Excerpted from the Miami Herald. Find the original story here.
Employee compensation exceeded budget at Jackson Health System in June while patient revenues fell below projections, stretching the books at Miami-Dade County’s safety net hospital system dangerously thin and emphasizing the need to attract more insured patients, according to a monthly financial analysis released by Jackson administrators on Tuesday.
Salaries and related costs exceeded the budget by $2.9 million for the month of June, according to Jackson’s financial statements, and for the nine months ended June 30, the hospital system has spent about $27.7 million more to compensate employees than what was budgeted.
In a memo to the Public Health Trust, the board that governs the hospital system, Jackson’s chief executive, Carlos Migoya, said “employee productivity has stabilized and personnel spending is closer to budget than it has been historically.’’
But Jackson continues to lose patient revenue, according to Migoya’s analysis, partly because of a continued shift from inpatient visits, or overnight stays, to more outpatient and short-observation visits. Migoya has said that advancements in medical technology and procedures have changed many traditionally inpatient procedures to outpatient, which typically generate less revenue.
Still, outpatient visits fell about 10 percent below projections, slowing what had been an area of growth.
Hospital administrators continue to work on marketing plans to attract more insured patients, but many are banking on Miami-Dade voters to approve an $830 million bond referendum in November to help fund renovations and improvements to Jackson’s aging buildings and infrastructure, including patient rooms and new facilities that are expected to make the system more competitive with local hospitals.
“Jackson’s business operations are stronger today than they have been in many years,’’ Migoya wrote in the memo, “but that strength can only be sustained through growth.’’
Among the growth strategies proposed by Jackson administrators are plans to expand the hospital system’s physician base, update academic relationships with the University of Miami and Florida International University medical schools, and target marketing campaigns at patients and physicians.
But the hospital system continues to attract fewer insured patients than administrators had projected.
For June, commercially insured patients made up about 1.68 percent of the total days of stays at the health system’s three hospitals, including the main Jackson Memorial campus in Miami’s Civic Center, and hospitals in North Miami Beach and South Miami-Dade.
Cash on hand also is precariously low, with Jackson reporting about 17 to 18 days of cash on hand. The benchmark is 175 days.
Jackson administrators succeeded at holding down costs in almost every category for the month of June, including the use of contractual and purchased services (about $1.8 million below budget), claims paid through the hospital’s managed care division (about $3.6 million below budget) and supplies (about $66,000 below budget).
But net patient revenue — derived from hospital and physician services, community medical centers, primary care centers and continuing care facilities — fell about $4.6 million below budget for June, and $16.7 million below budget for the nine months ending June 30.
Revenues from Miami-Dade’s half-penny sales tax dedicated to Jackson’s operations came in about $1 million above budget for the month, however, and have exceeded projections by about $6.5 million for the nine months ending June 30, according to financial reports.
Despite the dismal June and missed budget targets for the past nine months, Jackson still has an overall budget surplus of $2 million for the nine-month period ending June 30, according to financial statements.