HMHP, FORUM Hospital chiefs: Valley faces health-care crisis

One health-care official called for a national health-care plan.
WARREN -- The heads of the area's largest hospitals say the Mahoning Valley has a health-care crisis as bad as any in the country.
"The Valley's population is older, sicker and poorer than state and national averages," said Robert Shroder, president and CEO, Humility of Mary Health Partners. "If you combine these three things, you'll find out this community has higher health-care needs but has less ability to pay for those services."
Manufacturing jobs have gone away, he said, and the service industry jobs do not typically pay health insurance. And the situation is worse for those out of work -- the area's unemployment rate, about 7 percent, beats the state and national averages.
The pessimistic outlook was presented to the current class of Leadership Mahoning Valley, a civic education course for leaders of nonprofit corporations and businesses.
Challenges ahead
Both Shroder and his main competitor, Kristopher Hoce, president and CEO of Forum Health, say their companies are hard pressed to offer quality care as government and private insurers try to reduce reimbursements. The hospitals indicate that they will treat anyone regardless of their ability to pay, but it comes at a price.
Shroder said that charity care over the past four years has risen more than 65 percent increase in addition to bad debt amounting to $21 million just for this year. He said uncompensated care is passed on to those who have insurance.
"I think we need to pass some kind of national health-care insurance to set a minimum level of health care, even though not everyone would use it," Shroder said. "In the long run it will cost less."
Hoce noted, "We're sitting here trying to respond to health needs with reimbursement policies of four years ago. I think you have to have some minimal level of coverage, but how do you go about doing that without compromising care?"
Malpractice coverage
Both Shroder and Hoce said the growing problem of malpractice insurance is another serious issue for hospitals and their physicians, noting that Mahoning County has the highest per-capita rate for filing malpractice suits in the state.
Shroder said in the past two years HMHP has lost more than 30 physicians, and high malpractice rates make recruitment of new doctors to the area difficult.
Shroder explained that increased competition from new sources also is affecting the hospitals.
Physician costs are rising while reimbursements are declining. This, he said, has resulted in doctors' looking for other sources of income, often working with specialty companies, or niche providers, that perform procedure-based services with high reimbursements.
Facilities in suburbs
Hoce and Shroder discussed the hospital systems' moves to the suburbs in recent years. Both have emergency facilities in Boardman.
Hoce said access is the key to these decisions. "As the population moves, health care has to be where the people are," he said.
"We are not abandoning the city. In fact there is a $70 million dollar expansion of facilities at Northside [Medical Center]," Hoce said.
St. Elizabeth Health Center announced recently that it is building a new, acute care medical/surgical hospital in Boardman to serve the residents of southern Mahoning County and Columbiana County.
"St. E's biggest problem is that we have a lack of rooms [in Youngstown]. We have people in our emergency rooms waiting for beds," Shroder said. "We feel we'll give better service and make St. E's stronger."
HMHP's community hospitals will send the most serious cases to St. Elizabeth's, Shroder explained.
In addition, HMHP will construct new surgical suites at both St. Elizabeth's and St. Joseph Health Center in Warren.
Forum's chief added still another challenge for health care in the months ahead is a project of a $5 billion state budget deficit. Hoce said 85 percent of the state budget goes to prisons, education and health care.
"I would ask all of you to stay attuned to that because any change in how are the state funds health care is directly going to impact the type of services and issues discussed," Hoce said.