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Subsidium Healthcare
Insight and Action for Value
LakewoodCommunityMeeting
January28,2015
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Lakewood Mirrors Markets Across the U.S.
2
Common HospitalTrends National
Trend?
Lakewood
Trend?
DecliningMedicare
payments
Improvingoverallprofit margins
Inpatient volumesdecreasing;outpatient
volumesup
significantly
Governmentownedhospitalsdecreasing
Independenthospitalsdecreasing
Independentphysicians
decreasing
Qualityincreasing
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Lakewoods Experience Mirrors National Trends
3
940
960
980
1,000
1,020
1,040
1,060
1,080
1,100
1,120
1,140
State&LocalGov'tComm'tyHospitals
CommunityHospitalsOwnedby
StateandLocalGovts
2006 2007 2009 2012 2013
2,500
2,600
2,700
2,800
2,900
3,000
3,100
3,200
CommunityHospitalsinaSystem
CommunityHospitalsIna
System(vs.Independent)
2006 2007 2009 2012 2013
Source: AmericanHospitalAssociation,FastFacts20062015
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Market and Technology Trends are Shifting
Focus to Outpatient Settings
4
Percentoftotalhospitalrevenues(inpatientvs.outpatientservices)
Outpatient Inpatient
Early90s
Outpatient Inpatient
Estimated2019
Outpatient Inpatient
Current
Source: Taylor,Richard. JonesLangLaSallewhitepaperentitledTheSpokeBefore
theHub: TurningtheHealthcareDeliveryModelUpsideDown. Page2.
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Evaluation Process: Four Major Stages of Work
5
Context
Mustwe
act?
Isstatus
quo
untenable?
Review
market
Strategy
Whatshouldwe
do?
Besthealth
caremodel
for
Lakewood?
Partner
Whoisthe
bestlong
term
partnerfor
Lakewood?
Terms
Howshouldanyfuture
partnership
befunded
and
structured?
Late
2012
CurrentLate
2012
Current
July
2013
December
2013
July
2013
December
2013
July
2014
December
2014
July
2014
December
2014
January
2014
June
2014
January
2014
June
2014
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Market Context
6
7000
8000
9000
10000
11000
12000
13000
LakewoodAdmissions
LakewoodAdmissions
23500
24000
24500
25000
25500
26000
26500
27000
27500
28000
2008 2009 2010 2011 2012 2013 2014
Primary
Service
Area
Admissions
PrimaryServiceAreaAdmissions
Source: OhioHospitalAssociationdata. Source: InternalLKHdata.
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7
Hospital Performance: Context
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Strategic Options Evaluation Process
8
Webeganwith10potentialoptionsforLakewoodHospital
Step1: Preliminary
Screening
Istheoptionrealistically
viable?
Evaluated10Options;
Narrowedto3Options
Step2: Options
Analysis
ApplyLakewood
specificcriteria
to3options
Step3: Final
Evaluation
and
Recommendation
Comprehensive
OutpatientCare
CampusinLakewood
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Evaluated Ten Options for the Hospital
9
TransitionOutof
HealthCare
Comprehensive
OutpatientCampus
HybridOutpatient
Campuswith
SomeHospital
Beds
SpecialtyHospital
Orthopedics
Rehab
Behavioral
Health
LongTermCare
Downsized,GeneralHospital;
LowerAcuity
(ShortStay)
Hospital
StatusQuo
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Basis for Recommendations
10
Weconsistentlyappliedtwoprimarycriteriaforevaluationof
theoptionsforLakewoodHospital:
1. HealthNeedsoftheCommunity
2. LongTerm
Financial
Sustainability
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We Searched Locally and Nationally
for Potential Partners
11
Approached
LocalHealth
Systems
Fall2013
2initiallyexpressedinterest
Approached
7National
HospitalCos
Somepreliminary
interest,butalldeclined
topropose
OnePartner
Selectedand
Negotiated
Cleveland
Clinic
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Hospitalization Rate at
Community Hospitals
Hospitalization Rate at
Community Hospitals
500
600
700
800
900
1992 1995 1998 2001 2004 2007 2010
Inpt.Days
per1000Pop.
Year
1992-2012
-32%
Am. Hosp. Assoc.
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Average Length of Stay at
Community Hospitals
Average Length of Stay at
Community Hospitals
5.0
5.5
6.0
6.5
7.0
7.5
1992 1995 1998 2001 2004 2007 2010
Avg.Length
of Stay
Year
1992-2012
-31%
Am. Hosp. Assoc.
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Outpatient Visit Rate
at Community Hospitals
Outpatient Visit Rate
at Community Hospitals
1000
1500
2000
2500
1992 1995 1998 2001 2004 2007 2010
Outpt.Visit
per1000Pop.
Year
1992-2012
+58%
Am. Hosp. Assoc.
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LAKEWOOD
HOSPITAL
FOUNDATION
EnhancingHealth&Wellness
ThroughPhilanthropy
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Independent501(c)(3)organizationestablishedin1956toraisefundsexclusivelyforLakewoodHospital
23volunteerboardmembers/3fulltimestaff
Inthepastdecadealone,morethan$10.5millionhas
beenprovided
to
Lakewood
Hospital
to
fund
patient
programmingandservicesincluding: equipmentandtechnology
provisionofcaretodisadvantagedpopulations
capitalprojects
and
renovations
newandimprovedprogramsandinitiatives
www.lakewoodhospitalfoundation.org
WHO
WE
ARE
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NewCommunity
Based
Health
Foundation
$32millioninnewfunding(excludesassetsfrom
Lakewood
Hospital
Foundation)
Plansincludea21membergoverningboard,includingtwovotingpositionsappointedbyClevelandClinic
Collaborativeprocessbyallfourpartiestolookacrossthecommunityforpotentialcandidates
Mission/purpose
to
be
defined
as
we
work
through
the
definitiveagreement
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Forthelatestnewsandupdates,pleasevisitwww.onelakewood.com
NextTownHallMeeting:
Wednesday,
February
11
@
7PMLakewoodCityHallAuditorium
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for
more
information.