Hospitals’ Geographic Expansion In Quest Of Well-Insured Pat

[Jeff Dreger]

Hospitals’ Geographic Expansion In Quest Of Well-Insured Patients: Will The Outcome Be Better Care, More Cost, Or Both?

http://content.healthaffairs.org/content/31/4/827.full

"The situation of patients in poorer communities, where many are uninsured or have public coverage, is unlikely to improve. If their population is growing, lack of investment in these communities—because of more lucrative opportunities elsewhere—could limit access when hospitals close struggling facilities to focus on more successful ventures."
"Hospitals in urban areas may find themselves pushed into an exclusively safety net–oriented role."
"Cleveland Clinic recently closed Huron Hospital, a struggling safety-net facility in the poor community of East Cleveland, opening a smaller family health center at the site instead."

[Marguerite Harkness]

Lakewood Hospital actually made a profit in 2014 - EVEN after Cleveland Clinic sucked $24 million of Administrative Services fees out of the profits. Lakewood Hospital ran an operating profit for 5 out of 7 most recent years--even after Clinic's suctioning of admin fees. It SHOULD be able to run at a profit if managed properly.
Jeff, you did a really detailed analysis early-on in the Observer about the financial consequences of closing the hospital.

[Bill Call]

Lakewood Hospital actually made a profit in 2014 - EVEN after Cleveland Clinic sucked $24 million of Administrative Services fees out of the profits. Lakewood Hospital ran an operating profit for 5 out of 7 most recent years--even after Clinic's suctioning of admin fees. It SHOULD be able to run at a profit if managed properly.
Jeff, you did a really detailed analysis early-on in the Observer about the financial consequences of closing the hospital.

That is why Metro was so eager to buy the Hospital. They were so eager that they returned with a second proposal that was even better than the first. (The Mayor denied the existence of the second proposal until the discovery process proved it existed).

Metro breaks even at Medicare reimbursement rates.

It does not have the Cleveland Clinics overhead costs and would have made A LOT of money at Lakewood Hospital. That's why they were so eager for a deal. Metro is expanding in Strongsville, Croker Park and elsewhere. If Metro can get some of the more profitable business while maintaining its low overhead Metro will give the Clinic a run for its money.

It's possible that they are under enormous political pressure to walk away. The Cleveland Clinic needs Lakewood's business and it needs Lakewood Hospital dead. However...

Lakewood does not need the Cleveland Clinic. Hopefully the new Mayor can salvage something from this fiasco.

The biggest problem now is that Mayor Summers and his supporters on the LHF and LHA are doing as much damage as possible. They intend to destroy the Hospitals business by the end of the year.

At this point it's just spite.

P,S. Lakewood Hospital MADE A PROFIT even after the Clinic moved a half dozen of its most profitable specialties to Avon and Fairview. Another reason Metro was eager for a deal.

[Bridget Conant]

If anyone REALLY wanted to keep healthcare choices IN Lakewood, the Metro proposals would have made one jump for joy. They would continue as a full service hospital with a REAL emergency room, add services, increase patient load, increase employment, and modernize parts of the facility! What was NOT to like?

It was our leaders conspiring with CCF that kept anyone from seriously considering Metro. CCF did not want Metro here, and apparently, neither did our so-called leaders or those sitting on the hospital board and associations, whose sole purpose was supposed to be to protect our asset.

Though I dislike it, I understand the reasons why CCF would block Metro. But for the life of me, I cannot comprehend how our officials agreed so readily to this. They did not just roll over and play dead, either. They ACTIVELY participated in the fraud and spent tons of our money for suspicious studies that "proved" we didn't need a hospital. It's appalling.

[Brian Essi]

Actually, Metro breaks even at Medicaid reimbursement.

Medicare adds to the bottom line.

[Bill Call]

Actually, Metro breaks even at Medicaid reimbursement.

Medicare adds to the bottom line.

In that the case then Metro would have been making A LOT OF MONEY FROM LAKEWOOD HOSPITAL. Of course I suspect that the $24 million in annual administrative fees made the Cleveland Clinic a lot of money too.

As I recall Metro also planned to partner with independent physicians and bring back the private practice that the Clinic pushed away.

Metro stated that they only needed 40% of the City property so the other 60% would have been available for other development.

So... a full service hospital, a lot of new independent physicians working in Lakewood, 4 acres or so available for development, the potential release of the Lakewood Hospital Foundations money to control of the City and...

Mayor Summers refused even to acknowledge the existence of the offer.

I suspect that the real reason they are eager to destroy the hospital is to get control of the Foundations $33 million. Maybe that's the only reason. If that's the case this whole deal is worse than anyone thought.

[tom monahan]

Bill, Brian et al:

Be prepared for a dog and pony show like no other on July 27 when Dru Siley, Mike Summers and Council people Madigan and Bullock roll out their new concept for the CCF office building on the west side of Belle.

One of the insidious acts is to tear down the garage because they have not been maintaining it and thereby deny sufficient parking for hospital employees and visitors when we WIN THIS BATTLE AT THE POLLS!!!!!!!

[Bridget Conant]

The parking garage that CCF promised to upgrade/renovate in the 2009 Vision for tomorrow?

[tom monahan]

Bridget:

That's the same one. It probably was overlooked in all of the other promises that were made to Council--i.e. the Centers of Excellence among them.

[Brian Essi]

The Clinic is not very good at running hospitals. Someone recently posted an article that they got themselves in hot water with CMS on infractions and such. No surprise for anyone that knows how the Clinic operates.

They are very good at the high end specialty stuff--that's where the money is. But get out of the hospital ASAP after the surgery. Sound Familiar?

In my opinion they conned Summers into believing he was a "hero"---Summers told me that HE convinced THEM that preventative care was the model for the future and HE believed THEM. Really? They must be laughing at him behind his back. There is little or no money in that so the Clinic really is not interested in it.

Please note my other post:

viewtopic.php?f=7&t=13635

On May 15, 2014, before Summers began "negotiating' with the Clinic, the Clinic proposed a $40 million facility. After 7+ negotiating session beginning in June 2014 and ending September 2014, Summers managed to get them to invest $34 million in the new facility.

Good Job!

[Bridget Conant]

The Clinic is doing a booming business with Medicaid:

http://m.clevescene.com/scene-and-heard/archives/2015/03/05/cleveland-clinic-posts-best-year-in-a-decade-while-failing-to-cite-medicaid-expansion#CommentsMobile

Note that they are making record profits while charity care has decreased 25%.

As for their "world class" status, in reality, they are the WORST hospital in the entire area for patient safety, so bad that Medicare threatened to cut off their certification. These citations are for medical errors, safety violations, and such:

http://www.ideastream.org/news/cleveland-clinic-cited-federal-safety-violations

The fact is they spend enormous amounts of money on marketing and publicity campaigns to raise their status. It's well known that US News rankings can be bought and they have done precisely that to increase their rating.

The Cleveland Clinic is THE most overrated hospital in the nation. Their political power, however, is impressive.