Recognizing its “unsustainable” business model, the Metro Nashville Hospital Authority board announced Tuesday it had launched a strategic planning process for the city’s health care facilities that serve the indigent.
The hospital authority — which oversees Nashville General Hospital, Bordeaux Long-term Care and Knowles Home Assisted Living & Adult Day Services — received a final strategic assessment at its Tuesday board meeting that outlines potential options to create a more sustainable operation.
“Our initial challenge was to identify near-term opportunities for financial improvement of the facilities and assess the long-term implications of the rapidly changing health care environment,” the authority’s board chair Waverly Crenshaw said in a statement.
“As the process has evolved, however, it is clear to the board that the current operational model is financially unsustainable and the ultimate goal must be to redesign the business model of the MNHA facilities to better meet the community’s changing health care needs.”
According to a hospital authority news release, the options range from “maintaining the status quo to re-purposing the hospital as an ambulatory care facility with reduced inpatient services to a full scale re-design of the business model focused entirely on outpatient and clinical services.”
The consulting firm Alvarez & Marsal produced the assessment, which the board plans on further reviewing before deciding on a course of action. The hospital authority says it also intends on working with other Metro agencies, patients, staff and other community stakeholders before taking action. Community “listening sessions” are also in store.
The hospital authority announced two options aren’t on the table: doing nothing or closing Metro General Hospital.
“With the elimination of those two extremes, however, all options to preserve and enhance access to primary health care services and create a sustainable operational model will be considered,” the press release reads.
According to hospital authority figures, Nashville General Hospital’s emergency room and clinic provided approximately 76,000 patient encounters but the hospital encountered only 4,000 hospital admissions. Although the facility has 150 beds, the hospital admits only 11 patients per day and cared for only 47 acute patients per day last year.
The hospital required more than $46 million in subsidies and extraordinary payments last year. Another $10.5 million were required collectively for the Bordeaux and Knowles center.
The hospital authority anticipates the new federal health care law will drive greater health care competition as more people are insured service — and perhaps destabilize an already depleting enterprise.
Despite 2,300 licensed beds within a 2.5-mile radius, Nashville General Hospital captured only 6 percent of that audience, the hospital authority says.
“With the expectation that more patients will become insured in the changing health care environment, it is anticipated that individual choice will increase and drive even greater competition in the marketplace,” the authority says.