Dean wants General to remain 'viable' part of health care system

Wednesday, May 20, 2009 at 1:53am

Mayor Karl Dean offered instruction as he kicked off the first meeting of a community advisory board Tuesday.

“We want to see General Hospital remain a viable part of the city’s health care system,” said Dean, adding that he wants the process to lead to where “we’re also in a position where we’re controlling the cost to the Metropolitan government.”

The board’s task is to provide expertise to a consulting firm hired to examine how Metro pays for, and provides health care for, those who can’t afford to pay.

The city subsidized the Hospital Authority, which oversees the hospital and long-term and adult day care facilities, about $50 million this year and the mayor’s office has proposed to cut the authority’s budget by 10 percent for the fiscal year starting in July. It has hired health care consulting firm John Snow Inc., to assess ways to provide more cost-effective care.

However, Dean and Finance Director Richard Riebeling cautioned that this process is about more than just cutting costs.

“I think there have been management studies done on the day-to-day operations of the hospital,” Riebeling said. “I think the focus is broader than that, and that [would be] what’s the best model for health care delivery needs to the medically poor and underserved. From my perspective if we can also save money in the process, that’s as critical.”

The team from John Snow Inc, will spend about four months working up recommendations. The first order of business will be to interview stakeholders.

“[That includes] underserved folks to see what their needs are, how their needs are currently being met and how they would recommend meeting their needs,” explained Reesa Webb, the manager for the project.

Many on the advisory board, including HCA Chairman Jack Bovender, say the key to curbing costs at General will be to increase access to primary care. The idea is that if people have a primary care physician they see on a regular basis, they’ll be healthier and less likely to make costlier emergency room visits.

“We get a lot of women presenting themselves in active labor at our emergency rooms having no prenatal care,” Bovender said. “The incidence of complications in [those] pregnancies and then the neo-natal intensive care babies it presents drives up the cost of health care dramatically.”

The consultants’ work may provide long-term solutions, but will not change the short-term budget outlook for Nashville General Hospital.

Riebeling said that the proposed $4.6 million cut for the hospital shouldn’t translate to cuts in services, though Metro Councilman Jerry Maynard has been concerned that may be the case. The councilman is holding a rally, along with Nashville clergy, on Thursday to demonstrate support for the hospital.

The Metro Council budget hearing for the Hospital Authority is scheduled for Thursday.


4 Comments on this post:

By: nurseangel on 5/20/09 at 7:54

Remember when the nurses stood outside Southern Hills HCA and protested the closing of the Labor & Delivery and Neonatal ICU units? They connected the dots for Nashville and showed us how closing these units in the working class, diverse Southern Hills neighborhood added an additional burden on Metro General. This after the State Health Agency caught them in an outright lie about why they "needed" to close these units.

Now, in a brilliant move, Jack Bovender has been appointed to a Metro advisory board to look at how Metro can contain costs. And in perhaps one of Nashville's most ironic moments he becomes the fox in the henhouse as evidenced by his astounding quote: "we get a lot of our emergency rooms having no prenatal care...and it drives up the cost of health care dramatically."

Wake up, Mayor Dean! Wake up, Nashville! HCA's closing of vital services to the Southern Hills community is a contributing factor to Metro's financial and Bovender actually admits it. We should take this money-grubbing corporate representative off the Board and insist that HCA do it's fair share in relieving the burden at Metro General by re-opening their Labor and Delivery. What better evidence do we need than the quote from The Fox?!?

By: pandabear on 5/20/09 at 8:32

"Riebeling said that the proposed $4.6 million cut for the hospital shouldn’t translate to cuts in services,"

The problem is we have the chief idiot: Karl Deano

...and his sub-ordinary idiots like this Riebeling guy
making their politically oriented, greed motivated decisions.

I think they let about 33 people go and still there's " cuts in services".

If there are no cuts in services at $4.6 million, let's cut another another
$4.6 million and see what happens then.

Idiots !

They don't have the money to take care of all the cheap labor
for the proposed convention center, and yet they can manipulate
$75 million to start funding land purchases for a convention
center that will lose we, the taxpayers, will pay for it.

Nationally, convention centers have been losing money for the last 10 years.

Idiots !

By: RNmruss on 5/20/09 at 12:54

Yes, help keep Metro viable by not allowing other local hospitals to close vital services, like HCA's Southern Hills was recently allowed to do when they closed their Labor & Delivery department. I was surprised to learn that L&D is the only hospital service that requires permission from the state board to be able to close. To help ease the burden on Metro, a way needs to be found to expand public access to health care, not shrink it. This is one more reason we need public health insurance, which is part of the President's call for health care reform.

By: Oldasdirtguy on 5/23/09 at 12:21

I hope that the mayor and council were attentive to the support rally outside of the courthouse on Friday. It was apparent from this group that many people are served by Metro General, not just the indigent. Keeping services at the present level allows Meharry Medical School to continue to practice and offer what appears to be top quality service, based on the customer satisfaction surveys. Metro employees can get discount rates for care at General and save thousands of dollars in costs. General is seeking to obtain contracts with some HMOs to fill beds and could possibly increase revenues that would exceed expenditures if certain departments were allowed to expand. There IS a way for General to not only survive, but to thrive, but the public, the council and the mayor need to understand this and then push for it. Without General Hospital, indigent patients will flood the emergency departments of the other hospitals of the city to seek the same care at a much higher cost. It makes sense to keep General at it's current operating capacity.