News: MSMC Strategy Has Led to Solid Financial Picture

Despite a tough economy and an environment in which many fear the effects of health care nationalization, Miami Beach’s Mount Sinai Medical Center (MSMC) has parlayed its business strategy into uncommonly solid financial success.

The most recent audit posted on March 26 reports nearly $14 million in profit for 2009. Mount Sinai experienced an overall five percent growth in revenue from $497 million in 2008 to $524 million in 2009, while controlling a targeted 1 percent increase in expenses.  As of the end of 2009, the combined medical center and Foundation reported 108 days cash on hand.

“The strategic planning we do here … is for the long-term,” said MSMC President and C.E.O. Steven D. Sonenreich. “It’s not that we forget the short term, we just make sure we are hard-wired for the future.”

Michael M. Adler, chairman of the board, credits Mount Sinai success to three key points.

“Leadership is focused on the hospital’s core mission to provide high quality care, diligence in the hospital’s revenue cycle, and celebrating Mount Sinai’s philanthropic supporters,” Adler said.

Several specific changes and upgrades have been made in terms of personnel and strategy, leading to MSMC’s ongoing success.

According to the Agency for Healthcare Administration Statistics, Mount Sinai had been the region’s leader in heart care for more than two decades. However, this lead began to shrink in 2008.  To achieve continued success, Sonenreich recruited Dr. Joseph Lamelas in 2008 to join the hospital as a chief of Cardiac Surgery. A pioneer in minimally invasive valve surgery, Dr. Lamelas is the most successful cardiac surgeon in the tri-county area. His mortality rate is 67.5 percent below the expected rate of mortality as forecast by the state of Florida based on his volume and complexity of procedures. Having performed more than 8,000 open-heart procedures in his career, Lamelas also trains surgeons throughout the world in advanced and innovative surgical techniques.

Several specific changes and upgrades have been made in terms of personnel and strategy, leading to MSMC’s ongoing success.

The new cardiac surgery team attracted 51 percent more patients growing from 430 cardiac surgeries in 2008 to 649 in 2009 and instituted efficiencies that continue to save the hospital thousands of dollars per procedure.  The infection rate is significantly below national benchmarks and length of stay is cut in half.  Patients are back on their feet in less than two weeks.

Mount Sinai was also faced with challenges in diagnostic imaging, where the radiology residency pass rate had declined on professional board exams and the department was mired in inefficiency.

When encouraged to increase the number of subspecialists in radiology and improve overall care, the then existing radiology group fought back, giving 30 days notice of a mass resignation which would have left patients without the proper care needed.

At this critical juncture, Sonenreich reacted quickly to redefine the department of radiology, which resulted in the recruitment of Dr. Jeffrey Neitlich to serve as the chair of the Department of Radiology. Dr. Neitlich immediately went to work, building a multidisciplinary team with expertise ranging from virtual colonoscopies to neurointerventional procedures. Since then, patient care has improved significantly and the pass rate on professional board exams has shot to 100 percent.  Mount Sinai’s imaging volume increased nearly 10 percent in 2009.

The mass resignation in radiology accentuated the controversial nature of some of the personnel changes that have accompanied the changes at MSMC in the past few years.

“Succession is always difficult to deal with,” Sonenreich said. “Not many leaders are good at succession planning and I think that has been part of the difficulty in recent years. But we are committed to change for the better.”

However controversial key personnel changes have been at Miami Beach’s only hospital, the results, Sonenreich said, have been entirely positive when examining patient care and medical staff successes.

Advances at MSMC have also taken the form of technology and its application.

Sonenreich expanded the hospital’s surgical oncology program, acquired the da Vinci Robot to provide the most sophisticated minimally invasive treatments, and put the infrastructure in place for Mount Sinai to gain designation as a Comprehensive Stroke Center. There are only 16 accredited comprehensive centers in the entire state of Florida.

“Mount Sinai’s medical staff is truly a notch above the rest,” said Tony Carvalho, president of the Florida Safety Net Hospital Alliance.  “The physicians who choose teaching hospitals care about future of medicine; they want to be challenged; they want to be innovative.”

Mount Sinai’s minimally invasive surgical program is a great example of this dedication.  The medical center’s surgical oncologists are the first in Florida to install a laparoscopic technology called microwave ablation.  This tool uses ultrasound guidance to directly eradicate tumors.

Sonenreich also cites the success of MSMC’s Freestanding Emergency Room in Aventura as indicative of the hospital’s innovation. Last year alone, more than 13,000 people have sought care at the freestanding ER in Aventura. Patients have experienced practically zero wait time and the ER has made a significant contribution to the hospital’s revenue stream.

A strong management team and MSMC donors have also been key elements to ongoing success. Sonenreich personally reaches out to donors, shares Mount Sinai’s vision and gives them a true stake in its future. They have responded with renewed support and a strengthened level of commitment to the medical center.

“I support Mount Sinai because I believe in its mission and trust Steve Sonenreich to put the hospital and its future above anything else,” said Philanthropist Donald Golden. “I know how important Mount Sinai is to our community and donors like me are willing to make significant philanthropic gifts to provide the equipment and support the services the hospital needs to remain viable.”

In a strange era in which it seems businesses that prosper are somehow seen in a negative light, Sonenreich points out the benefits to the public of a strong and vibrant MSMC.

“Being financially stable means being able to support capital project efforts at Mount Sinai that benefit employees and patients,” he said.

MSMC is also a massive economic engine, being the largest private employer in Miami Beach and 11th largest private employer in Miami-Dade County.

The plan to perpetuate MSMC’s success revolves around continuing to “stay focused on our mission and our key strategies for 2010,” Sonenreich said.

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