What's at Stake?

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WHAT’S AT STAKE Arkansas hospitals and their impact on the state's economy

JANUARY 2019

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Arkansas hospitals

their impact on our state Introduction

Arkansas hospitals are proud to provide quality, efficient health care to communities in every part of the state. They stand ready to care for everyone, with their doors open 24 hours a day, seven days a week, 365 days a year. Each year, they provide care during millions of patient visits and keep our communities healthy, strong and vibrant. Their record of service is – and always will be – their most valuable contribution to the state.

Beyond the central role of connecting the various facets of the health care system, hospitals strengthen the infrastructures of local communities. Arkansas residents rely on their local hospitals and health systems to: ▪

Provide high-quality, efficient health care.

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Readily respond with care for community members throughout their lifetimes, whenever illness or injury strikes.

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Serve as a community safe harbor during and after emergencies or disasters.

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Provide an optimal setting for bringing new life into the world.

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Provide comfort at the end of life.

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Educate people about preventing and managing diseases, while promoting practices that support health and wellbeing.

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Attract new health care services, businesses and industries to our communities – resources which are essential for future growth.

Recognized much less often are the contributions hospitals make to local economies and to the state economy, through the people they employ and the impact of their spending. Arkansas hospitals are, in fact, critical to the economic viability of our state. They are major employers and purchasers of goods and services; and the health care they provide also allows people to be productive, contributing citizens.

CALCULATING THE TOTAL IMPACT OF HOSPITALS IN OUR STATE

TOTAL JOBS PROVIDED/CREATED

88,500

ECONOMIC IMPACT Payroll impact Non-salary spending impact Capital spending impact

TOTAL IMPACT

$5,404,997,000 $5,480,670,000 $652,823,000

$11,538,490,000

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This report highlights the significant role Arkansas hospitals play within our communities. It identifies and measures the direct involvement of our hospitals in the state economy and demonstrates the “ripple” effect of the dollars the health care sector brings into the state and the jobs it helps create. In addition, it illustrates the benefit hospitals provide in building a safe, stable and healthy community. The specific examples cited here are illustrations and certainly do not cover all the outstanding work that Arkansas hospitals are doing throughout the state. A technical addendum to the reported data is available upon request.

AN ECONOMIC DRIVER FOR OUR STATE In addition to enhancing the health and well-being of the communities they serve, Arkansas hospitals also contribute significantly to the state’s economic health. In 2017, the total combined estimated annual economic impact of hospitals in our state was $11,538,490,000.

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Hospitals provide well-paid, consistent employment and are often among the top employers in their communities.

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Arkansas hospitals employ 45,800 individuals in the state, with a total payroll of $3,358,184,000.

Hospital payroll expenditures serve as an important economic stimulus, creating and supporting jobs throughout the state and in local economies.

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Dollars earned by Arkansas hospital employees and spent on groceries, clothing, mortgage payments, rent, etc., generate approximately $5,404,997,000 in economic activity and create an additional 42,700 jobs in the state.

Hospitals stimulate the local economy with purchases of goods and services.

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Arkansas hospitals spend about $3,405,200,000 per year on the goods and services they need to provide health care—things like medical supplies, electricity for buildings, and food for patients. Funds spent to buy goods and services flow from the hospitals to vendors and businesses, creating a ripple throughout the economy.

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Dollars spent by Arkansas hospitals generate approximately $5,480,670,000 for the state economy.

Hospitals’ construction and capital spending bolsters the economy and improves infrastructure for all Arkansas residents.

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In 2017, Arkansas hospitals spent $405,606,000 on buildings and equipment.

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Capital spending by Arkansas hospitals generates approximately $652,823,000 for the state’s economy per year.

A ZONE OF SAFETY Communities can take comfort in knowing that their local hospitals are preparing, today, for the challenges of tomorrow. In this new world, hospitals do more than provide medical care to the community. Hospitals are also a place of refuge, food, shelter and information in times of distress.

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Hospitals are always prepared to respond to emergencies.

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Trauma System The state-wide trauma system, established by Act 393 of 2009 and coordinated by the Arkansas Department of Health, assures that citizens in crisis are appropriately evaluated, triaged and transported to the hospital best able to care for their injuries. Sixty-one hospitals in Arkansas have met the criteria and gone through the process to become designated Trauma Centers, and six have met the highest level of designation, Level I. The trauma system has been credited with decreasing the state’s preventable death rate by nearly half and saving more than $180 million per year.

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Mobile Hospitals Hospitals in all regions of the state have partnered with the state of Arkansas through the Arkansas Hospital Preparedness Program to develop mobile hospitals. These facilities include all the necessities to provide deployable, portable hospital care, including beds, crash carts, emergency medical supplies and support equipment. Arkansas’s mobile hospitals can be used for training, demonstration or emergency response and can serve as alternate care sites if a hospital is incapacitated.

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Rapid, Effective Responses to Mass Trauma Events The highly-trained professionals at our state’s hospitals respond to all manner of natural and man-made disasters. The July 2017 shooting at the Power Ultra Lounge club in Little Rock injured 28 people, making it one of the largest nightclub shootings in the United States. However, because of the heroic actions of first responders and hospital personnel, there were, remarkably, no fatalities – making this the only major mass shooting in U.S. history with that outcome. Arkansas hospital personnel continue to prepare for the unexpected and stand ready to care for those most in need.

CARING FOR OUR COMMUNITIES ▪

Arkansas hospitals offer health promotion and disease prevention services to support the well-being of members of our communities.

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Health Promotion Outreach Through programs aimed at preventing disease before it occurs, hospitals save individuals and the state millions of dollars in treatment costs and lost earnings. Many hospitals host health fairs or participate in other organized community events, providing risk assessments, health promotion materials, and health care access help and information.

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Mobile Disease Screening Hospitals provide screening programs to detect medical conditions in the population earlier, thus lowering the costs of treatment. Many screenings are offered in conjunction with health fair activities, such as Conway Regional Health System’s annual Women’s Health Fair, which offers cholesterol and glucose screenings, blood pressure checks and bone density scans. Other screening services are offered through mobile facilities, such as the mobile mammography units operated by the University of Arkansas for Medical Sciences and Mercy Hospital Northwest. Mobile disease screenings bring these valuable tools to geographically remote areas that lack easy access to health care resources.

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Services to Combat Food Insecurity Arkansas has one of the highest rates of food insecurity in the nation. Recognition of this public health problem has led hospitals to reach out to their communities to provide nutritious food to children and families. Some, such as Arkansas Children’s Hospital, have developed programs including neighborhood food pantries, summer and after-school meal programs, and assistance with WIC and SNAP applications.

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Hospitals help people gain access to essential services and information.

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Health Insurance Access Hospitals have played a key role in assuring the success of the health insurance marketplace and Medicaid expansion in Arkansas, by helping people connect to marketplace insurance or Arkansas Works (formally called the Private Option). Since the launch of these programs in 2013, Arkansas’s uninsured rate has dropped by more than half.

Hospitals throughout the state have had staff certified as application counselors and in-person assisters, to directly help people seeking access. Some, such as Washington Regional Medical Center, have devoted space within their facilities to provide publicly accessible computer stations, where individuals can apply for coverage or fulfill the state’s reporting requirements, and many have also supplied wireless internet access.

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Medical-Legal Partnerships (MLPs) Personal and legal barriers, such as insurance denials, safe housing issues and personal safety concerns can make it difficult for a person to address and recover from health problems. MLPs are innovative and effective collaborative agreements between hospitals and legal-aid organizations, and they serve as free resources for people in need. Arkansas has seven MLPs, involving hospitals in many areas of the state.

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The vital health care services provided to our communities represent the core contribution provided by Arkansas hospitals. In 2016, the most recent year with data available, our hospitals had: ▪

352,722 inpatient visits.

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4,691,316 outpatient visits and procedures.

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1,503,862 emergency room visits.

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35,864 births.

Other key indicators include: ▪

102 hospitals of all types are members of the Arkansas Hospital Association and serve Arkansans living in cities, towns and communities throughout the state. They include 76 general acute care community hospitals (including 28 Critical Access Hospitals), five long-term care hospitals, eleven psychiatric hospitals, four rehabilitation hospitals, as well as two Veterans Affairs hospitals, two pediatric hospitals, a cardiac hospital, and a women’s hospital.

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40 Arkansas counties are served by a single hospital.

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44 Arkansas community hospitals have fewer than 100 beds. Twenty-eight of them are designated by the federal government as Critical Access Hospitals, having no more than 25 acute care beds.

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36 Arkansas counties count hospitals among their top five employers. In 21 counties, a hospital is among the top three employers, providing stable, well-paying employment to residents in small, rural communities.

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56% of AHA member hospitals are charitable, not-for-profit organizations, while 30% of the hospitals are operated by private, for-profit corporations, and 14% are public hospitals owned and operated by a city, county, state or federal government.

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$371 million was spent by Arkansas hospitals in 2016 to provide uncompensated care for patients who could not afford to pay for the cost of their services.

Conclusion Hospitals are a key contributor to the quality of life of Arkansas residents, and they play a key role in keeping communities healthy and vibrant. The data and illustrations contained in this report provide strong evidence that the economic impact of our hospitals on local and state economies is significant. To continue to attract employers to Arkansas, it is critical that the state have thriving hospitals, as well as high-quality health care providers and services.

We urge our legislators, members of Congress, and community leaders to recognize that our hospitals are instrumental to supporting the state and local economy and steps need to be taken to continue to invest in our state’s health care system.

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