Deeper and deeper cutbacks in federal reimbursement and an ultra-conservative managed care climate create an uncertain environment. So hospitals that do achieve national standing for their financial achievements have to be careful how they tout these accomplishments. "These days hospital [financial] success and failure turns on a dime," says John A. Fiorillo, president of The Health Strategy Group, a strategic planning healthcare firm in New York. To avoid creating unrealistic expectations about your hospital's financial health, it's important to have contingency plans for unfortunate, but sometimes inevitable, business decisions that result in layoffs, downsizing and limited expansion.
Brigham and Women's Hospital (BW) in Boston is a key example. Although BW's operational viability has earned it a spot among HCIA's Top 100 hospitals for five consecutive years (including 1998), it had to cut 110 positions and lay off 20 employees in April as a result of steep Medicare cuts. Fair and honest dialogue about the financial challenges that BW and other academic hospitals are confronting is the best way to address this irony, says Vin Petrini, BW's chief public affairs officer. The local media are regularly briefed on how federal cutbacks will affect the quality of healthcare delivery.
Given the costlier research mission of academic hospitals, it's more important than ever to reinforce the importance of high-quality care. Recently, BW was the first hospital in the region to perform the successful triple transplant of a heart and two lungs. This kind of cutting edge care is what demonstrates the value of academic hospitals in a financially conservative healthcare environment, says Petrini.
(BW, Vin Petrini, 617/732-5216; The Health Strategy Group, John Fiorillo, 917/270-4458)