Hospital leaders in Florida take on the competition
Beyond the Turnaround
Jackson CEO Carlos Migoya has ambitious plans for the once-ailing public health system.
Between 2008 and 2011, Miami-based Jackson Health System lost $419 million, putting it on the verge of bankruptcy. At the end of that three-year period, the taxpayer-owned medical system hired Carlos Migoya, a retired banker and former Miami city manager, to turn things around as CEO.
Since then, Jackson has cut costs and boosted income by attracting more patients with private insurance to have surgery or give birth at one of its facilities, offsetting a decline in revenue from publicly funded patients. Last year, Jackson reported a surplus of $17 million, its fifth consecutive annual surplus.
With finances stable, Migoya is now leading the hospital network through a 10-year, $1.5-billion plan to help it compete against other large medical centers.
Jackson’s main campus in downtown Miami has undergone extensive renovations and has added new technology and equipment. It consolidated emergency services and has a new layout that’s easier for visitors to navigate, Migoya says. About $150 million in improvements also have been made to satellite hospitals in northern and southern Miami-Dade.
“Up until four or five years ago, Jackson really had not spent any money on itself because of the financial situation,” Migoya says. “We were way behind where we needed to be.”
In 2013, Miami-Dade voters approved $830 million in taxpayer financing to help pay for the upgrades, leaving Jackson to come up with the remaining $670 million. Jackson faces the challenge of having to “generate enough extra earnings” to cover the project costs amid Medicaid reimbursement cuts, Migoya says.
Migoya notes that Jackson has increased its revenue from paying patients, especially maternity patients, by 10% annually for the past three years. More patients are choosing Jackson not only for its quality care, he says, but also because they see it as a “comfortable place.”
Jackson Health System
- With about 13,100 employees, Miami-Dade County’s taxpayer-owned Jackson Health System consists of six hospitals, a stand-alone trauma center, three urgent care centers, multiple primary care clinics and specialty centers and two long-term care centers. The system’s flagship is Jackson Memorial Hospital, a 1,493-bed teaching hospital in downtown Miami.
- Jackson has expanded its geographic reach with new urgent care centers throughout Miami-Dade County. A proposed Jackson West campus in Doral will include a hospital, pediatric ambulatory pavilion and outpatient treatment center. Plans also call for a $173-million rehabilitation hospital at the downtown campus.
- Last March, Nashville, Tenn.-based HCA won the latest round in its battle with Jackson Health System to build a new hospital in Doral. In a lengthy decision, a Florida administrative law judge recommended that the state Agency for Health Care Administration approve HCA’s certificate-of-need application over a competing bid by Jackson. HCA, a forprofit operator of health care facilities, is proposing an 80-bed hospital in Doral. Jackson, for its part, wants to build a 100- bed hospital at a new medical campus in Doral. The state health care agency, which gave Jackson’s plan preliminary approval in 2015, ultimately will decide which hospital will better meet the community’s needs.