Case study: IN hospital racks up surplus through prevention

Far too often, hospital systems serving the poor and uninsured have a tale of financial woe to tell, particularly given that their patients are often uninsured. But at Wishard Health Services, the story ends a little bit differently. True, the Indianapolis, IN-based health system includes Wishard Memorial Hospital, a haven for the poor and uninsured. Nonetheless, it expects to report an estimated $5.5 million surplus when it officially closes its 2007 books. It also posted surpluses in 2005 and 2006.

It's not that Wishard has a rich base of commercial patients to milk. In fact, 34 percent are uninsured, and 28 percent are covered by Medicaid. Only 10 percent of its patients have commercial health coverage. However, leaders say that an intense effort to reach out and help patients before they get sick enough to be hospitalized has helped to minimize the expense of caring for such patients. 

For example, when a pregnant woman seen in one of Wishard's eight clinics is considered to be economically or medically at risk, they're assigned a public health nurse, who makes house calls to see that the patient gets appropriate prenatal care. Ultimately, this makes it less likely that the woman will deliver prematurely, which leads to longer lengths of stay and sicker newborns.

To learn more about Wishard:
- read this Indianapolis Star piece
- read this Wishard fact sheet (.pdf)

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