Published: 16 August 2001
Analyst(s): Jonathan Edwards, Patrick J. C. Powers
Management Summary Consolidation among health plans and the recent closure of two Tulsa hospitals have the potential to improve the efficiency and profitability of Tulsa's healthcare organizations. Positive factors affecting the local market include temporary reimbursement relief from federal and state governments, less inpatient bed capacity, a strong local economy, and steady population growth. Offsetting these strengths are concerns about long-term Medicare and Medicaid reimbursement, unreimbursed indigent-care expenses, the nursing shortage, and rapidly increasing medical and pharmaceutical costs. Still unresolved is the ultimate fate of the region's largest integrated delivery system (IDS), Hillcrest HealthCare System, which has narrowly averted bankruptcy but remains in fragile condition. The Tulsa metropolitan statistical area (MSA) is composed of the northeastern Oklahoma counties of Creek, Osage, Rogers, Tulsa and Wagoner. According to the U.S. Census Bureau, the population of the Tulsa MSA increased 13 percent between 1990 and 2000. The fastest-growing counties were Rogers County (with 28 percent growth) and Wagoner County (with 20 percent growth). Three IDSs own or operate almost all the hospitals in the Tulsa MSA. The financially troubled Hillcrest HealthCare System accounts for 34 percent of acute-care hospital beds and 38 percent of total hospital discharges in the Tulsa MSA. St. Francis Health System, which operates the largest hospital in Tulsa, accounts for 28 percent of beds and 32 percent of discharges. St. John Health System accounts for 27 percent of beds and 23 percent of discharges. The financial crisis at Hillcrest HealthCare System has dominated healthcare news in the Tulsa area during the past year. In the fiscal year ending June 2000, the IDS reported an operating loss of $100.3 million and a net loss of $25.6 million. In September 2000, the local newspaper, Tulsa World, reported that the IDS had approximately $35 million cash...
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