debt service coverage covenants continues to translate into limited bandwidth for revenueunder performance. About 90% of Howard University Hospital's patients are covered by either Medicare or Medicaid.
"Despite its important role in the district, the hospital is financially challenged by a myriad of issues including a high Medicaid population, tightening reimbursement, aging facilities, increasing market consolidation and intensifying competition, and past disruptions resulting from changes in hospital leadership,” Moody’s said.
Not-for-profit, Gaithersburg, Maryland-based Adventist HealthCare's footprint in Maryland and the Metropolitan D.C. region includes three acute-care hospitals, two rehab hospitals, a number of outpatient and mental health clinics, and physician practices, and employs 1,700 physicians.
