November 29, 2023

Economic Backbone

Hospital leaders in Florida take on the competition

Amy Martinez | 11/28/2017

Hospital Diagnosis

Stand-alone non-profit hospitals must be nimble to compete.

In November 2016, after four years as CEO of Tampa General Hospital, Jim Burkhart was asked to resign by the hospital’s board of directors, who Burkhart says had grown dissatisfied. “They would like to see the finances be better because we’re in an environment where you are trying to build a health care system,” he told the Tampa Bay Times.

Indeed, increased consolidation in the health care market over the past decade has made it harder for stand- alone, non-profit hospitals such as Tampa General to compete.

Before joining Tampa General in 2012, Burkhart led UF-affiliated Shands Jacksonville Medical Center. He now works as a health care management consultant for CSuite Solutions in Tampa.

Burkhart spoke to FLORIDA TREND about the challenges and opportunities facing hospital leaders and the most important skills for being successful in today’s health care environment.

Jim Burkhart on ...

Financial Pressures

“Access to capital is going to be a huge issue, particularly if you’re not an extremely large health care system with almost unlimited resources. If you’re buying something like an MRI, you can be talking $3 million to $4 million. Those dollars are hard to come by, particularly when the ability to squeeze dollars out of Medicare, Medicaid and other government payers is limited. As profit margins in hospitals continue to shrink, CEOs will have to look for other ways to do things. It might be as simple as a landlease deal where somebody else builds and owns a new facility and the hospital just rents the space.”

Non-Acute Care Services

“CEOs are having to figure out how they’re going to take care of more and more people outside the acute-care environment, which is so expensive. At some point, the system is going to break if we don’t change things.”

Doctor/Nurse Shortage

“You have to worry about are we training doctors in the right specialties to fill the shortfalls we’re going to have as more doctors retire. There will be some holes in areas you wouldn’t think about, like radiology and general surgery. We need more nurse practitioners, more physician assistants and more pharmacists who can prescribe medication to try to keep patients away from hospitals and in the lowestcost settings. Also, we have way too severe a cap on the number of residents we can train in Florida. Florida is the third-most populous state, and yet we’re 47th in the number of residents we’re allowed to train per capita. You’ve got way too many residents being trained in northeastern states, where populations used to be, and not nearly enough in southern states. The industry needs to put pressure on Congress to make changes.”

Hospitals As Insurers

“Let’s say you’re a company with 100 employees, and we came directly to you and asked how much you were spending on insurance premiums. You say ‘$300,000 a year,’ and we offer to do a deal with you that’s going to cost you 25% less. First, we’re going to take the insurance company and its 15% to 20% profit margin completely out of the equation, and then we’re going to do the backroom, third-party kinds of things at a 10% lower cost. You’ll use our network, and we’ll buy reinsurance for catastrophic cases. We’re confident that for 25% less, we can provide you the same level of service. It’s a huge opportunity.”

Being a Successful Leader

“This is still a people business. You have to be able to listen effectively, take instructive criticism, put the best minds in a room and not worry about whether or not you’re always in charge. You have to be willing to start things quickly and quit things quickly. Hospitals sometimes are too slow to respond and very slow to quit.”

His Ouster at Tampa General

“My sense is the board just wanted to go in a different direction. I had a new board chair and four or five new board members. The board members who brought me in for the most part were not there anymore. The average tenure of a CEO is only 3½ years. I had a good run.”

Taking Over

John Couris, a former executive with the BayCare Health System in Pinellas and Pasco counties, recently took the reins at Tampa General Hospital. From 2010-17, Couris was president and CEO of Jupiter Health in Palm Beach County. There, he developed partnerships with Mount Sinai Hospital in New York and Nicklaus Children’s Hospital in Miami.

Tags: Healthcare, Economic Backbone

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