Hospital E

History of the System for Hospital E

The healthcare company that owns this hospital was founded after 1950 with the purchase of a hospital by a group of business partners. The network expanded into rural areas by buying nonprofit hospitals or building for-profit hospitals. This strategy was innovative for consolidating management of several hospitals under one corporation. The private healthcare corporation began to be publicly traded in the 2000s. Today the system owns and operates +100 hospitals and +1500 ancillary sites of care in the US and internationally. It is one of the top three largest for-profit health systems in the US.

Executive management points to a philosophy of social responsibility combined with the aim of building trust in their hospital brand as motivations for prioritizing community outreach and engagement. This company’s consolidation strategy is applied to anchor-planning from the corporate to the community level.

This health network has a strategic three-tier approach at the corporate, regional, and hospital-level that uses community data to balance the benefits of the system’s scale with the challenge of localized health. At the enterprise level, the system can lead, partner, or follow other large-scale organizations on national initiatives. At the regional level, leadership is trained by corporate to analyze community needs and then identify which of those needs the system is best equipped to meet. At the hospital-level, leadership interacts directly with the community, providing “ears on the ground.”

History of Hospital E

Hospital E is a for-profit, large institution (+400 beds) providing acute care, general services to the Mountain West region. The hospital was established over fifty years ago by business leaders as a private alternative for insured patients to public and nonprofit hospitals. The hospital's ownership was transferred through a series of companies until it was purchased by its current chain. Today, Hospital E is its city's largest acute care facility and the state's largest care facility. Surrounded by for-profit and nonprofit competitors, Hospital E is in a state with a CON law program. This state is amongst the top five states with the highest percentage of for-profit hospitals.

This hospital is in an urban area with a population between 500,000 and 1 million residents. The community is middle-class and diverse with representation by White, Black, and Latino residents that mirrors the national racial/ethnic landscape. Black/white segregation in this city is amongst the lowest of the 100 largest metropolitan areas in the US. Educational attainment is on par with the national average for high school graduates but falls short of the national average for college graduates. A typical resident is likely to be in their 30s, less likely than average to own a home, and has a median household income between $50,000 and $60,000. Median property values are more than $200K.

Hospital E as an Anchor Institution

A key characteristic of anchor institutions is economic development of the community, including through serving as a major employer Research indicates that generally nonprofit hospitals have a higher Full-Time Equivalency (FTE) of medical personnel. Hospital E, however, is unusual amongst for-profit hospitals because it has a high number of FTEs per bed. Located in a union state, Hospital E’s employees are unionized. Thus, union standards mitigate FTE ratios in favor of employees and patients at Hospital E.

In addition to providing employment, Hospital E supports the community through health promotion and health education programs for all ages. Faithful to the system strategy of localized health, leadership is vigilant for trending health and safety concerns in the community. Staff utilizes diverse outlets such as social and traditional media to distribute targeted prevention and education. Similar channels are used for community outreach regarding regular weekly or monthly topical health campaigns.

Leadership is supportive of community involvement, possibly due to overlap between personal and professional spheres. Board members, for instance, live in the neighborhood surrounding Hospital E. Executives with a history of working in non-profit hospitals prior to Hospital E report similarities between non-profit hospitals’ and for-profit Hospital E’s commitment to social responsibility.

Barriers to the hospital engaging in anchor-like activities include the need for increased awareness of those anchor activities amongst community members, the media, and between hospitals. Hospital E is in a city with an acute care, general services hospital on average every fifteen miles. Nonprofit and for-profit hospitals collaborate on organizational boards, but Hospital E personnel admit that competition amongst hospitals that offer similar services remains a challenge. Nevertheless, staff state they are receptive to documenting community benefits activities to share with peer organizations.

Anchor Areas

Funding

• Hospital partners with local television stations on healthcare prevention and education stories.

Health Promotion

• Program for access to healthcare for newborns.
• Classes for the elderly on issues like fall prevention and healthy living.
• Marketing team uses social media to disseminate PSAs on general health topics on a weekly or monthly schedule.
• Hospital acts as a mailing address for homeless patients.

Community Building

• Employee works as outreach coordinator. Runs education on child safety and drinking and driving programs.