UNC Health Care: By and for the people

As all of you know, UNC Health Care is operated by and for the people of North Carolina. It has always been that way. It will always be that way. We strive for excellence in everything we do. Delivering top quality health care and outstanding service to patients and their families is our primary focus.

I have been speaking recently at our town hall meetings about our mission, which extends far beyond the recent public focus on financial matters of the health care system.

These are our guiding principles:

¢ Deliver excellent care and operate leading programs
¢ Engage with people to meet their health challenges
¢ Maintain a stable financial foundation

Our principles are all connected. They underpin our mission, our vision and our values. They are why you all have been working so hard to improve this system over the past few years.

What really happens around here day in and day out is about delivering the best care possible for our patients. But, recently, there has been a great deal of public discussion about UNC Health Care's pursuit of profits. We have set a goal of having a positive operating margin (which some refer to as profit) of between three and four percent which we believe represents a stable and responsible financial base.

Operating Margins

As you can see from the chart (above), there have been large swings in this percentage over the past 15 years getting as high as 18.6 percent and as low as negative 3.2 percent. I don't have to tell you that it is not possible to meet any mission at home, in business or here at UNC Health Care when the financial picture is negative.

The good news is we are on track financially. As such, our focus can shift to our other guiding principles.

It is important to understand how our changing health care system impacts UNC Health Care and its ability to maintain a strong foundation for meeting our mission.

Uncompensated Care vs. State Support

The chart above illustrates two important points. First, the red line shows how the uncompensated care we provide at UNC Health Care is increasing to an all-time high of $216 million in the last fiscal year. Second, the lower blue line shows the amount of money the state provides in support for this institution.

The gap between the two numbers $173 million is the cost of care we provide to our patients who cannot afford to pay full charges for which we receive no assistance from the state. The good thing about the top line increasing is that we are serving more people who need care and also need financial assistance. That is a good measure of service to our mission.

These big numbers are easier to understand when you look at them on a daily basis.

¢ We provide more than $550,000 in uncompensated care
¢ More than 800 patients per day receive uncompensated care
¢ Approximately one-third of all daily admissions receive financial assistance.

We want everyone who seeks care from UNC Health Care to know that it will be provided to them without concern for their ability to pay for the total cost of their care.

These numbers will no doubt increase. But, as they do, we are now better able to meet our mission.

I have spent virtually my whole career in public service. I come to my job every day to provide North Carolinians with the highest level of medical care that we can muster. That is not always easy to do at a safety-net institution.

We want to be the place where North Carolinians want to bring their family members when it really matters. We want to be the institution that North Carolinians turn to for the very best health care they can get. And that, my friends, is a balancing act worthy of Ringling Brothers.

In the operation of this complex health care system we have made some mistakes. We have not done a good enough job of letting some of our patients know that financial assistance is available. We have moved to fix that. We have made some billing errors in which patients got collection notices before they received bills. That's not acceptable, and we're moving to fix it.

I believe the changes we are making will go a long way toward helping patients in financial need. These are necessary changes and we will be diligent in implementing and monitoring them.

Please remember that we are all here to serve the people of North Carolina and to make this institution the leading academic health care system in the nation. Both are tall orders and both are connected. With our guiding principles in place, we can accomplish both.

This is a great place with a great mission. Thank you for your dedication.

1 thought on “UNC Health Care: By and for the people

  1. maryann lewis

    It’s well known that the image that you put forth over and over again is the main characteristic that people will associate with you. We ARE the state safety net institution and it would behoove us to fly that flag above all others in all our relations to the public. Remaining fiscally solvent is very important, but especially in the not-for-profit circles, our emphasis should remain on the large amount of free or compensated health care we give to the people of North Crolina.
    Thank you, Dr. Roper for staying true to the mission of our institution


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