Tuesday, November 14, 2017

Mayor Barry Letter to Council Regarding Meharry Medical College and Nashville General Hopsital

Last Thursday, Mayor Barry announced plans to phase out General Hospital as a hospital and instead turn it into an ambulatory surgical care center, which would provide only outpatient services. She has been criticized for not giving the Metro Hospital Authority nor the Health and Hospitals Committee of the Council advance notice.  I can understand those in the Council or on the Hospital Authority for feeling blindsided, yet I applaud her for taking bold action.  Advance notice would have only given those who oppose this action time to rally, demonstrate and organize. There will still be plenty of time for that as this move will not take effect until sometime next fiscal year.

For a very long time, Metro General has been a money pit, that cannot fill its beds and there is no charter requirement or state law requirement requiring the city to maintain a charity hospital. This should been done a long time ago.

Below is a copy of the letter Mayor Barry sent to the Council explaning her actions. The highlighting in the letter is mine.

November 9, 2017
Dear Vice Mayor Briley and Council Members:

I want to let you know about an important change in the relationship between Nashville General Hospital and Meharry Medical College and plans for reconfiguring the hospital’s operating model to make it more financially stable.

Meharry, a historically black medical college, has trained doctors to provide care throughout our nation, including in many underserved areas, for more than 140 years. Nashville General has served as the index teaching hospital for Meharry since 1992, giving medical students invaluable experience working with patients from across our community. However, Nashville General’s current daily census is about one-third of its licensed capacity. Only about 40 of its 120 beds are being used on an average day, and 20 percent of those are part of an inmate care contract. Meharry currently has to pay to send students to other states in order to get the experience necessary to enter the medical profession. 

As a result, Meharry, which owns the building in which Nashville General operates, needs access to a local hospital serving a greater number of patients in order to make its educational program the best it can be. Today Meharry announced that it will partner with Nashville-based HCA’s TriStar Southern Hills Medical Center, giving the nation’s premier hospital company access to some of the best and brightest young minds the medical community has to offer.

This is also an opportune time to revisit Nashville General’s operating model, which has proven fiscally unsustainable, and restructure it in a way that will promote better health care outcomes for residents in North Nashville and across our city. Since 2005, Metro has provided more than half a billion dollars to support the operations of Nashville General, while the number of patients being served has decreased. I believe we can invest our resources more strategically to provide for the health care needs of our city’s indigent population, while maintaining operations at Nashville General Hospital.

With the help of restructuring specialist Kevin Crumbo, who has donated hundreds of hours of his time, the Metro Hospital Authority and my administration have been exploring ways to improve Nashville General’s long-term outlook. It’s time for a new model, one that will be focused on preventing people from needing in-patient services while ensuring that the patients currently using Nashville General for their outpatient health care needs, which amounts to more than 90% of the total patient visits, will still receive the same – or better – care at this facility.

Later this year, my administration will submit to the Council a substantial request for supplemental funds to stabilize Nashville General’s fiscal situation so the hospital can continue to provide services and meet its financial obligations for the rest of this budget year. Meanwhile, we will work with stakeholders throughout the upcoming budget cycle toward a goal of refocusing Nashville General Hospital’s operations to an ambulatory care model that provides high-quality clinic and other outpatient care services.

We also will create an indigent care fund to ensure that all patients who are currently using Nashville General will still have their health care needs met either at Nashville General or at other area hospitals. This will result in better health care outcomes for the patient population being served.

As a city, we are financially committed to promoting better health results and health care operations. We can restructure that commitment in a way that results in the best health care outcomes for residents while providing a more stable funding model that won’t require Metro to sacrifice services in other areas of government, or possibly raise taxes, in order to provide that quality care.

As I’ve said many times, I am committed to safety-net care in our community. This will take all of us, working in good faith and with good intentions, to create a successful new model for Nashville General Hospital. My administration and Meharry Medical College are absolutely committed to working with community stakeholders to do just that. I know we’re up to the task, and I appreciate your partnership as we take on this important work.

Kind regards,

Megan Barry

For more on this issue and background on General Hospital see the following:

Mayor Megan Barry announces plan to end Nashville General inpatient care

Metro General Hospital is seeking an additional $10 million dollar subsidy from the city.

General Hospital request for additional subsidy jumps from $10 Million to $16 Million.

Metro General seeks $7.5M more, on top of a recent $10M more, on top of the budgeted $33.5M subsidy.

How the Mayoral candidates would address Metro General Hospital. None of them impress me. 

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