Silvers’s research has focused in the areas of financial management and health services, and it’s highly unlikely that his specialty in financial management is a coincidence.
MetroHealth has faced increasing scrutiny from the new Cuyahoga County Council, as members have questioned lucrative consulting contracts awarded to the former company of CEO Mark Moran.
During a May hearing in front of the council, members also questioned Moran on the health system’s plans to expand its footprint in the suburbs rather than the city. At the hearing, Moran referred to public hospitals as “endangered species” due to significant financial pressures.
To his credit, Moran has helped turn the health system’s finances around and has led it to three consecutive years in the black.
But it doesn’t appear that things will be getting easier for Moran or MetroHealth any time soon. In the same hearing, Moran referred to federal health reform as “a freight train heading toward us.” Most of the law’s provisions take effect in 2014.
Moran’s biggest challenge in the coming years likely will be figuring out a way to prevent MetroHealth from being flattened by that freight train.
MetroHealth will receive a $36 million subsidy from the county this year, a fairly small portion of its revenue, which stood at $763 million last year.
Earlier this year, Moran outlined in an internal memo the challenges facing Metro: an industry-wide shift from inpatient to outpatient care, a continuing decline in inpatient volumes, rising charity care and “significant pressure” on funding sources including Medicare and Medicaid.