Healthcare: Fueling the
Missoula Economy
Jeff Fee, President
More than
135 Years of Tradition
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In 1873, sixteen years before
Montana statehood, the Sisters
of Providence founded St.
Patrick Hospital in Missoula
Today St. Pat’s is a 247 bed
multi-specialty facility serving 7
primary counties and a referral
center for 17 counties
Services here are recognized
among the top 5% in US
hospitals by several
independent healthcare
evaluators
Is the second largest employer
in the city
Sisters of Providence
Lists of Service
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International Heart Institute, recognized in the top 5% of cardiac
programs in the country
Western Montana’s only Level II Trauma Center
Comprehensive Cancer program with medical and radiation oncology
all under one roof. Recently awarded the Outstanding Achievement
Award by the Commission on Cancer
Chronic Disease Prevention and Management Program –
Cardiometabolic Risk Reduction Pilot, recently received PH &S
President’s Award
1 of only 3 certified air flight programs in MT with fixed and rotor wing
aircraft
Comprehensive Neurosurgical, Stroke & Orthopedics programs
Bariatric Surgery Program
24/7 Intensivist coverage in our critical care units
279 physicians on staff, 105 employed physicians
da Vinci Robotics Surgery
– Cardiac
– GYN
– Urology
Emergency Services
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St. Patrick Hospital is Western Montana’s only Level II Trauma Center
The Emergency Department was built in 1984 to serve 10,000 patient
visits per year
2008 seen in ED: 25, 502
- Trauma cases accounted for 31% of visits
- Mental health disorders accounted for 7% of visits
- Patients under the age of 18 accounted for 10% of visitors
ED Visits Projected to be over 33,000 by 2017
Emergency Services
The Emergency Department Facilities Plan includes the
following additions:
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Expanded capacity to serve our current and future patient demands
More technology to support our award winning
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Level II Trauma Center,
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Accredited Chest Pain Center
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Accredited Stroke Center
Larger trauma rooms and better access for our staff to streamline time-critical
care
Disaster preparedness to handle large scale infectious, toxic, biological and
natural disasters
Improved Stroke Care to instantly proceed with lifesaving, brain-preserving
treatment
Improved layout, design and equipment to improve speed, accuracy and safety of
our treatment
Stronger regional emergency services to the19 smaller community hospitals with
which we partner
Private treatment areas for our mental health patients
More efficient treatment of patients with minor illnesses and injuries, with 21
rooms and best-practice procedures
Economic Impact
of Healthcare
• St Patrick Hospital:
FTE = 1287
Head Count = 1650
• St Joseph Medical Center
FTE = 179
Head Count = 235
• Volunteers: 230 Hours: 34,000 per year (divided by 2080 =
16.35 FTE employees)
• Total Payroll going into the economy
$61,199,700
• 2008 Tax benefit for SPH of $2,481,621 and $278,221 for
SJMC.
Economic Impact
of Healthcare
• Signed physicians; 2007 (18), 2008 (26) and 2009 (11) YTD
– Average home purchase price $450-500K
– 2009 Employed Physician Salaries $14.4M
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Annual Net Operating Revenues $258M
Annual Operating Expenses $246M
Typical capital reinvestment $10-25M/year
SPH Inpatient Discharges
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PSA (Missoula and 6 surrounding counties) - 82.9%
Over 50% of SPH Discharges come from outside Missoula County
Out of State 4.8%
Tertiary Service Area (covers over 60% of the population of the
state) - 9.1%
– Other MT 3.2%
– Average length of stay ~5 days=lodging and food to economy
Outreach and Clinics
• The current state of the U.S. health care system is
• broken
Cardiac
(quality, cost, access).
• These
issues
push us to
make significant
changes
– Butte,
Kalispell,
Helena,
Anaconda,
Deerin
the way we deliver health care for our patients.
Lodge
• Working toward the vision will allow us to influence
way health
care is delivered, rather Polson,
than waiting
• the
Primary
CareClinics-Seeley,
for others to decide how to change the system.
Florence, Stevensville, Lolo,
• For example, payors are beginning to demand more
Frenchtown
value
in health care. Our ability to demonstrate value
(via quality and affordability) will position us for a
• successful
Rural ER
Out Reach
future.
Economic Impact
of Healthcare
Rural ER Outreach
Location
Anaconda Community Hospital
Anaconda
Barrett Hospital
Dillon
Clark Fork Valley Hospital
Plains
Granite County Hospital
Phillipsburg
Madison Valley Hospital
Ennis
Powell County Hospital
Deer Lodge
Ruby Valley Hospital
Sheridan
Steele Memorial Hospital
Salmon, ID
Teton Medical Center
Choteau
Community Benefit
• Charity Care: Is free or discounted health services provided to
persons who cannot afford to pay and who meet the criteria for
financial assistance.
• Government Sponsored Health Care: Includes unpaid costs of
public programs- the shortfall created when a facility receives
payments that are less than the cost of caring for public program
beneficiaries; e.g. Medicaid, IHS, including negative margin
programs such as behavioral health, emergency services and
renal dialysis.
• Community Benefit Services: Programs or activities carried out
to improve community health that are subsidized by the hospital.
Community Benefit
Community
Benefit
Services,
8,048,891
2008
2008- $21,551,000
Charity Care,
6,260,037
Government
Sponsored
Health Care,
5,386,834
Community
Benefit
Services,
$5,721,261,
2006 - $14,572,059
2007
Government
Sponsored
Healthcare,
$4,665,459,
2007 - $17,468,901
Charity
Care,
$6,668,960,
2008 unpaid costs for
providing Medicare $20.9M
Changing Demographic
Area
Primary
Tertiary
Combined
State of MT
USA
Total Pop
4.52%
5.27%
5.02%
3.49%
4.61%
% Growth 2007-2012
18-44F pop
45-64 Pop
0.42%
6.09%
1.36%
6.58%
1.03%
6.41%
-0.05%
5.69%
-0.80%
10.20%
A aging demographic requires focus and growth on
certain medical service:
•Cardiac
•Cancer
•Orthopedics and IP Rehabilitation
65+ Pop
18.76%
18.34%
18.48%
15.35%
14.10%
As people of Providence, we reveal God’s love for all,
especially the poor and vulnerable through our compassionate service.
Respect  Compassion  Justice  Excellence  Stewardship
VISION: Our ministry will be a transformational force for our
communities by advancing health care excellence and access for all.
Responsibility: Health Care Excellence
Each person we serve receives
the best possible outcome and
has an exceptional experience.
Responsibility: Access for All
Every person within our community
easily gets the care they need.
Clinical
Outcomes
Strategies
Compassionate
Care
Strategies
Coordinated
Care
Strategies
Affordability
Results
Results
Results
Results
Strategies
Mission Inspired  People Centered  Service Oriented
Quality Focused  Financially Responsible  Growing to Serve
2009 Strategic Priorities
• Maintain the integrity of our Mission
• Quality Strategic Plan (zero preventable deaths or
injuries, top decile for all publicly reported measures)
• Ensure continued economic viability
• Aggressively advocate for meaningful healthcare
reform
• Stabilize Primary Care Base and movement to an
ambulatory strategy
• Establish a comprehensive regional electronic
medical record
• Transforming Healthcare=Alternative medical
models, medical home
Questions and Comments