Ascension Health has ascended to the pinnacle of not-for-profit health care. As the largest Catholic hospital system in the US, and thus one of the top providers of charity care in the nation, the organization's health care network consists of some 80 general hospitals, along with a dozen long-term care, acute care, rehabilitation, and psychiatric hospitals (combined, more than 17,500 beds). Ascension Health also operates nursing homes, community clinics, and other health care providers. Its network of medical facilities spans 20 states and the District of Columbia. Ascension Health was created in 1999 from a union of the Daughters of Charity National Health System and the Sisters of St. Joseph Health System.
Consistent with its not-for-profit status, Ascension Health provides generously in "community benefit," a vaguely defined term that includes charity care to the indigent and uninsured, costs not covered by Medicaid, and other community health programs. Ascension Health recorded more than $1 billion in community benefit costs in 2011, a 14% increase over unpaid costs in 2010.
The system's income from operations for 2011 was $424 million, a 25% decline from the previous year's $569 million. This was due to factors that included increases in operating expenses and charity care, a slight shift from commercial to government payors, and reduced Medicaid rates.
Ascension Health advocates for expanded access to health care and has set a goal of guaranteed access to care in all its markets by the year 2020 (its 2020 Vision plan). It is working in partnership with local and federal governments and private groups (persuading doctors to add some uninsured patients to their rolls, for instance) to achieve that goal. The organization is also engaged in system-wide efforts to improve patient safety at its facilities, vowing to reduce preventable deaths from hospital-acquired infections, surgical and drug complications, birth trauma injuries, and other avoidable circumstances by 2014.
Alongside its role as a mission-driven organization, Ascension Health is also a large business, and it has used its business savvy to make it one of the nation's largest and most successful health care organizations. To address accelerating changes in the health care industry, Ascension Health kicked off the new year in 2012 with a new organizational structure under a new parent holding company, Ascension Health Alliance. Within months, the Ascension Health Alliance entered into a partnership with Narayana Hrudayalaya Hospitals of India to build a health care city in Grand Cayman, (the largest of the Cayman Islands). The project will be built over 15 years and is projected to cost approximately $2 billion. The 200-acre site will include a tertiary-care hospital with up to 2,000 beds, an educational facility, a biotech park, and an assisted living community. Phase one is expected to have 140 beds available in early 2013. Ascension Health Alliance will provide facilities planning, supply chain management, and biomedical engineering services to the project, while Narayana Hrudayalaya will provide technical input and direction to the team in Cayman.
Strategic goals set under the new structure include increasing focus and accountability on the delivery of person-centered services through Ascension Health; organizing high-performing, optimized service subsidiaries to have greater independence in support of Ascension Health's needs and those of its for-profit joint venture Ascension Health Care Network (formed with Oak Hill Capital Partners); providing a solutions incubator to build on development activities (seeking relationships and providing research capabilities and opportunities); and building Ascension Health Care Network to strengthen Catholic health care.
The organization is not afraid of growth, and it has snapped up hospitals and health systems to expand its geographic footprint and market share. Over the years it has bought Eastern Health System, a three-hospital group in Birmingham and merged it with its existing St. Vincent's Health System. It also became co-owner of Via Christi Health System in Wichita, Kansas, and agreed to an affiliation of its Columbia St. Mary's system in Milwaukee with Froedtert & Community Health. In 2012 it acquired Chicago-area provider Alexian Brothers Health System and has signed an agreement to bring the 36 hospitals of Marian Health System into its ranks.
It has consistently pruned money-losing operations, including the divestiture of St. Joseph Hospital of Augusta, Georgia, to Triad (now part of Community Health Systems), and the 2009 spinoff of the 150-bed St. Anthony Hospital in Chicago. The divestiture marked the system's exit from Illinois. Ascension Health decided the financially unstable hospital would fare better being run by an independent board that could place more focus on performing outreach to local communities.
To make a little money on the side, Ascension joined with Catholic Health Initiatives and Catholic Health East, to create investment firm Ascension Health Ventures (AHV). AHV has built a portfolio of investments in the medical technology and service sector that have the potential to improve health care delivery, but that will also reap financial rewards for Ascension Health and its partners. AHV was the second such venture for Ascension Health, which set up a wholly-owned fund in 2001. – less