Despite the struggling economy, the two largest health systems in Cleveland have found ways to expand, according to a new report.
The report, released Wednesday by the Center for Studying Health System Change, is based on interviews of 45 Cleveland healthcare leaders, including representatives of major hospital systems, physician groups, insurers, employers, benefits consultants, community health centers and state and local health agencies, researchers said.
It found that the Cleveland Clinic and University Hospitals have used similar strategies of attracting well-insured suburban patients, expanding profitable specialty-service lines and winning physician loyalty to expand their markets.
Many of those interviewed said healthcare is one of the region's strongest economic sectors, and that they hope growth in medical care and research can contribute to an economic turnaround.
Others questioned whether the competition between the Cleveland Clinic and UH would lead to higher healthcare costs from excess capacity if the hospital systems can't attract more patients from outside the Cleveland metropolitan area.
"Like other communities, Cleveland is hoping medical care and research can replace manufacturing as the area's economic engine," said HSC President Paul Ginsburg, "How that proposition works out for the community depends on, as one respondent put it, the degree to which medical care is exportable or that patients are imported."
The report found that the Cleveland Clinic and UH reportedly have maintained strong financial performances but face challenges, including rising uncompensated care costs and declining or flat patient volume.
To improve financial performance, officials at both systems said they envision transferring patients freely within their organizations, allowing them to match patients' medical needs – and expected reimbursement – to the expertise and unit costs of individual admitting facilities. The goal, they said, is to manage complex, high-margin cases at the flagship academic hospitals with the highest unit costs per bed, while patients with less-complex needs are admitted to community hospitals.
Cleveland is one of 12 communities across the country tracked intensively as part of HSC's Community Tracking Study site visits, which are jointly funded by the Robert Wood Johnson Foundation and the National Institute for Healthcare Reform. HSC has been tracking these communities since 1996.