Two days after bemoaning the loss of more than $70 million in federal funding, Jackson executives reported that its cost-saving, revenue-enhancing initiatives were going well -- and the overall loss this fiscal year could be as low as $50 million, a dramatic improvement from a $244 million loss last year.
In a meeting Wednesday of a Public Health Trust committee, Vice President Christopher Bayer said a detailed analysis showed the loss would be $50 million for the fiscal year ending Sept. 30 for a variety of reasons, including increases in sales tax revenue.
Some observers doubted the latest good news. ``I continue to be a skeptic,'' said Stephen Dresnick, a physician-healthcare entrepreneur who was one of 41 civic leaders who signed a letter in May urging the county commission to fix Jackson's ``broken'' business model. ``It's hard to understand how they can go from $240 million to $50 million.''
Alina Tejada Hudak, an assistant county manager who monitors Jackson, said at the Wednesday meeting she was concerned about shifting projections in Jackson's reports.
Chief Operating Officer David Small said some of the improvement could be attributed to ideas of Pricewater-houseCoopers, whose $10 million consulting contract to improve Jackson operations was approved by the board on Monday.
``With PricewaterhouseCoopers' help, we're several months ahead of where we would have been,'' Small said.
On Wednesday, Chief Executive Eneida Roldan said Jackson is doing a much better job of collecting on bills from insurers and co-pays from patients.
``Remember,'' she said of the 2009 audit reporting the $244 million loss, ``that was a snapshot on one point in time. We're still collecting on those receivables'' -- bills that were written off as losses in fiscal 2009.
`DID TAKE HIT'
Roldan said she didn't see any conflict with her Monday statements, in which she lamented that Jackson had lost a lump sum of $50 million in enhanced federal Medicaid funding, plus another $2.3 million a month in ongoing Medicaid support. On Monday, Chief Interim Financial Officer Ted Shaw estimated the fiscal 2010 loss would be between $80 and $100 million, before considering the new $50 million loss.
``We did take a hit,'' Roldan said Wednesday, but the projections are always changing. ``You are seeing a lot of moving pieces.''
Jackson's last published financial statement, for April, showed a year-to-date loss of $74 million. To reduce that to a $50 million loss will mean the system showing a net surplus for the rest of the fiscal year -- despite continuing declines in patient admissions.
`SURPRISES'
Trust Treasurer Marcos Lapciuc said he wasn't certain how much people should rely on the latest projections: ``We always seem to have surprises.''
Roldan's statements on the lost Medicaid funds came during a Monday meeting that involved heated debate on the closing of Jackson South's obstetrics unit.
Roldan said the move would stop an annual $2.5 million loss while earning more money by turning over an operating room, now on stand-by for possible cesarean sections, to money-making laparoscopic surgeons who do bariatric and other kinds of minimally invasive operations.
At the Monday meeting, Commissioner Javier Souto warned the Trust that ``you're getting into some ugly things'' by closing the center. The OB closing is scheduled to be discussed at the commission meeting next Thursday, and several other commissioners are reportedly planning to complain about it.
On Wednesday, Hudak said she was puzzled why the OB closing was rushed onto the agenda at the last minute Monday, when it seemed more appropriate for a discussion during the 2011 budget talks. The county commission generally has a say in major changes in Jackson services.
Roldan emphasized Wednesday that, despite the latest upbeat projections, Jackson, like other public hospital systems around the country, faces a tough future with growing numbers of uninsured, declining admissions and less government support.
UM WITHDRAWS REQUEST
In other Jackson developments Wednesday:
• A University of Miami spokeswoman said the UM hospital has withdrawn a request to the state that it be allowed to perform organ transplants.
Transplants have been a major mainstay at Jackson Memorial, using UM surgeons. For most hospitals, transplants make money because they're supported by government programs. Jackson's program had shown losses, and the system considered abandoning it.
On Wednesday Roldan said a further analysis showed that the transplant program was doing well, and Jackson saw no reason to abandon it.