When former President Jimmy Carter's sudden illness struck on his way to Cleveland in late September, he was taken directly to the hospital, of course. It's the hospital to which he was taken to that seemed to raise questions: Carter went not to the Cleveland Clinic or to University Hospitals, two world-renowned medical centers within roughly equal distance from the airport. Instead, the Secret Service escorted him straight to MetroHealth, the Cleveland area's public hospital.
Some were surprised, but MetroHealth is a quality institution. It's among the top 1% of hospitals in the country for quality and safety, according to the Premier healthcare alliance, and all its physicians are faculty at Case Western Reserve University School of Medicine. However, outside its home base, and even within, the fact that MetroHealth serves the majority of the uninsured and indigent population had some asking questions about why such an important person would go there in an emergency.
MetroHealth is far from a decayed urban shell of its former self. Led by a former economics professor and high-powered consultant for Booz Allen Hamilton who has worked in a variety of industries outside healthcare, MetroHealth is in the midst of transforming itself into a provider of choice—rather than last resort—for Clevelanders and those in its suburbs. It's doing so by remaking its image as a comprehensive healthcare provider, not just a hospital for the indigent, says President and CEO Mark J. Moran. "We're serving the toughest cases—people who can't get access to the other systems in town, and we're also in the most competitive markets in the country," he says, discussing the biggest roadblocks for MetroHealth.
"We've been working recently to tackle a challenging business problem, which is how to compete and be attractive and relevant in this town," he says. "But that problem has morphed, because now it's about how to compete and be relevant in a post-health-reform world."
It's true that public hospitals might benefit from the nation's healthcare reform law, which will provide coverage for many more patients. But Moran isn't counting on that alone.
"More of the uncompensated care is now going to have some form of compensation, but at the same time, we see disproportionate-share payments phasing out, and our outlook will depend on how rates are set and access to insurance is provided. We have only a vague understanding of how that's going to work at this point."