After two years of struggling to contain a financial crisis, leaders of Miami-Dade’s public hospital system adopted a budget for 2014 on Friday that invests in hiring more physicians and nurses, upgrading electronic health records and improving patient outcomes — all helping to position Jackson Health System for epic changes coming with federal healthcare reform next year.
The Public Health Trust that runs Jackson Health System ratified the $1.5 billion budget, which now must receive approval from Miami-Dade commissioners by Sept. 30, the close of the fiscal year.
“The bleeding has stopped,” said Irene Lipof, a trustee. “Now we’re looking to improve quality.”
Calling the 2014 budget “radically different from its predecessors,” Chief Executive Carlos Migoya said Jackson’s strategy for the future “is tactical growth — adding programs, growing volumes and expanding our footprint in Miami-Dade County.”
Beginning Oct. 1, when a key component of healthcare reform — the online health insurance exchanges offering subsidized plans to millions of Americans — opens for business, Jackson will embark on an uncertain voyage.
While more people will have health insurance, Jackson administrators do not know if the increase in coverage will translate to more revenue.
Federal grants and Medicare reimbursements for hospitals are expected to change under the Affordable Care Act, and Florida’s shift of nearly 3 million Medicaid beneficiaries into managed care likely will lead to a reduction in reimbursements, said Mark Knight, Jackson’s chief financial officer.
The hospital system’s budget assumes that Medicare payments next year will drop by $4 million due to federal budget cuts called sequestration starting in January, and that Florida’s Medicaid reform will reduce Jackson’s reimbursements by $6 million next year.
And depending on Jackson’s success at reducing patient readmissions and cutting costs in programs under Medicare, the hospital may increase its reimbursements or pay penalties that will lower them.
“While we may see more patients covered,” Knight said, “there may not be true increases in dollars.”
Jackson’s budget projects an increase in patient admissions of .7 percent above 2013, or an increase of about 408 patients over the estimated 57,698 patients the hospital system will have admitted through Sept. 30.
Migoya said patient admissions rose in 2013 over the prior year, indicating that renovations to patient rooms and other improvements have begun to produce results.
In November, Miami-Dade voters will decide whether to increase their property taxes to fund $830 million in bonds for new buildings, equipment and other upgrades of Jackson’s aging facilities.
“More patients are choosing Jackson,’’ Migoya said. “That reflects the improvements we’ve made already, and primes our pump to continue moving forward.”
Darryl Sharpton, chairman of the trust, said Jackson is investing in growth for the first time in two years, in part by improving facilities but also by recruiting more physicians for certain programs, such as transplants, offering better training programs for current physicians and doing a better job of recruiting residents once they’ve graduated.