Straight Talk

March 19, 2015

Dear Friend and Colleagues,

The healthcare debate across the nation—and especially here in Florida—has centered on providing insurance for the uninsured. This was one of the hot topics at last week’s “Hospital Days” in Tallahassee, sponsored by the Florida Hospital Association (FHA), of which I am this year’s Chair. All of us in healthcare should be concerned about this pressing issue.

Unfortunately, Medicaid expansion has become a highly politicized issue—for uninsured citizens whose health suffers as access is impeded; for business owners and anyone else buying health insurance as premiums are higher when costs are shifted; for politicians who have limited resources competing for funding; and for healthcare providers like all of us who care for the uninsured.

In Florida, where an estimated almost four million individuals are uninsured making us second in the nation in the rate of residents without health insurance at 24.3%, our state legislature is locked in debate about accepting approximately $5 billion a year to provide Medicaid health insurance to about one million of this uninsured population.

According to a recent review by the Brookings Institute, “Medicaid enrollment across the nation has increased by 18% in the last year; offering coverage to 69 million low-income Americans as of November 2014. For states that expanded Medicaid, enrollment increased 25.5%, while non-expansion states [Florida being an example] saw a rise of 7%.”

The good news is that Florida’s healthcare quality—the other hot topic at the FHA meeting—has improved and our state’s opportunity to improve financing care for the uninsured has never been better.

FHA’s Hospital Engagement Network (HEN) initiated a project focusing on 11 areas with the highest incidence of preventable harm. These included adverse drug events, catheter-associated urinary tract infections, central line infections, early elective deliveries, falls, obstetric harm, pressure ulcers, readmissions, surgical site infections, ventilator associated events, and venous thromboembolism. A total of 77 hospitals participated in the FHA HEN with another 62 hospitals in Florida engaged in HENs sponsored by other effective organizations. Results from the FHA HEN were spectacular, with some 27,500 cases of harm prevented and overall harm rate reduced by 54%, resulting in an estimated $170 million in health care costs avoided. Similar results can be expected from HENs sponsored by other organizations.

According to the Agency for Healthcare Research and Quality, Florida has risen from the 4th quintile in 2007 to the 2nd quintile in 2014 (1st quintile being best). The agency’s metrics included skilled nursing facilities and other pre-and-post hospital facilities. When only hospital quality metrics are examined, Florida’s hospitals rank 6th of 50 states—remarkably good. As a state we will be starting our next set of HEN projects, in which NCH will continue to be an active participant. (Metrics can be viewed at )

As our elected officials in Tallahassee debate how to care for four million uninsured Florida citizens, NCH and the Florida Hospital Association will continue to be supportive. I’m confident that at the end of the day, by working together with our legislators, we will be successful in helping ensure that all Floridians live longer, happier, and healthier lives. Meanwhile, our journey to improve healthcare quality and the wellness of our neighbors is never-ending.


Allen Weiss, M.D. Signature

Allen S. Weiss, M.D., President and CEO

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