Aurora considers downtown clinics to relieve burden at Sinai

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Aurora Health Care is considering opening more community-based clinics in Milwaukee’s inner city to relieve the demand for urgent care in the emergency room of Aurora Sinai Medical Center.
Aurora president and chief executive officer G. Edwin Howe said Aurora is determined to keep Sinai open, even as the only surviving downtown Milwaukee hospital continues to bleed money.
Howe said the hospital, which serves patients from Milwaukee’s poorest neighborhoods, has recorded financial net losses over the last several years, including $17 million in 2002.
Over the past three years, Sinai has incurred cumulative net losses of $48 million.
Yet, Howe said Aurora is committed to maintaining a presence in Milwaukee’s downtown.
"There is no conceivable way that we wouldn’t be there," he said. "We’ve put a lot into that hospital over the last several years. It’s a nice, up-to-date hospital that offers wonderful, quality health care. But we do have to do things differently."
Aurora has invested $57 million in upgrading Sinai’s buildings and in purchasing new equipment over the past five years.
Aurora is looking into ways to expand access to health care so patients in the Sinai neighborhood are not routinely turning to the high-cost care available through the hospital’s emergency room.
"One of the things we need to do is give people alternatives when they have urgent care needs," Howe said.
An alternative might include more community-based clinics for central city and downtown area neighborhoods.
Howe expressed both optimism and concern for Sinai’s future.
Wisconsin Gov. Jim Doyle’s budget proposal to cut medical education funding to teaching hospitals would have dire consequences for Sinai. If approved as proposed, the budget would eliminate $57 million in Medicaid funding that pays for graduate medical education and physician training at hospitals with ties to medical schools, such as Aurora Sinai, which has an affiliation with the University of Wisconsin-Madison Medical School.
Doyle’s proposal would eliminate about $23 million of state general purpose revenue for a portion of the teaching hospitals’ costs.
Under the proposal, Aurora would lose about $8 million in Medicaid funding, with most of that coming out of the Aurora Sinai campus.
"Of course, the general medical education fund pays for the people who provide a lot of the charity care (at Sinai)," said Howe. "We are trying to convince the governor that if there are reductions – and there have to be to address the state budget deficit – they shouldn’t be against the hospitals that provide most of the medical education.
"Aurora Sinai, Froedtert, Children’s (Hospital of Wisconsin), Marshfield Clinic and University Hospital in Madison – those are the places that are taking the brunt of the Medicaid cuts. And that’s not fair. They need to be spread among everybody," Howe said.
However, Howe remains optimistic for the future of Sinai’s service area.
"My expectation is that Milwaukee is on the beginning edges of revitalization," he said. "When you look at all the new housing that’s going into downtown, our expectations are that it will be a growing market. But at the present time, we have a huge social mission. We are by far the largest charity in Milwaukee, as far as what we are providing at Sinai.
"What we have to do is figure out how to meet the needs of the downtown population in a more efficient and effective way than we do right now," Howe said. "There are going to be a lot of changes, but our total dedication is to make sure that there will always be good health care in downtown Milwaukee."

April 18, 2003 Small Business Times, Milwaukee, By Julie Sneider, for SBT

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