A medical center on every corner? A smorgasbord of hospital providers from which to choose?
Get ready for the future of health care in Palm Beach County.
Health care providers are expecting big business in 2030, partly from from more Baby Boomers retiring to Florida, but also from an expected 200,000-plus added residents in the county that will add critical mass and a vast variety of medical needs and healthy living plans. Not only will there be more patients, but with medical and technological advances, these patients also will be living longer, too.
That's good news for health care providers, especially those who will cater to aging residents. Strong growth is expected in numerous specialty fields, including cancer, cardiac care, orthopedics, dermatology and gastroenterology.
Many hospital companies already are opening medical offices, out-patient surgery centers and stand-alone emergency rooms throughout the county, part of the "retailization" of medicine that is bringing the care to the patient instead of the patient having to travel long distances to receive treatment.
Among them are out-of-area, and even out-of-state companies.
Expect more.
It used to be that to receive the nation’s best care, patients needed to step on an airplane and fly elsewhere for treatment. Now that care increasingly is coming to Palm Beach County patients.
Hospital companies, particularly from the Northeast, are expanding to Florida to meet the needs of their patients who spend time in the state for part of the year. Many of these hospital companies like the county’s high percentage of insured population, as well as the generosity of the area’s philanthropists willing to finance centers for treatment and research.
The presence of a variety of players benefits existing residents who may not have had the ability to fly elsewhere for treatment.
However, the proliferation of medical providers could cause confusion, much the same way too many choices at the grocery store make decision-making difficult.
Options galore
Community hospital? Brand-name hospital? Regional chain? For-profit or not-for-profit facility?
Does it matter? It does, if patients want excellent care, said Dr. Kenneth Davis, president and chief executive of Mount Sinai New York Health System.
Patients willneed to do their homework to discern if a hospital company truly is excellent, or just touts its services with no valid objective measure.
“Consumers have to be thoughtful about where they want to get their care,” Davis said.
The options will be there. One example is Mount Sinai New York, a not-for-profit medical center ranked among the top 10 in the nation for cardiology and heart surgery, according to U.S. News & World Report.
And there are signs that existing and would-be patients already are starting to do their homework.
People who crowd concert halls for musicians are just as likely these days to fill venues featuring top doctors. For instance, during a March presentation on Palm Beach by New York’s Hospital for Special Surgery, more than 500 people crowded a ballroom at The Breakers Resort to hear these rock-star surgeons talk about the latest in orthopedic care.
But providing good care while staying afloat financially will be a challenge for hospital companies. Experts expect huge strains on the Medicare system as more Baby Boomers retire.
As a result, many stand-alone centers are pairing up with larger hospital systems, a trend likely to continue.
The time to start planning for the future was yesterday. Just ask Jerry Fedele, president of Boca Raton Regional Hospital.
After shepherding the Boca Raton hospital through tough financial times into a position of strength, he stunned the hospital staff when about five years ago, he began pushing Boca Raton Regional leaders to seek a larger partner.
Fedele, a keen observer of macroeconomic trends, knew that Palm Beach County would be a microcosm of what was going to happen across the country: The largest population ever to enter the Medicare system, slated to clock in at 10,000 people a day nationally for the next decade.
"There are more of us than at any other time going into Medicare. It's just enormous numbers," Fedele said. "It's coming. It's inevitable. You can see the tsunami right in front of you."
That retirement movement will be concentrated in Palm Beach County, as it will be in other warm weather destinations, Fedele said.
But Medicare wasn't set up to take care of patients who now live 15 years or more past the retirement age of 65, instead of five years, as originally envisioned when the program was created, he said. Nor was Medicare set up to handle increasingly expensive health care, which uses advanced technology to heal or extend lives.
With Boca Raton Regional now regularly treating patients 90 or even 100 years old in its beds, hospitals need to think of ways to manage the strain on resources going forward, Fedele said.
For Boca Raton Regional, that meant looking at ways to be more efficient, including selling to a larger hospital company. After a beauty contest that saw numerous health care companies express interest, Boca Raton Regional chose non-profit Baptist Health of Coral Gables.
The deal, still being finalized, gives Baptist a major boost in its effort to be a dominant player in South Florida, stretching from Monroe County to Palm Beach County.
Baptist already owns Bethesda East and West hospitals in the center of the county, and Boca Raton Regional gives it a strong south county toehold. The deal also brings to Baptist a hospital with a deep history of philanthropy: Fedele said the hospital has received more than $3 million a month for the past seven years.
But Baptist is not stopping there. Baptist Health South Florida sees the Palm Beach County market as part of its South Florida network that will be working to keep up with the demand for services.
Boom in Medicare
In South Florida alone, “over the next ten years, about half a million folks will age into Medicare,” said Ana Lopez-Blazquez, Baptist Health executive vice president and chief strategy officer.
Patients will include active seniors, as well as those with chronic health conditions, including some types of cancers. For Baptist Health, the major areas of focus are cancer, cardiology, vascular as well as neuroscience, including treatment of Alzheimer’s and strokes.
In addition to buying Boca Raton Regional, Baptist Health now operates two free-standing outpatient surgery centers in the county, one in Boca Raton and one in West Palm Beach.
Baptist also just purchased the former Toys R Us building in Royal Palm Beach. Word is the facility could be turned into some type of outpatient facility, such as a free-standing emergency room, to serve the western communities. Lopez-Blazquez said Baptist doesn’t know what it wants to do with the site yet.
But she does expect collaborations among the various Baptist facilities will could take place in the future.
For instance, Baptist’s Miami Cancer Institute might be able to work with the Lynn Cancer Center, part of Boca Raton Regional, to provide advances in treatment and equipment.
That said, most hospital executives said there still will be a need for hospital beds, particularly for the sickest and most complex patients. “Folks who end up in hospitals are really sick,” Lopez-Blazquez said. “You’re seeing a lot of hospitals look at expanded capacity for intensive-care beds for patients who typically are more acute and more compromised.”
To that point, Lopez-Blazquez said plans are afoot to expand the number of beds at Bethesda West. The facility has 80 beds now but talk is ongoing about adding additional beds and other services.
Indeed, Baptist isn't alone in looking to expand its presence in western Palm Beach County.
After all, this is where homes are sprouting and the population is growing in housing communities under construction now. Wellington Regional Medical Center already got a jump on the competition by opening a free-standing emergency room in the new western community, Westlake.
Cleveland Clinic sees its future in the western part of the county, too.
In 2007, Cleveland Clinic Florida was the first out-of-area medical provider to establish offices in Palm Beach County, opening offices in downtown West Palm Beach to expand its reach from its Weston-based hospital and campus.
In January, Cleveland Clinic bought 35 acres on Lake Worth Road, just west of Florida’s Turnpike near Wellington.
Word is the famed Ohio-based nonprofit medical center may seek to build a hospital on the property, as a way to serve the many patients it sees at various clinic offices in West Palm Beach, Palm Beach Gardens and Wellington. The Wellington office, which opened last year in the Village Green Center, at the corner of Stribling Way and State Road 7, offers primary, cardiology and gastroenterology care.
Cleveland Clinic wants a hospital to accommodate its Palm Beach County patients who do not want to make the long drive to Cleveland Clinic’s hospital in Weston. “This is what we get from our patients all the time,”said Dr. Wael Barsoum, president of Cleveland Clinic Florida. “They say they want a Cleveland Clinic here.”
Cleveland Clinic bought the Lake Worth Road land after it lost in its bid to buy Boca Raton Regional Hospital. Losing was an anomaly for the aggressive health care company. As proof, Cleveland Clinic just completed its acquisition of Indian River Medical Center in Vero Beach and Martin Health System in Martin and St. Lucie counties.
Other players
But Cleveland Clinic isn't the only out-of-area hospital company to strengthen its presence in Palm Beach County, also by setting up shop out west.
Joe DiMaggio Children's Hospital of Hollywood, which had two offices in Boca Raton for years, made a bold expansion into Palm Beach County by opening a large standalone center in Wellington in February. The $22 million Health Specialty Center will offer a variety of services including specialized clinical care, comprehensive imaging, outpatient surgery and rehabilitation services.
By opening in family-friendly Wellington, the goal is to serve pediatric patients needing specialty services by bringing the care to them, said Caitlin Beck Stella, chief executive of Joe DiMaggio Children’s Hospital. “Where it’s possible, we should not make families drive long distances,” Stella said. “Children need to be taken care of near their home environment.”
Joe DiMaggio officials who track population growth spent at least five years scoping out the county to find a site.
Mount Sinai New York also is taking the long view when it comes to patient needs in the coming years.
Dr. Arthur Klein, president of the Mount Sinai Health Network, said plans are afoot to grow the center’s existing cardiology presence in West Palm Beach by adding pulmonologists. The hospital company also plans to build a peripheral vascular intervention lab at its Palm Beach Gardens office. The incidence of vascular problems is growing due to diabetes, age and lifestyle, Klein said.
Cancer treatment also is being eyed by Mount Sinai New York, and Klein said an alliance with Florida Cancer Specialists, a large medical practice, is in the works. Moreover, in the future, Mount Sinai might also create a West Palm Beach location of its famed Inflammatory Bowel Disease Center of New York.
Two other New York-based players in the county also are seeking to serve new and existing patients.
New York's famed Hospital for Special Surgery is completing an outpatient center in West Palm Beach that will perform outpatient surgeries and over time, outpatient joint replacements, as well as doctor visits and rehabilitation services.
The goal, HSS doctors say, is to keep the aging Baby Boomer population the way they want to be: Active and moving around. Advances in treatments, as well as the latest in surgical techniques, are designed to keep patients playing golf, tennis or other activities, just as they always have been.
HSS is building the West Palm Beach center on Palm Beach Lakes Boulevard through United Surgical Partnerships International, a subsidiary of Tenet Healthcare Systems. The center, across the street from Good Samaritan Medical Center, should be completed by the end of the year or early next year.
"We’ve been working on this for a long time," says Louis A. Shapiro, president and CEO of HSS, explaining the plans to open HSS Florida. "But we wanted to do it right, not fast."
Then there’s NYU Langone, which also also has set up shop in Palm Beach County. NYU Langone has clinical offices in downtown West Palm Beach, featuring internists treating a range of conditions, and Delray Beach, where it has a cardiac practice.
Interestingly, Mount Sinai is in talks with Tenet’s Good Samaritan Medical Center about a relationship that could involve say, treatment of cardiac care patients. A collaboration could take place, too, with HSS.
Of course, existing hospital companies are stepping up their game to meet the needs of the growing population:
- Palm Beach children's Hospital, part of Tenet-owned St. Mary's Medical Center, is getting the word out about its growing pediatric services. For instance, the hospital features a newly renovated pediatric medical and surgical unit; Child Life Specialists who attend to pediatric patients throughout a hospitalization to relieve stress, including the use of “bravery bands,” wristbands for treatment in various departments; and a growing roster of pediatriac surgeons, including the presence of a pediatric neurosurgeon.
- JFK Medical Center in Palm Springs, part of HCA East Florida, a large hospital system, is in the midst of a $108 million expansion. The plan is adding a three-story bed tower, expand the emergency room, complete patient unit renovations and expand and upgrade its parking facilities. (JFK Medical also has a smaller full-service hospital in West Palm Beach; parent HCA owns Palms West Hospital, and the Children’s Hospital at Palms West, in Loxahatchee.)
- Jupiter Medical Center, the county’s only independent non-profit hospital, continues on its ambitious growth plans, fueled by a generous philanthropic base. The 327-bed hospital is in the midst of a $300 million fundraising campaign to open new clinical programs. It just opened a Comprehensive Stroke Center and is finishing a new 6,300-square-foot Mastroianni Family Pediatric Emergency Department, with eight treatment rooms, pediatric triage rooms and an isolation room.
Hospital executives cautioned that growth will not come without smart planning to ensure the right mix of physicians with the services needed by the patient population.
But they said that continued growth of medical services will come, and Palm Beach County patients will see it. Said Baptist’s Lopez-Blazquez: “We’re looking at the entire county as a market, and we have fairly ambitious growth strategies.”
