Florida Governor Rick Scott panel cannot compare Florida hospitals

The following article was published on January 3, 2012 in the Tampa Tribune:

Scott panel cannot compare Florida hospitals

By Bill Kazcor

A panel appointed by Gov. Rick Scott, who once headed the nation’s largest for-profit hospital chain, told him on Tuesday that it could not determine whether Florida’s public hospitals provide better or worse care than private ones.

A study commissioned by the seven-member Commission on Review of Taxpayer Funded Hospital Districts said it was difficult to compare the quality of care at various types of hospitals because they are very diverse and have complex business models.

The commission noted a third of Florida’s publicly owned hospitals are in rural areas that have too few patients to generate data comparable to urban hospitals.

The report did conclude that patient expenses are up to 12 percent higher in public hospitals. A public hospital economist attributed the difference largely to Miami’s Jackson Memorial Hospital.

Scott created the panel last March to determine if it’s in the public’s best interest to continue having government-operated hospitals.

Florida has 30 active hospital districts but only 16 have the authority to levy taxes or receive tax money.

The panel recommended a number of changes in its final report to Scott and the Legislature, but it stopped short of calling for an end to public hospitals.

A key proposal is that voters should be given a chance every eight to 12 years to determine if local hospital districts should continue receiving taxpayer funds.

The panel also urged the districts to pay for indigent care at private as well as public hospitals and clinics.

The commission also agreed with the Republican governor’s push to make Medicaid reimbursements more uniform for public and private hospitals alike.

Scott has proposed cutting Medicaid reimbursements in his annual budget proposal to the Legislature.

“The more wisely we use taxpayer dollars in our hospital systems the better we’ll be able to fund other priorities like education,” Scott spokesman Lane Wright wrote in an email. “At this time, Governor Scott and his staff are still reviewing the report and look forward to implementing the recommendations that make sense.”

The panel said Scott and lawmakers should support efforts by the Florida Agency for Health Care Administration, which oversees the state’s Medicaid program, to refine and publish data on outcomes and quality.

The report notes Commissioner Paul Duncan, a University of Florida health services researcher, pointed out there’s great potential for coming up with misleading results when trying to compare private and public hospitals without a thorough and rigorous analysis of available data.

“This level of research would be a very significant undertaking, beyond the scope of the commission and more appropriately conducted by a team of academic researchers,” the panel wrote.

Keon-Hyong Lee of Florida State University’s Askew School of Public Administration and Policy conducted the cost analysis that showed public hospitals had higher expenses than their private counterparts.

Jim Zingale, executive director of research and fiscal analysis, for the Safety Net Hospital Alliance of Florida, presented a response showing the average cost per adjusted admission at public hospitals drops by nearly 15 percent if Jackson Memorial and tiny Campbellton-Graceville in the Panhandle are removed from the calculation.

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