由 Sean Ruck
, Contributing Editor | December 05, 2017
From the November 2017 issue of HealthCare Business News magazine
In part, Chattanooga is an amazing community that has realized a huge part of the infrastructure for our town is the Children’s Hospital. It’s a significant investment we need to keep economic development happening. Back in 1969, (CBS Evening News anchorman) Walter Cronkite said this was the dirtiest city in America due to the steel industry. Today, we’re the top outdoor city three years in a row. Chattanooga has turned itself around in a big way, and now we’re doing the same thing with infrastructure.
Prior to two years ago, we really did not have a huge culture of philanthropy. Now, we have close to 6,000 people participating in our campaign. Normally, these types of projects are done with two or three huge gifts. In our case, we’ve had one $4 million anonymous gift, and Erlanger Health System put in about $11 million, but the majority of the funds have come from people writing checks at their kitchen tables. It’s been a group effort with work done by Girl Scout and Boy Scout troops as well as a host of nonprofits. It’s important to note that our community isn’t just Chattanooga. We cover a 50,000-square-mile area, so people an hour and a half away . . . this is their children’s hospital.
HCB News: How are you staffing up the facility?
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What we’ve done is try to rightsize it. Our strategy is to create access that is defined by geography and time. We aim to have enough doctors and nurse practitioners for each specialty so children can get an appointment in a reasonable time. We’re also using outreach clinics to help improve geographic access as well as telemedicine suites for consultations throughout the region.
HCB News: What challenges does your facility have at the regional level and/or at the national level?
The biggest problem with pediatric health care is that the majority of the kids in our country are covered by Medicaid. When the ACA was enacted, it expanded to include a lot of adult working poor. Now, people are talking about doing away with the ACA and it will disproportionately hurt children when Medicaid gets a cut. Medicaid already pays less than what it costs to provide care. As Congress and the president talk about reducing Medicaid, if they’re not considering the children, they’re not considering the long-term implications. Children used to be two-thirds of the enrollees, but one-third of the cost. Now, they’re only one-third of the enrollees.
I think the other conversation we need to have is how we can control the rising costs and actually reduce costs. Of course, you do things more efficiently and more cost-effectively. So we don’t have any offices in the hospital, for instance. You can’t justify office space in a building that costs so much per square foot. There’s also the way we’re constructing our medical space. By planning and scheduling to share spaces, focusing on one type of specialty one day and a different the next, we’ve picked up a significant amount of capacity. We’re also offering a school-based health care program where we’re supporting 33 school nurses and that also supports the medical home.