1. 1 Current Issues Future Outlook January 12, 2009 Economic Summit Wendy Warring, Connecticut Children’s Medical Center

2. 2 True or False? Most free-standing children’s hospitals either break even or lose money. On average, a third of the patients at a children’s hospital are insured by Medicaid. It costs more to operate an adult hospital than to operate a children’s hospital The need for pediatric services in the Northeast will decline over the next five years as the pediatric population declines

3. 3 T or F ? A quarter of the kids treated at Connecticut Children’s are under the age of 1 and nearly half are under the age of 5. Connecticut Children’s is one of the smallest children’s hospitals in the country. Connecticut Children’s is one of the most expensive children’s hospitals in the country. There were a record no. of hospitals that pursued mass layoffs in 2008. The number of employees at hospitals grew in 2008.

4. 4 Current and Future Issues for CCMC Size Reimbursement Number of Patients The Economy Information Management: Affording and Adopting Technologies Physician Sub-Specialty Recruitment Reputation Federal Legislative Changes

5. 5 National View: Compelling Reasons for Health Care Reform ? Need for universal coverage. Unsustainable Costs –Lack of Coordination of Care/Primary Care Quality: Need for Useful Information Cost Access Quality

6. 6 Connecticut : Compelling Reasons? Reform here? Are there problems with Access, Cost, or Quality? –The Business Community: no, YES, not sure –Consumers/Advocates: YES, YES, not sure –Government: no, YES, yes –Insurers: no, yes, yes –Providers (Hospitals and physicians): yes, yes, yes

7. 7 Connecticut: Opportunities for Leadership Defining common ground :Balancing and aligning key interests of consumers, providers, insurers, and the business community Ensuring reasonable access to high quality care Building sustainability and developing opportunities for diversification and innovation Measuring and obtaining value (an improvement on controlling costs) Making tough choices: defining what key stakeholders need to get and give (Politics: AGH!!) Resolving immediate crises (need cash) while pursuing the larger agenda

8. 8 Next Steps? WHAT: –Clarify the immediate issues in the context of a long term vision –Define a long term vision with sufficient “buy-in” WHY: –Goes without saying: The health care sector is a critical part of CT’s economy and well-being of CT’s communities –What’s the alternative? Muddling through will lead to repeated “crises”

9. 9 Next Steps HOW: –Develop forums for constructive and actionable dialogue among stakeholders with political clout; –Communicate key information. –Set deadlines for specific achievements WHEN: –Now WHO: –Depending on scope of the vision, who are the key stakeholders???? Don’t forget consumer/ patient advocates