The New York Times recently featured Temple University Hospital in a front-page story about hospitals bracing for the repeal of the Affordable Care Act (ACA).
Left: 2:30 p.m.: In North Philadelphia with Temple Community Health Worker Eugene Godonou. Top: An 8 a.m. class at the medical school on Biochemistry of Hormones of the Thyroid and Parathyroid Glands.Bottom: 5:20 p.m.: The second airtransport of the day at Temple University Hospital.
We have made innovative business deals. Our contract with GE Healthcare, forging a partnership for radiology service and technology, is a world-first. A contract based on mutual risk. And it’s producing the intended results. We have created world-class programs in robotic surgery and cardiothoracic surgery; were the first in the nation to establish a Department of Thoracic Medicine and Surgery that integrates medical care, surgical care, and research; and were the first in the region to establish a familial cardiomyopathy program — as well as vascularized lymph node transfer surgery for lymphedema, a dedicated Limb Salvage Center, and a Head and Neck Institute. We were also the first in the world to excise the DNA of HIV from cultured human cells and then live animals, and to find a link between vitamin D and pancreatic cancer. Our faculty members hold leadership positions in major organizations. And teach. And edit major journals and texts. All while caring for the poor, the rich, and everyone in between. We are in a much stronger position today, yet because of the twin challenges of maintaining high-tech and safety-net missions, Temple Health remains in a fragile state — which makes ongoing advocacy for its unique role imperative.
For decades, Temple has been known nationwide for squaring itself against the toughest health care challenges of the day — and thriving; therefore, the Times wanted our perspective on threats to the ACA. With 20 million people at risk of losing insurance coverage, wholesale repeal of the ACA could incite a bona fide public health crisis in America. Hospitals stand to lose $165 billion through 2026. The stakes are especially high for hospitals that are caretakers of communities in “Deep Poverty,” the Census designation denoting family income of less than half the federal poverty level of $24,300 for a family of four. About a third of the people in Temple University Hospital’s primary service area somehow manage to live on this income. If the ACA is repealed, Temple University Hospital will absorb the cost of caring for uninsured patients to the tune of about $45 million per year. Even with the ACA, the hospital operates on a thin margin. Last fiscal year, Temple Health had revenues of $2 billion, yet netted just $3.6 million. A margin of 0.2 percent, compared to the 5 percent average margin in the state. Why the difference? Payer mix. Medicare and Medicaid contribute a markedly disproportionate share of Temple University Hospital’s revenue: about 85 percent. Public programs reimburse at far lower rates than commercial insurers. That makes our margin difficult to maintain. We must deliver high-quality care without outspending what we recoup. Health care financing is a world of shifting sands. The only predictable factor is this: Temple will continue to embrace patients other hospitals turn away. This makes us indispensable. A critical access point for public health in the largest American city without a public hospital. A world-class academic medical center that goes miles beyond what most public hospitals do. Temple crafts populationbased approaches that keep patients out of the hospital. We’re the leading regional provider of disaster relief and emergency medical response. We educate tomorrow’s health care workforce — and lead world-class research that’s advancing diagnostics, treatments, preventions, and cures. Temple’s biomedical research funding doubled during the past four years. With nearly $80 million in NIH research funding, Temple Health has catapulted Temple University to top-tier Carnegie Classification last year, the pinnacle benchmark of research funding productivity, the nation’s top four percent. And with more than 10,000 employees, Temple’s health system is essential to Philadelphia’s economic engine. Recognizing its unique, outsized mission, the Commonwealth of Pennsylvania gave Temple University
I have come to appreciate the value, the necessity, of social conscience in health care. It is a moral and professional imperative that Temple embodies.
SUMMER 2017 | TEMPLE HEALTH MAGAZINE |
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