Developed after three years of consulting with the likes of former U.S. Surgeon General C. Everett Koop, futurist Leland Kaiser, architect Robert A.M. Stern and experts from Stanford, Harvard and the National Institutes of Health, the $111 million Celebration Health "wellness center'' boasts the ambiance of a five-star hotel and enough slick gadgetry for a Star Trek movie. The facility - set to open late next month - is clearly a showcase; the question is whether it all makes economic sense.
Here's healthcare, Disney-style: At Celebration Health, patients leave their cars with valets and enter an atrium lobby, where they stop at the concierge desk to pick up silent pagers that politely summon them when the doctor is ready. At their disposal in the meantime are a library, restaurant, conference rooms and a rehab center.
Hands-on treatment will be ultra high-tech: Doctors with handheld computers for updating charts, ordering X-rays and relaying prescriptions to the pharmacy; physicians using futuristic medical technology such as virtual reality imaging, ultrasonic scalpels, video teleconferencing and a computerized X-ray system. Even the stethoscopes are electronic.
Disney, of course, is paying special attention to bedside manner. Every employee from valet to CEO will undergo Disney's vaunted customer-service training to "improve the experience of healthcare delivery," according to project documents. "It will bring the Disney customer-service orientation to healthcare," says Des Cummings, CEO of Celebration Health. "It teaches you to be more engaging in terms of listening better, of finding ways to pleasantly surprise and exceed the expectations of your customers.''
For health information, residents of Celebration won't even have to leave their homes. They can use a telephone and a personal computer to get a video link with personnel at the center. Without going out, they can get consultation and monitoring. The health center and its doctors also can send e-mail reminders to residents to schedule their children's vaccinations and checkups.
The high-tech amenities are courtesy of companies such as Johnson & Johnson, General Electric and Sprint. Those firms have contributed cutting-edge communications, surgical and diagnostic imaging equipment worth millions of dollars - not the kind of equipment normally found in a small town - hoping to cash in on Disney's stated goal of making the center "a world showcase for medical skills, equipment and technology."
When that showcase opens its doors in late November, however, there may be a fly in the ointment. While Celebration Health encompasses doctors' offices, outpatient surgery center, pharmacy and diagnostic imaging facilities, it won't include a 60-bed hospital that Disney planned as part of the facility. Why? When the state plugged all Disney's razzle-dazzle into its formulas that determine how many hospital beds an area can support, it found that the hospital isn't needed and would be charging its patients too much.
Disney's partner, Florida Hospital of Orlando, owns and will operate the entire facility. Florida's Agency for Health Care Administration turned down Florida Hospital's request for the Certificate of Need necessary to open a hospital.
The state's biggest concern is that occupancy rates at the region's hospitals average an anemic 37%. State officials question whether Disney and Florida Hospital of Orlando can convince healthcare plans and insurance companies to pay higher-than-average rates for hospital services in an area where more than 60% of hospital beds are empty.
The regulators don't buy Celebration Health's assertion that all the high-tech gadgetry will lure patients from outside the immediate area. "It is recognized that the Disney companies are in the business of creating realities that are 'larger than life,' wrote the agency's reviewers in their report on the application, but they added that, "The local residents in the Celebration service area clearly do not need a healthcare complex of this magnitude.''
The agency wrote that the project is financially feasible "primarily due to the economic strengths of the parties involved in its construction. It is unlikely the project could sustain itself in a competitive environment."
And indeed, in spite of higher charges and optimistic assumptions, Celebration Health officials themselves expect that a hospital at Celebration would lose money during its first two years of operation. It projects average per-patient per-day revenues of $2,415. For competing hospitals in the area, that figure ranges from $1,865 to $1,731.
The state also questions Celebration Health's projected occupancy of 50% next year. "Nobody's explained how a hospital this expensive for a community so small makes sense, unless it's serving patients from outside the area," says Joe Brown, spokesman for the six-hospital Orlando Regional Healthcare System.
"I'm not sure how it could be accomplished, unless they could contract exclusively for Disney employees and all their dependents and capitalize on international patients," says Jim Norris, executive director at St. Cloud Hospital.
Disney employees are encouraged to use Celebration Health, says Celebration spokeswoman AnneMarie Mathews, but not restricted to it. Celebration hopes to draw patients from Osceola, Lake and Polk counties and serve tourists and is negotiating provider agreements with healthcare and insurance firms in Brazil and Canada (see related story, page 48).
But Brown and Nancy Smith, executive director of Humana in central Florida, say people choose a hospital based on convenience. They don't think people are likely to go out of their way to use the Celebration hospital.
While the economic future of Celebration Health won't be imperiled by the absence of a hospital, Disney will lose a part of its marketing appeal for the Celebration community - particularly to elderly potential residents - if the hospital isn't there. The town is designed for 20,000 residents; about 1,200 have moved in so far [FT, November 1996].
Disney officials profess to be unconcerned. Although the hospital was presented to the state as a necessary component of Celebration Health's "continuum of care," Cummings says failure to win permission for beds will have no affect on other services at the health center. Its whiz-bang technology was intended for outpatients, as well. Nor have any residents expressed concern, says Mathews. Celebration Health was never described to them as a hospital. "It was always positioned as a wellness center," she says.
Celebration Health hopes it can work out a compromise with the state that will enable it to open at least some hospital beds. One possibility: The state proposes closing the 120-bed Kissimmee Hospital, one of five owned by Florida Hospital, in exchange for opening 60 beds at Celebration. Florida Hospital is balking at the suggestion, wanting to keep Kissimmee Hospital open with 60 beds and move the other 60 to Celebration, on the grounds that both communities need hospitals.
Whatever the outcome, the economic uncertainties surrounding Disney's venture into healthcare will remain for some time. One of the biggest is whether other hospitals will want to buy pricey high-tech equipment after they see it showcased at Celebration. It's a gamble, but corporate donors of Celebration's hospital-of-tomorrow technology are betting on Disney.
As Ralph Randall, Florida's regional marketing manager of Sprint put it, "We're making a leap of faith."