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St. Luke’s Health System

“One St. Luke’s” Serving Our Community




                                         1
More Than a Century of Caring: 1902-2010




         Our Mission

 “To improve the health of
   people in our region”

  Not-for-profit
  No investors or stockholders
  Community Ownership
  Community Governance
  Excess revenues reinvested in people, facilities, and technology
  Philanthropic support stays at St. Luke’s and in Idaho
                                                                      2
St. Luke’s Health System
A Brief History


• 1902 – St. Luke’s Hospital founded in Boise.

• 1928 – St. Luke’s opens new four-story hospital at the corner of Bannock and First Street.

• 1952 – St. Luke’s opens a new $1 million expansion becoming Idaho’s largest hospital with 245
  beds.

• 1968 – Dr. Rodney Herr performs the first open-heart surgery in Idaho
  at St. Luke’s.

• 1972 – Mountain States Tumor Institute (MSTI) created.

• 1996 – St. Luke’s Meridian opens as outpatient facility.

• 2000 – St. Luke’s Wood River opens.
                                                                                  St. Luke’s Hospital opened in this
• 2001 – St. Luke’s Meridian opens as full-service community hospital.            Boise home on December 1, 1902.

• 2006 – St. Luke’s and Magic Valley Regional Medical Center form partnership; St. Luke’s Health
  System is created with St. Luke’s Boise/Meridian, St. Luke’s Wood River, and St. Luke’s Magic
  Valley.

• 2010 – McCall Memorial Hospital joins St. Luke’s becoming St. Luke’s McCall.

• 2011 – St. Benedict’s joins St. Luke’s becoming St. Luke’s Jerome.
                                                                                                                3
• 2012 – St. Luke’s opens St. Luke’s Nampa Medical Plaza
St. Luke’s Health System 2012




  St. Luke’s Magic Valley                                                          St. Luke’s Meridian
                                            St. Luke’s Boise                            Beds: 167
         Beds: 228
                                                Beds: 399                           Employees: 1,372
      Employees: 1,978
                                           Employees: 6,035*




  St. Luke’s Wood River                    St. Luke’s Jerome                          St. Luke’s McCall
         Beds: 25                          Beds: 25                                        Beds: 15
      Employees: 379                       Employees: 178                              Employees: 222

 * Includes, St. Luke’s Eagle Health Plaza, outlying MSTI and medical clinics, and system staff.
St. Luke’s Health System
Idaho’s Largest Health Care Provider



   • 6 hospitals

   • 100+ clinics

   • 866 licensed beds

   • 1,000+ physicians

   • 10,000+ employees

   • 1.8 million outpatient
     visits each year


                                       5
St. Luke’s Health System – A Community Asset

 • St. Luke’s is community-owned.

 • St. Luke’s is Idaho-based and Idaho-
   led.
     • The only Idaho-based health system.
     • Governed by a volunteer board of
       directors comprised of local
       community leaders.

 • St. Luke’s is not-for-profit.
    • 100 percent of net revenue is
      reinvested in the organization and the
      communities served.
    • St. Luke’s accepts all patients
      regardless of their ability to pay.
                                               6
Idaho’s Most Awarded Health System




   Recent Awards:
   • St. Luke’s MSTI designated as an
     National Cancer Institute Community
     Cancer Center
   • St. Luke’s Boise Meridian Medical
     Centers are a Health Grades
     Distinguished Hospital for Clinical
     Excellence™.
   • Consumer Choice Award – ongoing since
     2001
   • Thomson Reuters 50 Hospital for
     Cardiovascular Care
   • Proud to be a Magnet-designated
     Hospital for Nursing Excellence         7
St. Luke’s Areas of Focus: The 3 E’s


•Excellence:
   •In all that we do
       People



•Efficiency:                    R
                                       S
                                E
   •Good stewards of our        L      T
     community’s resources
                  S
                         Q
                         U
                                A      E
                                       W
                  E             T
   •Lean implementation A
                  R             I      A
                   V     L      O      R
                   I     I      N      D
•Engagement:       C     T      S      S
                   E
   •Of employees and     Y      H      H
                                       I
                                I
   physicians                   P      P
   •Our people are St. Luke’s   S

   most valuable resource
                                           8
St. Luke’s Health System by the Numbers

St. Luke’s Boise               St. Luke’s McCall
• Babies Delivered: 4,158      • Babies Delivered: 83
• Inpatient Visits: 25,309     • Inpatient Visits: 456
• Outpatient Visits: 796,693   • Outpatient Visits: 67,304

St. Luke’s Magic Valley        St. Luke’s Meridian
• Babies Delivered: 1,613      • Babies Delivered: 1,185
• Inpatient Visits: 10,719     • Inpatient Visits: 10,046
• Outpatient Visits: 518,567   • Outpatient Visits: 311,067

                               St. Luke’s Wood River
                               • Babies Delivered: 221
                               • Inpatient Visits: 1,333
                               • Outpatient Visits: 78,351


FYE Numbers (9/30/2011)

                                                              9
St. Luke’s Health System Main Service Lines




 St. Luke’s is home to        First open-heart           Founded in 1971, MSTI
  Idaho’s only Children's       surgery in Idaho            has become Idaho’s
  Hospital.                     performed at St.            largest cancer care
                                Luke’s in December          provider.
 St. Luke’s Children’s         1968.
  Hospital at our Boise                                    St. Luke’s MSTI treats
  facility is a hospital       St. Luke's provides         approximately 800
  within a hospital.            cardiac care for heart      patients each day from
                                patients throughout         Idaho, Nevada, Utah,
 St. Luke’s Children’s         Idaho, and in parts of      and Oregon.
  Hospital has Idaho’s          Oregon, Nevada, and
  largest and most              Utah.                      St. Luke’s MSTI is one
  experienced Level III                                     of only 30 National
  Newborn Intensive Care       St. Luke's provides         Cancer Institute
  Unit and the state’s only     more heart procedures       Community Cancer
  Pediatric ICU and             than any other hospital     Centers.
  Hospital School.              in Idaho.                                            10
St. Luke’s Health System Core Values


• Integrity – Being honest; doing the right thing,
  even when no one is looking.

• Compassion – Acting to help others in need, and doing so with
  kindness and understanding.

• Accountability – Being responsible for your job duties, the quality of
  your work, and the consequences of your actions.

• Respect – Being considerate of other people, their property, and
  their point of view.

• Excellence – Always doing your best and doing what is best, in
  every situation.

                                                                           11
Transforming Healthcare

      St. Luke’s is transforming so that our patients
     experience better health and better care at lower
                   cost, our Triple Aim.




                          VALUE



                                                         12
Our Income Comes from Three Places

 Operations

                  Debt (Loans)




                                 Philanthropy




                                                13
SLHS Payer Mix



                        Medicare
                         38%




      Medicaid                     Commercial
        14%                           40%
                 Other
                  4% Self Pay
                       4%




                                                14
Financial Summary – Last 5 Years


              ($ in 000's)       FY7       FY8        FY9         FY10        FY11

     Net Operating Revenue       834,432   898,237    988,552    1,082,195   1,296,938

     Cash Flow (EBITDA)          122,902   107,843    134,252     136,189     181,284

     Cash Flow Margin (EBITDA)    14.7%      12.0%      13.6%       12.6%       14.0%

     Capital Plan                111,013   130,466    158,327     190,559     185,000

     Ending Cash                 238,067   244,468    487,694     433,552      417,594
     Total Debt                  228,221   257,661    533,327     531,172      527,124
       Cash to Debt Position       9,846   (13,193)   (45,633)    (97,620)    (109,530)

     Days Cash on Hand              119       111        189          159         130

     Debt to Capital              31.6%      32.4%      48.2%       45.7%       42.7%




                                                                                          15
Community Benefit




                         R
                         E   S
                         L   T
                     Q   A   E
         P       S
             P   E   U   T   W
         E
             e   R   A   I   A
         O
             o   V   L   O   R
         P
             p   I   I   N   D
         L       C
             l       T   S   S
         E       E
             e       Y   H   H
                         I   I
                         P   P
                         S


                                 16
St. Luke’s Health System Economic Impact


• Idaho’s largest private employer: 10,000+ jobs

• Annual salaries and benefits for employees: $450 million.

University of Idaho Economic Impact Study - 2009
Economic Multiplier Effect of St. Luke’s

• Produced nearly $1.87 billion in sales

• Generated more than 18,700 jobs

• Produced $36.7 million in sales and
  property taxes (indirect business taxes)

                                                              17
St. Luke’s Health System – 2010 to 2020

 St. Luke’s must invest $1.28 billion over the
 next decade to continue providing the
 exceptional level of care that people of our
 communities expect and deserve.

 Philanthropy is critical to achieving our
 long-term goals.

     • We will work with community leaders and
       donors to raise $128 million over the next
       decade
                                                    18
Future Investments in St. Luke’s Communities



  • New Facility in Nampa – Hospital, ED, and Medical Plaza

  • New Facility in Fruitland – Medical Plaza

  • Electronic Medical Records – “One Patient, One Record”

  • A new Healthy Living Center in Meridian

  • Expanded Cancer Services in Meridian, Boise, Nampa, and Fruitland

  • Expansion of downtown Boise campus

  • Children’s Hospital expansion


                                                                        19
St. Luke’s Health System
Perspective on Health Care Reform


• Positive:
   • 10 million – 30+ million more people with health
    insurance; coverage for folks with a pre-existing
    condition

• Concerns:
   • Cuts to Medicare and Medicaid to pay for “reform”
   • Provision of health insurance for all not supported by
     adequate supply of primary care providers and health
     care services
   • Likely increase in number of Medicaid beneficiaries.
     Medicaid doesn’t cover our costs.
                                                                 20
St. Luke’s Health System position paper: www.stlukesonline.org
St. Luke’s Health System Challenge
Becoming an Integrated Health Care System

Driven by the unified efforts of physicians,
community leaders and committed
employees St. Luke’s will provide:

  • A comprehensive health care delivery
    system with convenient, timely access
    to care providers.
  • Safe, effective and efficient care with a
    strong focus on wellness and
    prevention throughout our patient’s
    lives and across our health system.
  • Timely and convenient access to
    health care data across St. Luke’s
    Health System with a system-wide
    electronic record system (one patient,
    one record).                                21
The St. Luke’s Health System Promise



• We will focus on providing
  value to those we serve.
  Our aim is to achieve
  superior outcomes at the
  lowest possible cost.

• In all that we do – we will
  never lose sight of the
  reason we are here… to
  serve patients.

                                       22

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St. Luke's Health System overview

  • 1. St. Luke’s Health System “One St. Luke’s” Serving Our Community 1
  • 2. More Than a Century of Caring: 1902-2010 Our Mission “To improve the health of people in our region” Not-for-profit No investors or stockholders Community Ownership Community Governance Excess revenues reinvested in people, facilities, and technology Philanthropic support stays at St. Luke’s and in Idaho 2
  • 3. St. Luke’s Health System A Brief History • 1902 – St. Luke’s Hospital founded in Boise. • 1928 – St. Luke’s opens new four-story hospital at the corner of Bannock and First Street. • 1952 – St. Luke’s opens a new $1 million expansion becoming Idaho’s largest hospital with 245 beds. • 1968 – Dr. Rodney Herr performs the first open-heart surgery in Idaho at St. Luke’s. • 1972 – Mountain States Tumor Institute (MSTI) created. • 1996 – St. Luke’s Meridian opens as outpatient facility. • 2000 – St. Luke’s Wood River opens. St. Luke’s Hospital opened in this • 2001 – St. Luke’s Meridian opens as full-service community hospital. Boise home on December 1, 1902. • 2006 – St. Luke’s and Magic Valley Regional Medical Center form partnership; St. Luke’s Health System is created with St. Luke’s Boise/Meridian, St. Luke’s Wood River, and St. Luke’s Magic Valley. • 2010 – McCall Memorial Hospital joins St. Luke’s becoming St. Luke’s McCall. • 2011 – St. Benedict’s joins St. Luke’s becoming St. Luke’s Jerome. 3 • 2012 – St. Luke’s opens St. Luke’s Nampa Medical Plaza
  • 4. St. Luke’s Health System 2012 St. Luke’s Magic Valley St. Luke’s Meridian St. Luke’s Boise Beds: 167 Beds: 228 Beds: 399 Employees: 1,372 Employees: 1,978 Employees: 6,035* St. Luke’s Wood River St. Luke’s Jerome St. Luke’s McCall Beds: 25 Beds: 25 Beds: 15 Employees: 379 Employees: 178 Employees: 222 * Includes, St. Luke’s Eagle Health Plaza, outlying MSTI and medical clinics, and system staff.
  • 5. St. Luke’s Health System Idaho’s Largest Health Care Provider • 6 hospitals • 100+ clinics • 866 licensed beds • 1,000+ physicians • 10,000+ employees • 1.8 million outpatient visits each year 5
  • 6. St. Luke’s Health System – A Community Asset • St. Luke’s is community-owned. • St. Luke’s is Idaho-based and Idaho- led. • The only Idaho-based health system. • Governed by a volunteer board of directors comprised of local community leaders. • St. Luke’s is not-for-profit. • 100 percent of net revenue is reinvested in the organization and the communities served. • St. Luke’s accepts all patients regardless of their ability to pay. 6
  • 7. Idaho’s Most Awarded Health System Recent Awards: • St. Luke’s MSTI designated as an National Cancer Institute Community Cancer Center • St. Luke’s Boise Meridian Medical Centers are a Health Grades Distinguished Hospital for Clinical Excellence™. • Consumer Choice Award – ongoing since 2001 • Thomson Reuters 50 Hospital for Cardiovascular Care • Proud to be a Magnet-designated Hospital for Nursing Excellence 7
  • 8. St. Luke’s Areas of Focus: The 3 E’s •Excellence: •In all that we do People •Efficiency: R S E •Good stewards of our L T community’s resources S Q U A E W E T •Lean implementation A R I A V L O R I I N D •Engagement: C T S S E •Of employees and Y H H I I physicians P P •Our people are St. Luke’s S most valuable resource 8
  • 9. St. Luke’s Health System by the Numbers St. Luke’s Boise St. Luke’s McCall • Babies Delivered: 4,158 • Babies Delivered: 83 • Inpatient Visits: 25,309 • Inpatient Visits: 456 • Outpatient Visits: 796,693 • Outpatient Visits: 67,304 St. Luke’s Magic Valley St. Luke’s Meridian • Babies Delivered: 1,613 • Babies Delivered: 1,185 • Inpatient Visits: 10,719 • Inpatient Visits: 10,046 • Outpatient Visits: 518,567 • Outpatient Visits: 311,067 St. Luke’s Wood River • Babies Delivered: 221 • Inpatient Visits: 1,333 • Outpatient Visits: 78,351 FYE Numbers (9/30/2011) 9
  • 10. St. Luke’s Health System Main Service Lines  St. Luke’s is home to  First open-heart  Founded in 1971, MSTI Idaho’s only Children's surgery in Idaho has become Idaho’s Hospital. performed at St. largest cancer care Luke’s in December provider.  St. Luke’s Children’s 1968. Hospital at our Boise  St. Luke’s MSTI treats facility is a hospital  St. Luke's provides approximately 800 within a hospital. cardiac care for heart patients each day from patients throughout Idaho, Nevada, Utah,  St. Luke’s Children’s Idaho, and in parts of and Oregon. Hospital has Idaho’s Oregon, Nevada, and largest and most Utah.  St. Luke’s MSTI is one experienced Level III of only 30 National Newborn Intensive Care  St. Luke's provides Cancer Institute Unit and the state’s only more heart procedures Community Cancer Pediatric ICU and than any other hospital Centers. Hospital School. in Idaho. 10
  • 11. St. Luke’s Health System Core Values • Integrity – Being honest; doing the right thing, even when no one is looking. • Compassion – Acting to help others in need, and doing so with kindness and understanding. • Accountability – Being responsible for your job duties, the quality of your work, and the consequences of your actions. • Respect – Being considerate of other people, their property, and their point of view. • Excellence – Always doing your best and doing what is best, in every situation. 11
  • 12. Transforming Healthcare St. Luke’s is transforming so that our patients experience better health and better care at lower cost, our Triple Aim. VALUE 12
  • 13. Our Income Comes from Three Places Operations Debt (Loans) Philanthropy 13
  • 14. SLHS Payer Mix Medicare 38% Medicaid Commercial 14% 40% Other 4% Self Pay 4% 14
  • 15. Financial Summary – Last 5 Years ($ in 000's) FY7 FY8 FY9 FY10 FY11 Net Operating Revenue 834,432 898,237 988,552 1,082,195 1,296,938 Cash Flow (EBITDA) 122,902 107,843 134,252 136,189 181,284 Cash Flow Margin (EBITDA) 14.7% 12.0% 13.6% 12.6% 14.0% Capital Plan 111,013 130,466 158,327 190,559 185,000 Ending Cash 238,067 244,468 487,694 433,552 417,594 Total Debt 228,221 257,661 533,327 531,172 527,124 Cash to Debt Position 9,846 (13,193) (45,633) (97,620) (109,530) Days Cash on Hand 119 111 189 159 130 Debt to Capital 31.6% 32.4% 48.2% 45.7% 42.7% 15
  • 16. Community Benefit R E S L T Q A E P S P E U T W E e R A I A O o V L O R P p I I N D L C l T S S E E e Y H H I I P P S 16
  • 17. St. Luke’s Health System Economic Impact • Idaho’s largest private employer: 10,000+ jobs • Annual salaries and benefits for employees: $450 million. University of Idaho Economic Impact Study - 2009 Economic Multiplier Effect of St. Luke’s • Produced nearly $1.87 billion in sales • Generated more than 18,700 jobs • Produced $36.7 million in sales and property taxes (indirect business taxes) 17
  • 18. St. Luke’s Health System – 2010 to 2020 St. Luke’s must invest $1.28 billion over the next decade to continue providing the exceptional level of care that people of our communities expect and deserve. Philanthropy is critical to achieving our long-term goals. • We will work with community leaders and donors to raise $128 million over the next decade 18
  • 19. Future Investments in St. Luke’s Communities • New Facility in Nampa – Hospital, ED, and Medical Plaza • New Facility in Fruitland – Medical Plaza • Electronic Medical Records – “One Patient, One Record” • A new Healthy Living Center in Meridian • Expanded Cancer Services in Meridian, Boise, Nampa, and Fruitland • Expansion of downtown Boise campus • Children’s Hospital expansion 19
  • 20. St. Luke’s Health System Perspective on Health Care Reform • Positive: • 10 million – 30+ million more people with health insurance; coverage for folks with a pre-existing condition • Concerns: • Cuts to Medicare and Medicaid to pay for “reform” • Provision of health insurance for all not supported by adequate supply of primary care providers and health care services • Likely increase in number of Medicaid beneficiaries. Medicaid doesn’t cover our costs. 20 St. Luke’s Health System position paper: www.stlukesonline.org
  • 21. St. Luke’s Health System Challenge Becoming an Integrated Health Care System Driven by the unified efforts of physicians, community leaders and committed employees St. Luke’s will provide: • A comprehensive health care delivery system with convenient, timely access to care providers. • Safe, effective and efficient care with a strong focus on wellness and prevention throughout our patient’s lives and across our health system. • Timely and convenient access to health care data across St. Luke’s Health System with a system-wide electronic record system (one patient, one record). 21
  • 22. The St. Luke’s Health System Promise • We will focus on providing value to those we serve. Our aim is to achieve superior outcomes at the lowest possible cost. • In all that we do – we will never lose sight of the reason we are here… to serve patients. 22