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Cuts, trauma changes threaten quality of care

A new year often brings resolutions that reflect our goals. Whether it's to read more or eat less, we use the fresh calendar as a catalyst to achieve our priorities.

Significant changes in health care call for us to expand our resolutions to include community considerations as well. In 2012, important hospital priorities will be defined that affect everyone who calls Pinellas County home.

Health care is experiencing a paradigm shift unrivaled in the last 25 years. In keeping with 2010's Affordable Care Act, providers are re-engineering processes to make way for increased access and improved quality at lower costs. Providers, payers and networks generally agree that this is the ideal destination for our industry, but the ways we'll get there are as varied as the populations we serve. Everything is on the table, and no service can be taken for granted.

Those intermediate decisions can have a big impact on our community's quality of care, which impacts far more than individual patients. A healthier community that receives primary care in medical homes instead of emergency rooms can be tied to better jobs, better schools and an overall elevated quality of life. And access to a robust continuum of services that includes everything from preventive to lifesaving trauma care matters just as much.

This year, Pinellas County faces decisions that may severely hurt both preventive and trauma care access. Proposed state budget cuts and two newly designated trauma centers in neighboring counties threaten our local health care options. Our collective engagement around these issues now can soften the blow of unintended consequences that could come later.

Consequences of budget cuts

While national reform ramps up to expand Medicaid eligibility, our state chips away at the program's integrity. Gov. Rick Scott's recent budget proposal includes $2 billion in Medicaid cuts and eliminates important federal and local matching funds. The Florida Hospital Association says Bayfront Medical Center stands to lose more than $9 million, a debilitating blow to an already razor-thin margin. Also on the list: nearly $41 million for children at our neighboring All Children's Hospital and more than $10 million for hospitals in the rest of the county.

This budget, if passed, carries dire consequences that not only hurt our community's most vulnerable but puts all of us at risk. When a hospital changes its scope of services, it doesn't preserve a portion for privately insured and paying patients. The service ceases to exist for everyone who needs it.

A traumatized trauma network

Scott's Department of Health's Office of Trauma recently granted level II provisional status to HCA's Blake Medical Center and Regional Medical Center at Bayonet Point. This, despite a ruling that found the application review process to be outdated and invalid.

The best trauma centers operate regionally, as a cooperative network that draws the area's most experienced specialists to a few strategic locations. At Bayfront, Pinellas County's only trauma center, a team of experts armed with technology and talent stand by to provide lifesaving care and the subsequent continuum of intensive treatment most trauma patients need.

Not every hospital can meet these demands. The strong relationship between trauma center volume and quality tells us that absent need, diverting critically injured patients away from established centers to fledgling programs results in compromised care across the network. Bayfront, St. Joseph's and Tampa General ideally meet our community's trauma needs, exceeding standards and expectations. Fortunately, trauma volume in our area does not call for additional centers. Unfortunately, more centers have been added. If, at the end of the state's review period, their provisional status converts to trauma center designation, we will all see less volume, undue competition for trained specialists and diminished outcomes all around.

A proliferation of trauma centers, where there is no need, will not increase quality and access but do just the opposite.

Likewise, such drastic cuts in Medicaid rates, on top of significant cuts to last year's rates, will change the scope of care you have come to count on.

Our community is fortunate to have a well-established health care network that includes our industry's best offerings. That infrastructure is built on a generation of community engagement, advocacy and ownership. It cannot be taken for granted.

In some cases the votes of our state delegation will decide these issues for us. In others, our expectations will set our community's bar. In every scenario, your voice matters.

In 2012, resolve to halt this attack on your hospitals' ability to answer our community's call to care. Engage in the issues that define this important aspect of our quality of life and hold those responsible accountable for the consequences they bring to your options for care.

Sue G. Brody is president and CEO of Bayfront Health System, which operates Bayfront Medical Center, a 480-bed teaching hospital and trauma center in St. Petersburg.

Cuts, trauma changes threaten quality of care 12/29/11 [Last modified: Thursday, December 29, 2011 5:00pm]
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