Heading into what its chief executive calls “a transformational year’’ in 2016, trustees for Jackson Health System adopted a $1.8 billion spending plan Monday that seeks to position Miami-Dade’s public hospital system for a future with reduced federal funding for treating the uninsured and greater emphasis on preventive medicine and population health.
The budget proposal, which elicited no comment during a public hearing, next requires approval from Miami-Dade commissioners, who must ratify the spending plan by Sept. 30.
Riding on the strength of a record profit of $14 million for the month of June, Jackson CEO Carlos Migoya cautioned members of the Public Health Trust that despite four consecutive years of budget surpluses there are difficult challenges ahead.
“We’re a long way from becoming the kind of visionary and patient-centered healthcare system that is well positioned for tomorrow,” Migoya said during the budget presentation.
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And while Jackson has budget surpluses now instead of the near-financial-collapse in 2011, Migoya said, “The heart of our transformation begins in 2016.”
In the coming year, Jackson will fund new efforts toward preventive care and population health, with an emphasis on managing chronic conditions. Jackson also plans to open in 2016 the first of eight to 12 urgent care centers throughout Miami-Dade, part of a scheme to bring the public hospital system’s brand into Miami-Dade’s suburban neighborhoods.
Earlier this year, Jackson announced the first two sites in North Miami and Country Walk. On Monday, in a letter to the Miami Beach Planning Board, a representative of Mount Sinai Medical Center said that Jackson plans to open an urgent care center in South Beach in partnership with the University of Miami.
The future locations of Jackson’s urgent care centers have been regarded as a competitive secret by the hospital system’s administrators and trustees. But Wayne Chaplin, board chairman for Mount Sinai, wrote to the city planning board that “Jackson/UM plans to open an urgent care facility in South Beach that will provide care to the indigent community and accept most forms of insurance.”
Migoya declined to comment on Chaplin’s letter. “I don't know where he got that information,” Migoya said. “We’re looking at all opportunities.’’ He added that two new locations will be announced in the next 30 days.
The urgent care centers are part of Jackson’s long-term expansion efforts, which include plans for overhauling infrastructure, building new hospitals, and purchasing new medical equipment and computer systems. The efforts will be funded primarily through $830 million in borrowing approved by Miami-Dade voters in 2013, with an additional $550 million generated by the public hospital system and other sources.
Those investments are expected to increase the numbers of insured patients who choose to get care at Jackson while reducing the hospital system’s reliance on federal government support. But Jackson’s local taxpayer support remains robust.
For the year that starts Oct. 1, Jackson administrators expect the county’s public hospital network will receive nearly $400 million in local sales and property taxes, according to budget documents.
With nearly 11,000 full-time employees, Jackson’s largest operating expenses for 2016 include salaries and benefits, purchased services such as agency staffing, and supplies.
With new buildings and new services to provide, Jackson will need financial reserves to help pay for expanded operations until patient volumes grow large enough to sustain growth, Migoya said.
June was a banner month, with a record $14 million profit, which boosts the hospital system’s total budget surplus for the current year to $68.7 million, and raises projections for the year-end margin to reach $70 million through Sept. 30.
Migoya attributed the strong showing to an increase in surgeries and outpatient procedures. But Jackson also is riding a wave of swelling sales tax support that has exceeded expectations by an average of $1.7 million a month.
Jackson trustees also on Monday approved $5 million in building and renovation projects funded with the voter-approved money, including the purchase of radiology equipment and renovations of the facility where it will be used, upgrades to the fire alarm system, a new roof on the central building and a new linen system.