Betsy Ryan is president and CEO of the New Jersey Hospital Association. Her blog, Healthcare Matters, examines the many issues confronting New Jersey's hospitals and their patients. Readers are encouraged to join the discussion, because healthcare matters - to all of us.

Hospitals Provides Jobs, Charity Care – and Hope

Even as our nation struggles to return to a more stable economy, a recent report shows that New Jersey’s hospitals are a strong and reliable source of jobs and economic growth. Garden State hospitals delivered 140,000 jobs statewide and about $18.6 billion in economic activity in 2010 – a $40 million increase compared with 2009. The full report is available here. You can search for details on your own local hospital’s economic contributions, as well as for individual counties.

Not only are hospitals the places you turn to in your time of need for quality patient care, hospitals are the economic engines that power our communities. Our healthcare community is a source for hope. It brings stability to our state and offers continued hopes for an economic recovery. Beyond jobs, our hospitals delivers $8 billion in employee salaries, $2.3 billion in services purchased from other N.J. businesses and $420 million in income taxes paid by hospital employees. And they play another essential role as our state’s healthcare safety net. N.J. hospitals provided $1.3 billion in charity care services last year to New Jersey’s uninsured and working poor. Clearly, our hospitals play a vital role in supporting our nation during tough times and leading the journey to economic recovery.

Written by Betsy Ryan at 19:40

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Healthcare Offers Rare Glimmer of Hope on Jobs Front

New Jersey and the rest of our nation continue to struggle with unemployment. President Obama has been on a cross-country bus tour touting his “Jobs” plan, and the GOP candidates have made jobs a central part of their debates. Meanwhile, Congress has been unable to forge any consensus on a jobs bill. But here in New Jersey, hospitals and healthcare providers are providing a glimmer of hope.

Healthcare employment increased 1.5 percent in New Jersey in 2010, according to a recent report from the state Department of Labor and Workforce. That same report says that the “healthcare and social assistance” sector remains the largest source of private-sector jobs in New Jersey, employing 493,410 people stateside. Of these, New Jersey hospitals provide about 140,000 jobs and about $18.6 billion in total contributions to the state’s economy. On the national level, healthcare recorded 44,000 new jobs in the September jobs report. The August report had shown healthcare as the lone source of new jobs in our otherwise stagnant employment market.

So New Jersey’s healthcare community is a source for hope, not just for the quality care we provide to people in their times of need, but because we are one of the only economic engines generating new jobs. My hope is that those contributions are not stamped out due to new cuts being contemplated on Capitol Hill. If the so-called “Super Committee” charged with reducing the federal budget deficit fails to identify $1.2 billion in cuts and secure both congressional and presidential approval, the healthcare provider industry is slated to be cut by 2 percent. This would cut N.J. hospital and post-acute care providers by about $130 million in its first year – on top of $4.5 billion in cuts New Jersey hospitals will shoulder under the Affordable Care Act. An analysis by the American Hospital Association shows that the proposed 2 percent Medicare cut would result in 200,000 hospital jobs lost nationwide.

So while Congress can’t agree on a “Jobs” bill, my plea is that we avoid stamping out one of the only glimmers of hope in our economy by enacting more cuts to healthcare.

Written by Betsy Ryan at 20:08

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These Healthcare Cuts May Never Heal

One of the things I enjoy about my job representing hospitals is that I learn something every day because healthcare is full of constant changes and challenges. One of the biggest changes during our lifetimes is the implementation of the Affordable Care Act. And one of the biggest challenges is an onslaught of proposed cuts to healthcare that could have an impact on patients for years to come.

These deep cuts actually begin with the Affordable Care Act, or ACA. The law promises to provide health insurance coverage to 39 million Americans who currently do not have insurance. The nation’s hospitals agreed to absorb a collective $155 billion in payment reductions over 10 years to pay for this program; New Jersey’s share of those cuts was $4.5 billion. It’s a lot of money, but we agreed it was the right thing to do to insure more Americans and bring much-needed reforms to our healthcare system.

But believe it or not, healthcare providers are now faced with three very real sets of additional cuts on top of the $155 billion in cuts under the ACA.

  • First, Medicare providers – hospitals, nursing homes and others that take care of our seniors – face an automatic cut of 2 percent in Medicare payments if the deficit reduction “super committee” cannot come up with an agreement to cut the deficit by $1.2 trillion by Nov. 23 and win congressional approval by Dec. 23. That 2 percent cut translates to $1.2 billion for New Jersey providers over the next 9 years.
  • Second, President Obama has proposed his own deficit reduction measure that would cut both Medicaid and Medicare to the tune of $320 billion.
  • And finally, the President has proposed a third set of healthcare cuts to stop a 29 percent reduction to physicians’ Medicare payments that is slated to take effect in January. We agree wholeheartedly that the physician cut must be averted to ensure Medicare patients have access to the doctors they need. But that action must not come on the backs of hospitals and other healthcare providers that also provide essential Medicare services.

Our hospitals have done a tremendous job in recent years to streamline operations and operate more efficiently, but cuts of this magnitude are not possible without cutting deep into the very heart of patient care services. We have agreed to be partners in transforming our industry and putting “skin in the game.” But with these cuts, we now are getting to the muscle, bone and the marrow. It’s all the more perplexing because healthcare is one of the few sectors in our economy that is growing and adding jobs – and these cuts could halt and even reverse those economic benefits.

Years ago, I worked in New York during an era of large proposed cuts to healthcare. Our mantra during that time was, Some Cuts Never Heal. We’re now in another pivotal period where proposed healthcare cuts could have a devastating impact for years to come – closed hospitals and reduced services, longer waits for patient care and job losses that further destabilize our shaky economic. Our nation – its economy and its citizens – can’t afford these healthcare cuts.

Written by Betsy Ryan at 15:04

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9/11 Ten Years Later: Response, Recovery and Remembrance

There are a handful of moments in history in which we all remember where we were and what we were doing. For me, they stretch all the way back to a 3-year-old’s foggy memory of her mom disrupting her daily routine of walking to the local deli when she learned that John F. Kennedy had been shot. We turned around abruptly and went home to turn on the black-and-white TV as tears streamed down my mother’s face. Next came the joyous and triumphant memories of Neil and Buzz walking on the moon. After that: the dreadful news of the explosion of the space shuttle Challenger… then the fall of the Berlin Wall. But the most recent memory seared into my brain is Sept. 11, 2001, and the events that changed America forever and cost 2,996 individuals their lives. I recall N.J. hospitals standing ready to assist the New York hospitals in caring for the survivors; they never came in the numbers we had prayed for. I recall my own fear, not knowing where my own husband was for several hours that day. Only later did I find out he was outside the building assisting, but I couldn’t get through to him. He finally made it home the next morning, covered in Ground Zero dust.

It was a horrible time in our nation’s history. We were attacked in New York City, in Washington D.C., and because of the heroism of those passengers on Flight 93, a plane crashed far from our nation’s capital in Shanksville, Pa. It was hard to fathom the loss of life, or the “why’s” of the attack. Politicians took action and a nation mourned as one.

There are so many lingering impacts of that fateful day. Among them: After Sept. 11, 2001, hospitals and other healthcare providers began a new era in the nation’s emergency preparedness efforts. Hospitals, by their very nature, are prepared for the unexpected. Confronting emergencies is part of their core mission of protecting the community’s well-being. But that mission has grown in the wake of Sept. 11 to prepare our healthcare system for any looming hazard – from a terroristic attack to a flu pandemic.

Hospitals across New Jersey and the nation use the Incident Command System, a mobilization strategy that allows healthcare facilities to respond very quickly to a large-scale threat. And they’ve formed key linkages with state and federal homeland security officials, state and local police, the New Jersey and U.S. Departments of Health, public health agencies, public utilities and others. Never before has such a broad array of health and safety entities been so strategically positioned to mobilize and protect the public’s well-being.

This somber anniversary of 9/11/01 is a time to remember and reflect on what we lost. But it’s also a time to realize that we are better prepared today then we were yesterday – and that work continues each and every day. My thoughts and prayers are with the families, friends and loved ones of all of those who lost their lives that day.

Written by Betsy Ryan at 18:47

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Storm Stories: Healthcare Facilities Show Their Heart During Hurricane

As is so often the case, the worst of times bring out the best in people. And that’s certainly true with Hurricane Irene. The news is full of stories of devastation and loss, and my heart goes out to those seriously impacted by storm. But today, let me focus on the warm and uplifting storm stories that are coming in from across New Jersey…

Like Dr. Dwight Lee at Meadowlands Hospital Medical Center, who climbed on to the back of a pickup truck, umbrella in hand, to assist a patient with chest pains. Meadowlands had wisely set up an “outpost” emergency department when the flood waters rose on its main facility. Working closely with their local EMS and county Office of Emergency Management, the hospital team continued to receive emergency patients throughout the storm, including critical cases of heart attack and stroke that could have been fatal without quick access to emergency care.

Or like the hospital workers hunkered down at hospitals all along the Jersey Shore. Many of them were evacuated from their own homes and went straight to their workplaces, committed to providing a shelter in the storm. While some hospitals in flood-prone areas made the right call to evacuate ahead of the storm, other hospitals made the prudent decision to “shelter in place” and continue to provide essential healthcare services to their community. To those hospitals and their dedicated staff, thank you for your bravery, your commitment and your very smart planning to assure the safety of your patients, community and colleagues.

Another heartwarming story came to us from Robert Wood Johnson University Hospital at Rahway, where the hospital’s chapel hosted a wedding Sunday for a happy couple whose original church location was made inaccessible by Irene.

We also heard about many other blessed events – babies born at hospitals at the height of the storm. (Anyone like Irene as a middle name?)

I could go on and on, and I apologize for not being able to share every single story of service and commitment that occurred this past weekend at our hospitals, nursing homes, home health agencies and other healthcare organizations. Nor am I able to fully extend our appreciation to first responders such as EMS and local law enforcement, or the state’s Department of Health and Senior Services. All of them were tremendous partners with healthcare facilities to ensure the safety and well-being of our fellow New Jerseyans.

Written by Betsy Ryan at 18:23

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