IU Health faces pandemic crisis with focus on patient care and a commitment to its workforce and community

INDIANAPOLIS (Feb. 25, 2021) – Indiana University Health strengthened its focus on key healthcare and operational goals in 2020 as it responded to unprecedented challenges during the coronavirus pandemic.

The year tested IU Health in many ways and Indiana’s largest healthcare system relied on its dedicated workforce, deep resources and operational resilience to carry out its critical healthcare mission in the face of the global healthcare crisis.

“The story of 2020 was one of loss and suffering, but as is often the case in times of crisis, our team members showed their commitment to our patients and each other every day under the most difficult circumstances we have ever faced. Their resilience and creativity in deploying solutions to the challenges of the pandemic have been remarkable,” said Dennis Murphy, president and chief executive officer. “IU Health has come through the year in a strong position. As the pandemic continues into 2021, this spirit of compassion and resourcefulness should continue to sustain IU Health and our care mission going forward.”

Responding to the pandemic

To aid Indiana in the fight against the viral outbreak, IU Health made significant investments in innovative care and service at a speed and scope unparalleled in its history. Highlights from 2020 include:

• Surge planning. Significant funds were redirected to new needs during the pandemic, such as personal protective equipment, expanded ICUs, temporary care facilities, extra frontline staffing and a hospital-at-home program to free up hospital beds for the most critically ill.
• Virtual COVID-19 screening clinic. Opened in March over just two days, the clinic became one of the foremost tools Indiana has used to identify thousands of suspected cases of the coronavirus without risking in-person contact.
• Coronavirus testing lab. One of the largest coronavirus test labs in the state has performed over 455,000 tests since opening early in the pandemic.
• Virtual care. Providers pivoted early in the pandemic to telemedicine and other virtual links to respond remotely to patient care needs. Usage has remained high as patients see virtual care as a safer, more convenient, and less-costly option than in-office visits.
• Nursing home communications platform. An expanded tech platform met the pressing need for better communications between hospitals and nursing homes during the pandemic to reduce infection chances and improve care for vulnerable patients discharged to nursing homes.
• Mask up campaign. To encourage mask-wearing, IU Health’s Wear Because You Care marketing campaign served more than 74 million impressions through paid media ads focused on populations disproportionally affected by COVID-19. IU Health also distributed more than 190,000 masks in communities it serves.
• Financial lifeline to vendors, patients. Payments were accelerated to Indiana suppliers in spring 2020 to boost cash flow and aid their financial viability during the partial economic shutdown. With many households financially stressed, patients were allowed to delay paying their medical bills without charge or penalty.

“COVID-19 disrupted the status quo, forcing healthcare to do things differently, and IU Health responded in agile and innovative ways,” said Michelle Janney, PhD., RN, executive vice president and chief operating officer who has headed up the executive-level System Incident Command activated to respond to the pandemic. “Within weeks of the pandemic’s arrival, IU Health made over 140 systemwide impactful changes in how we work and deliver care in order to effectively carry out our mission of protecting and improving the health of the citizens of Indiana during this crisis.”

No let-up in care quality

Despite the disruptions from COVID-19, progress was made on key quality-of-care metrics for the 1 million patients seen each year within the IU Health system. The number of in-hospital patient harm events and the systemwide mortality rate fell favorably below targets. Surveys showed more patients were satisfied with their care and likely to recommend IU Health than ever before.

For the 23^rd consecutive year, IU Health Medical Center was ranked among the nation’s top adult hospitals by U.S. News & World Report and the only nationally ranked hospital in Indiana. Eight specialties, including ear nose and throat, geriatrics and gynecology, were rated high-performing or among the nation’s top 50.

IU Health remained on the forefront of medical innovation, reinforcing its reputation as a destination healthcare provider with cutting-edge care. The IU Health transplant team did the state’s first living donor liver transplant in 20 years, giving hope to Indiana patients facing a shrinking supply of available in-state donor livers. At Riley Hospital for Children, a new precision genomics team leads the way in finding more effective treatments for deadly cancerous sarcomas in children.

To ensure continued high quality of care during the pandemic, IU Health committed to retaining its workforce with no furloughs or pay disruption, ensuring its 36,000 highly skilled professionals are in place for patients at a time of need.

Operational and capital investments

IU Health took significant steps to modernize its aging statewide hospital facilities, which will allow it to better serve its diverse urban and rural patient base and respond to changing patient needs and unforeseen events such as the coronavirus pandemic.

• A replacement hospital was opened in Frankfort and construction is nearing completion on a new regional academic health center in Bloomington.
• Rezoning was approved for an expanded medical campus in downtown Indianapolis that will be home to a consolidated adult academic medical center. It will open for patients in 2026, ushering in a new era of world-class care to future generations of Indiana residents.
• A new maternity unit at Riley Hospital for Children opens in 2021, offering comprehensive maternity and newborn health center for Central Indiana parents, including one of the largest neonatal intensive care units in the country.
• An expansion this year of IU Health West Hospital in Avon will add beds and operating room space to serve fast-growing suburbs of Indianapolis.

The investments further IU Health’s nonprofit mission of providing clinical care, research and education as Indiana’s most comprehensive healthcare provider, in a unique partnership with Indiana University School of Medicine.

Care affordability

IU Health is committed to making Indiana a healthier state by providing more affordable and accessible care. “We have put in place a multi-year pricing affordability plan that will essentially hold year-over-year pricing flat. Our plan targets pricing reductions for common and frequently used services that have the biggest financial impact on patients and employers,” said Jenni Alvey, senior vice president and chief financial officer. “Over the next five years, the plan should bring more than $1 billion in savings for healthcare consumers when considering inflation.”

For 2021, outpatient rates for the most common services have been reduced by $85 million, including a 45% reduction for radiology and 60% for laboratory services. In upcoming years, pricing reductions will focus on infusions, specialty pharmacy, and outpatient surgeries.

Since 2015, IU Health has offered a patient cost estimator that in 2020 provided estimates for 90,000 requested services. A new self-service tool lets patients see cost estimates for more than 800 services.

IU Health is investing tens of millions of dollars to address social determinants of health, focusing on infant mortality, tobacco use, obesity, the opioid crisis and access to behavioral health. IU Health Plans provides healthcare coverage for more than 80,000 plan members who benefit from a population health platform. IU Health has reduced annual Medicare spending by almost $70 million over a three-year period through its Next Generation Accountable Care Organization.

Community benefit

IU Health provides more community benefit than any other health system in Indiana. In 2019, total community investment amounted to $889 million, including $90 million in charitable financial assistance, as well as education for health professionals, clinical research and outreach initiatives. In 2019, a Community Impact Investment Fund was established with $100 million to improve the health of Hoosiers through local investments. Annual grants from the fund in 2020 addressed community needs brought on by the COVID-19 pandemic, funding programs providing home meals, nutrition education and reading programs for school-aged children.

IU Health also launched a pilot fellowship program with Indianapolis Public Schools that enhances health sciences education at Crispus Attucks High School and invests in the next generation of healthcare providers. Upon graduation, student fellows will receive job offers and tuition assistance from IU Health. Under an initiative with the City of Indianapolis, IU Health pledged money and other resources to foster more work opportunities, housing choices and healthier lifestyles in the Near North neighborhood adjacent to its Methodist campus. IU Health’s commitment includes helping fund two new mixed-income housing developments that will provide needed affordable housing options.

Financial results

Highlights for IU Health’s 16-hospital system, which also includes surgery and urgent care centers, four physician networks and a health insurance company:

• Operating income fell 3.4% from 2019 to $656 million. Total earnings were largely flat and included investment gains from favorable financial markets and $236 million in federal CARES Act coronavirus relief funding for hospitals.
• Declines were seen in most key patient service categories, including hospital admissions, surgery cases, ER visits and radiological exams, due in part to a state-ordered delay in nonessential surgeries and procedures in the spring.
• Operating revenue excluding CARES Act funds grew by 1.5% over 2019 to $6.81 billion, while operating expenses rose 6% to $6.39 billion.

• IU Health maintained AA bond ratings.