There is a relatively high level of non-trauma outmigration to Illinois. v The vast majority of trauma care to NWI residents is provided by facilities that are not designated trauma facilities. v Indiana trauma center designation is relatively new having only been established in 2009; many facilities in NWI plan to seek a trauma designation within 5 years. v Four of the largest facilities in NWI deliver 53% of trauma care to 7-county residents, with over 80% of their trauma volume coming from Lake and Porter County residents. v Four facilities are candidates for a Level I or II trauma program: Community Hospital (Munster), Methodist Northlake, Methodist Southlake, and Porter Regional. v Outmigration to Illinois appears to be a function of economic mobility: Commercially insured trauma patients are 3 times more likely to receive care at IL facilities than at IN facilities. Key Findings 11 Economic Summary * The 7 Indiana counties are Lake, Porter, La Porte, Starke, Pulaski, Jasper, and Newton counties. v In 2012 there were 326 (4.4% of all adult trauma cases) Indiana residents of the 7-county service area* who travelled to Illinois for trauma care and an additional 2,611 who travelled to Illinois for other inpatient care not related to trauma . In total, 2,916 NWI residents received inpatient care in Illinois. v In the first 9 months of 2013, there were 2,83 NWI residents who travelled to Illinois for trauma care and an additional 1,956 who travelled to Illinois for other inpatient care not related to trauma for a total of 2,239 NWI residents who received inpatient care in Illinois. v From trends observed from 2010 – 2013, it is expected that approximately the same number of NWI residents will continue to seek care in Illinois for the foreseeable future, unless Lake and Porter counties develop both trauma and GME programs. v KSM’s financial analysis estimates that Indiana must retain the following numbers of Indiana residents to offset the incremental expense of trauma and GME programs: Year Cases Revenue 1 1,219 $14,226,990 2 1,325 $15,461,186 3 1,431 $16,695,381 4 1,537 $17,926,576 5 1,643 $19,163,771 12 Year 1 Year 2 Year 3 Year 4 Year 5 Total Out Migration Revenue Approximately $35 million Total Out Migration Cases (1) 2,916 Cases 1,219 1,325 1,431 1,537 1,643 Percentage 42% 45% 49% 53% 56% Combined Program Revenue Incremental Case Revenue $14,226,990 $15,461,186 $16,695,381 $17,926,576 $19,163,771 Combined Program Expense Trauma Expense 2 Locations $3,594,500 $3,594,500 $3,594,500 $3,594,500 $3,594,500 Graduate Medical Education $832,000 $1,216,000 $1,600,000 $1,984,000 $2,368,000 Incremental Direct Costs $9,800,490 $10,650,686 $11,500,881 $12,351,076 $13,201,271 Total Program Expense $14,226,990 $15,461,186 $16,695,381 $17,929,576 $19,163,771 Net Income $ 0 $ 0 $ 0 $ 0 $ 0 Economic Benefit v The table below demonstrates how much inpatient outmigration to Illinois must be retained by Indiana facilities in order to cost justify the additional expenses of enhanced trauma services and a GME program. (1) Based on previous patterns, KSM is assuming outmigration is stable. 13 Economic Benefit cont’d v We assume a GME program is operating at full capacity of 36 residents by year 5. v Tripp Umbach estimates annual economic benefit as follows: ▫ Each resident: $200,000 ▫ Each resident who stays in the community after residency - $1,500,000. Residents Annually 36 Econ Ben/Resident $200,000 Annual Resident Benefit $7,200,000 Residents Who Stay 70% Number of Doctors 25 Econ Ben/Doctor $1,500,000 Annual Doctor Benefit $37,500,000 Total Economic Benefit $44,700,000 v We recommend that the following hospitals be considered for the expanded trauma and GME programs: ▫ Methodist Northlake ▫ Methodist Southlake ▫ Community Munster ▫ Porter Regional v These hospitals have: ▫ Reasonable access to highway systems and are near the highest population densities ▫ At least 250 acute beds with adequate capacity to accommodate up to an additional 40 patients per day v We recommend that the community pursue partnership among multiple hospitals, the IU School of Medicine, large employers and civic leaders. Hospital/Partner Recommendation Source: Tripp Umbach Consulting – May, 2014 14 v This table shows Total Acute Care Beds, Total Available Beds and Percent Capacity available for growth (1) Facility Beds Census ER No Adm ER Adm Available Capacity % Methodist Northlake 185 160 17,500 12,300 25 14% Methodist Southlake (2) 269 190 79 29% Community Munster 406 266 27,700 15,900 140 34% Porter Regional Hospital 257 138 25,600 10,200 119 46% Franciscan St. Anthony Michigan City 149 63 14,800 5,600 86 57% IU Health La Porte 124 59 6,000 5,000 66 53% Franciscan St. Margaret Hammond 185 110 10,800 6,100 75 40% Franciscan St. Anthony Crown Point 240 124 10,400 6,800 116 48% Franciscan St. Margaret Dyer 158 77 6,300 4,300 81 51% St. Mary Medical Center 175 140 15,800 8,300 35 20% St. Catherine Hospital 161 89 17,000 5,700 72 45% (1) Data from American Hospital Directory www.ahd.com (2) Reported as part of Methodist Northlake Hospital Profile Summary 15 Current Situation 16 In January 2013, the Regional Development Authority (RDA) issued a request for proposal (RFP) regarding specific