February Online Connection
February 2010 Online Connection
Smita Bailey, MD, PCMG, Pediatric Radiology
In the News
Phoenix Children's Hospital is pleased to announce its One Call Physician Assistance Line, (602) 546-DOCS (3627). The line is a one-stop-shop number for admissions, ED referrals, and Phoenix Children's Medical Group (PCMG) subspecialty consultation. This line is not for scheduling appointments. If you have any questions please contact Lynda Christel, Physician Relations, at (602) 546-5873.
Last week, Phoenix Children's President and CEO Bob Meyer sat down for an interview to talk about the status of the state budget and its impact on Phoenix Children's Hospital. To view the video from this interview, please click here, or read his comments in the transcript below.
Question: We keep hearing about the state budget crisis. What is really happening?
Answer: The situation with the state budget is all budgets are full of assumptions. You make assumptions for revenue growth, income tax collections, and other things. What's proven to be the case for the state budget that ends June 30, 2010, is many of the assumptions around revenue, tax collections, etc., have not come true. So we're half-way through the budget year, and it appears there's a $1.5 billion deficit.
[NOTE: Factors that led to Arizona's budget deficit include the economy, reduced tax revenues, added spending, state actions, voter-imposed constraints, and federal mandates.]
Question: We hear there have been cuts to AHCCCS. How does this affect Phoenix Children's?
Answer: If you were to look at AHCCCS and how it pays hospitals, there are basically eight different ways you get paid. The real issue with our situation at Phoenix Children's is that we participate in all the programs.
[NOTE: Any cuts to AHCCCS significantly impact PCH because 60 percent of PCH patients are Medicaid (AHCCCS) beneficiaries. Cuts to PCH's AHCCCS funding in recent years total approximately $45 million.]
To date, in the cuts that have come in the last three years, we've absorbed $35 million in Medicaid reductions. Just the Disproportionate Share and GME cuts that are currently proposed would add another $10 million to that.
[NOTE: "DSH" is Disproportionate Share, funds that support safety net hospitals, which care for a large number of AHCCCS patients. "GME" is Graduate Medical Education, funds that support training for physicians and other healthcare professionals.]
Question: How has the Hospital been able to balance its own budget with all these unplanned cuts?
Answer: Like all good businesses, we have been working hard to reduce our cost structure and continue to increase volumes, because volume does have something to do with spreading costs over things. We have no traveling nurses in the hospital any more. While that's better for patient safety, quality of care, and a whole variety of issues, it also saves us $7.5 million a year.
We still have some profitability left in terms of the organization, but it's foolish to gut programs for short-term issues. We've been focused as an organization a lot more on trying to fix the issue, and there are mechanisms used by many other states to generate additional Medicaid funding.
Question: What is the Hospital doing to minimize or eliminate more cuts to the AHCCCS budget?
Answer: One of the things that we've been doing is spending a lot of time educating legislators on the implication of these cuts. Recently I spent two hours with Speaker of the House Kirk Adams going through in detail the magnitude of these cuts, what they mean, how the Medicaid program actually pays hospitals, so we've spent an enormous amount of time on this education process …
So, what we've been trying to do is try to drive towards a solution. I went to a meeting recently that the governor and her staff put on – her budget people and advisors – which pretty clearly shows that the ability to "cut" our way out of [the budget crisis] is impossible. There is a $1.5 billion shortfall. The total amount of budget that could actually be cut because of voter-initiative protection, maintenance of effort through federal programs, etc., is $1.3 billion. So if you cut everything you possibly have the flexibility to cut, you can't get over the hump …
Phoenix Children's has been very out front in terms of pushing for solutions to the issue – we're not just saying "don't cut us, don't cut us." We're looking for solutions, and one of them is a concept called a provider assessment. It's used right now by about 30 other states. The concept is to put an assessment, or tax, on hospital revenues to generate the dollar that gets matched with the feds' $2 to $3, and it then gets redistributed back to the hospitals. That has some potential to add a significant amount of new dollars to the state Medicaid program …
It's time for legislators to become pragmatic. They've got to become leaders, they have to get off the ideologies that are out there – on the right and the left – get back in the mainstream, and figure out how to fix this problem. We're at the point that we're going to do incredible damage to the infrastructure of the state. But it's not just health care - it's education, it's higher education. There's a lot on the table right now, and again, we need some leadership.
Question: What can I do to help?
Answer: Join the Parent Action Committee.
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Want to take a peek at our construction progress since fall 2008? To view the time-lapsed progress, visit www.phoenixchildrens.com/about/expansion/construction-photos.html.
Consumers are using the Web for health information more than ever before. That's why we've been working hard to add more and more health content to our Web site, www.phoenixchildrens.com. Click on the Health Information tab to get to pediatric health information. This pediatric health library includes searchable content in English and Spanish, health news, diagnostic and surgical tests and procedure guides, interactive health quizzes and calculators, and more.
This will provide our Web site visitors with comprehensive information on hundreds of diseases and conditions. To take a look, www.phoenixchildrens.com/emily-center/health-information.html.
If you have a patient requiring same-day sports medicine evaluation, please call (602) 277-7678 to make a referral to the PCH Sports Injury Clinic. Same-day appointments are available in the Northwest and East Valley and central Phoenix.
Phoenix Children's has made several improvements to the Web page of the Division of Pediatric Radiology. To view the Web page, please click here.
Feb. 16: Grand Rounds, Sinusitis and Its Orbital Complications - Eugene Shapiro, MD. For more information, click here.
Feb. 19: Webinar, CME, Intoeing, Bowlegs and Most Other Deformities Not to Worry About! Register now.
Feb. 23: Grand Rounds, Inflammatory Myopathies - Michael Shishov, MD. For more information, click here.
For more information on events, visit http://pch.convio.net/site/Calendar.