[StBernard] Louisiana Recovery Authority to Hear Report on Louisiana's Healthcare System

[Westley Annis]

Louisiana Recovery Authority to Hear Report on Louisiana's Healthcare System



BATON ROUGE, La. - The Public Health and Hospitals Task Force of the
Louisiana Recovery Authority (LRA) today will receive a comprehensive report
on Louisiana's healthcare system in the aftermath of hurricanes Katrina and
Rita, including recommendations for improving the quality of healthcare for
all Louisianans and strengthening the safety net system of care for the poor
and uninsured. 

The 244-page report, drafted by PricewaterhouseCoopers LLP for the LRA
Support Foundation, will be presented at a meeting of the LRA Public Health
and Healthcare Task Force. It addresses three critical areas: emergency
preparedness and disaster recovery; healthcare workforce and medical
education needs, especially in areas of highest devastation; and design of a
health system that will ensure equal access to quality care for all
Louisianans. The full report is posted on the LRA's Web site
<http://keelson.eatel.net/websites/la.gov/action.cfm?md=communication&task=a
ddClick&msg_ID=1542&ID=d8iqeHiyn0n%25&redirect=http://lra.louisiana.gov/asse
ts/PwChealthcarereport42706l.pdf> . (lra.louisiana.gov)

The task force is expected to receive the report today and to make
recommendations in the coming weeks to the LRA regarding specific
recovery-related issues. One such recommendation that has emanated from the
PWC draft regarding "funding the Louisiana Emergency Response Network" had
been previously endorsed by the task force and was approved by the LRA at
yesterday's meeting. 

Because restoring and improving the health care system in the areas most
heavily affected by Hurricanes Katrina and Rita is broadly connected to the
overall structure of Louisiana's healthcare financing and delivery systems,
the PwC report makes recommendations in those areas. The task force could
recommend to the full LRA Board that these recommendations be taken up for
consideration by a broader group of stakeholders including the LRA, the
Department of Health and Hospitals, the LSU Health Sciences Center and
Health Care Services Division, private health care providers and interest
groups, and the Louisiana Legislature. 

"In the wake of this enormous disaster, Louisiana has an obligation to
restore a high quality healthcare system that meets the needs of all our of
citizens in our devastated communities," said Dr. Mary Ella Sanders, chair
of the Public Health and Healthcare Task Force of the Louisiana Recovery
Authority. "But we have another obligation as well: to redesign and improve
the health care delivery system as we rebuild the damaged structures, just
as the state is doing with the public schools in New Orleans. Because much
of Louisiana's public hospital and medical education systems are anchored in
the hurricane-affected areas and because redesigning and improving systems
in those areas has statewide implications and financing requirements, this
report sets forth a bold agenda and calls on all stakeholders of our health
care system to embrace the possibility of change as we strive to achieve
equity, quality and affordability in healthcare and contin! ued excellence
in medical education." 

According to the PricewaterhouseCoopers report: 

*	Louisiana has an immediate need for a statewide healthcare emergency
preparedness system to prevent the human suffering, loss of life and
displacement that occurred as a result of the 
	hurricanes. The report recommends funding the Louisiana Emergency
Response Network, formalizing the Public Health and Medical Services
emergency support function in accordance with 
	the National Response Plan and National Incident Management System,
and establishing long-term funding and planning to sustain emergency
preparedness by creating the "Bureau of Emergency 
	Preparedness." 
*	Louisiana needs to integrate its two-tier health care system -
private hospitals for the insured and the charity hospitals for the
uninsured - into one system. The result will be to dramatically improve the 
	quality of care for everyone by eliminating the financial
disparities between the public and private sectors. 
*	There is an urgent need to develop, finance and implement a plan to
deal with an expected rise in mental health disorders after Katrina.
Post-storm there has been a tripling of adults with mental 
	health needs and an estimated 260,000 adults and 120,000 children
who will need treatment. 
*	Between the public and private sectors, the region that includes New
Orleans has a sufficient number of acute care beds. In the region, there is
an immediate infrastructure shortage of nursing home beds, 
	long-term acute care beds, and permanent housing and outpatient
provider sites. Pre-storm, the region had 4,350 acute care hospitals beds,
about 50 percent more beds per capita than the national 
	average. The average occupancy rate of acute care beds pre-storm was
only 56 percent. Today, there are approximately one-half the pre-Katrina
acute care beds available in the region. The current 
	"bubble" of hospital bed occupancy in the region, called Region 1 in
the report, is caused by a shortage of safe places to discharge patients. 
*	There is an opportunity to build a new academic medical center as a
state-of-the-art, digital facility focusing on niche special areas of
national excellence, research and teaching that would become the 
	new permanent replacement home for level 1 trauma care in New
Orleans. The combination of this facility with the substantial Louisiana
State University medical school infrastructure in New Orleans 
	could be a source of significant economic development and a magnet
for new investments in the city. 
*	A combination of the need to replace the aging public hospital and
the population shift to Baton Rouge strongly suggests demand for additional
services and infrastructure there. Planning for a new 
	hospital should take into consideration the need for a Level 1
trauma center and academic medical education program located in Baton Rouge.

*	The report recommends integrating Louisiana's two-tier system -
private hospitals for the insured and the charity hospitals for the
uninsured - into an integrated model of care that includes 
	physicians, nurses, clinics, hospitals, and emergency rooms. The
result will be to dramatically improve the quality of care for everyone by
eliminating the financial disparities between the public 
	and private sectors. 
*	Louisiana's healthcare safety net can be strengthened by fairly
distributing disproportionate share hospital (DSH) funding among the public
and private sectors, based on the provision of care to 
	patients. Under this proposed financing mechanism, the safety net of
care for the indigent would be guaranteed by the availability of
high-quality integrated services. Both public and private institutions 
	would compete regionally in a mixed, market-driven environment for
all patients. 
*	The state should separate the safety-net mission for the under- and
uninsured from the educational mission of the LSU medical professional
teaching system. At the same time, the report suggests that 
	the LSU system of teaching hospitals strive to serve the insured and
uninsured population, with a healthy and balanced patient mix. LSU's
hospitals should disperse resident physicians to hospitals 
	with a higher percentage of Medicare patients. With a balance of
patients in the LSU teaching system, up to $100 million dollars of
additional funding could be available annually for the LSU 
	post-graduate medical program. 
*	The state needs to upgrade its "digital backbone" of electronic
medical records that are critical for healthcare continuity in time of
disaster. Louisiana is in a position to lead the nation in creating a 
	digital backbone that will lay the foundation for a system of
healthcare for all Louisianans that is integrated, continuous and
consumer-centric. 
*	A financial analysis conducted as part of the development of the
report indicates that Louisiana has the financial resources to implement
changes recommended in this report. 
	"Our assignment was to respond to the challenges imposed by the
hurricanes by envisioning a dramatically improved healthcare system in the
affected regions and for all of Louisiana, and our assessment was largely
driven by the people of Louisiana through many discussions with healthcare,
business, government and community leaders as well as those who suffered
personally from the collapse of the safety net system," said David Levy, MD,
of PricewaterhouseCoopers, who presented the report findings today. "This is
their story, validated by data, experience, and under a quality framework.
Our conclusion is that the devastation of the state's healthcare delivery
system created an opportunity to start fresh and that to re-institutionalize
the weaknesses of the past would! be a disservice to the people of
Louisiana." 

A full copy of the PricewaterhouseCoopers report is available on the LRA
website at www.lra.louisiana.gov
<http://keelson.eatel.net/websites/la.gov/action.cfm?md=communication&task=a
ddClick&msg_ID=1542&ID=d8iqeHiyn0n%25&redirect=http://www.lra.louisiana.gov>
or on the long-term planning website at www.louisianaspeaks.org
<http://keelson.eatel.net/websites/la.gov/action.cfm?md=communication&task=a
ddClick&msg_ID=1542&ID=d8iqeHiyn0n%25&redirect=http://www.louisianaspeaks.or
g> . The findings and recommendations in the report were derived from
multiple interviews and represent the accumulated best thinking, insight and
experience of PricewaterhouseCoopers and many people from within and outside
of Louisiana. 

PricewaterhouseCoopers was retained by the LRA Support ! Foundation. The
Foundation was created to provide experts needed by the Louisiana Recovery
Authority Board of Directors and its committees. No public funds were spent
on the production of this report. The LRA Support Foundation and its Board
of Directors were not involved in gathering of data, interviews or
production of this report. 

PricewaterhouseCoopers produced the findings of this report independently
and without any involvement from the LRA Support Foundation or its board
members. 

About the Louisiana Recovery Authority 

The LRA, a 33-member body appointed by Governor Kathleen Babineaux Blanco to
identify and prioritize short-and long-term needs of the recovery, is the
planning and coordinating body that will assist in implementing the
Governor's vision for the recovery of Louisiana. It will seek out and value
local input as it plans and implements the recovery. 

The LRA is supported by the LRA Support Foundation, a private, nonprofit
organization that has raised private funds to secure the current team of
world-renowned planners and experts who are responsible for developing plans
for rebuilding South Louisiana. 



About PricewaterhouseCoopers Health Industries Group 

PricewaterhouseCoopers Health Industries Group brings together the industry
expertise of the specialized Healthcare Provider and Payer, Health Sciences,
Biotech/Med Device, Pharmaceutical, and Employer practices to provide
assurance, tax, and advisory services to this highly integrated sector. 

PricewaterhouseCoopers applies deep industry and technical expertise
combined with a broad understanding of how these individual sectors work
together to influence the direction and performance of the overall health
system. Through its focus on performance improvement, risk management,
regulatory compliance, tax, financial assurance, transaction support and
human resource management, PricewaterhouseCoopers is uniquely positioned to
assist clients address critical issues associated with maximizing
stakeholder value, including: mergers, acquisitions and asset disposals,
regulatory demands, crisis management, organizational simplification,
optimizing current strategies, attracting and retaining talent, and managing
risk. 

PricewaterhouseCoopers (www.pwc.com
<http://keelson.eatel.net/websites/la.gov/action.cfm?md=communication&task=a
ddClick&msg_ID=1542&ID=d8iqeHiyn0n%25&redirect=http://www.pwc.com> )
provides industry-focused assurance, tax and advisory services for public
and private clients. More than 120,000 people in 139 countries connect their
thinking, experience and solutions to build public trust and enhance value
for clients and their stakeholders. 

Unless otherwise indicated, "PricewaterhouseCoopers" refers to
PricewaterhouseCoopers LLP, a Delaware limited liability partnership.
PricewaterhouseCoopers LLP is a member firm of PricewaterhouseCoopers
International Limited. 

# # #