Cleveland Clinic Indian River Hospital Committed to Serving All Residents of the County

Healthcare is seemingly at a crossroads. Hospital admissions are increasing, while labor, pharmaceutical, and supply costs continue to rise. This financial challenge is further complicated by workforce shortages and inflation. Additionally, inadequate reimbursements from government and private payers often do not cover the total cost of hospital-based care.

As a result, 40% of all U.S. hospitals are reportedly operating at a financial loss. Compounded by policies impacting governmental assistance programs, hospitals are experiencing an increase in uncompensated care. These challenges have resulted in many hospitals reducing clinical services in order to mitigate financial losses – and even bankruptcies or hospital closures nationwide.

Indian River County is not immune to these headwinds although Cleveland Clinic Indian River Hospital’s response has been different.

Cleveland Clinic Indian River Hospital has continued to expand clinical services based on the community’s needs. These services touch all residents of Indian River County and include women's healthcare services such as advanced breast cancer screening and labor and delivery; preventive care via the addition of more than 20 primary care physicians; psychiatry; neurology; and other services for aging populations.

In 2023, Cleveland Clinic Indian River Hospital provided care to more than 12,000 patients who were unable to pay. This is nearly double the number of unfunded patients cared for in 2019. The total cost of this care exceeded $17 million accounting for nearly a third of the hospital’s deficit in 2023.

With this unprecedented increase in unfunded care, representatives of the Indian River County Hospital District requested that we meet with them. Over the past four months, I presented information on the factors believed to be contributing to the increase in charity care along with supporting data from our hospital. Together, we reviewed the services most impacted. As an example, the number of uncompensated outpatient encounters has nearly doubled across a wide array of services ranging from emergency care to complex outpatient surgeries and cancer services.

For background, the Indian River County Hospital District is a special taxing district established by the Florida legislature approximately 65 years ago with the goal of funding vital healthcare services for all county residents. In 1984, it began funding care for underserved populations, or approximately 35 years before Indian River Hospital’s integration with Cleveland Clinic.

The hospital district, which owns the hospital property, provides this land in return for our investments in the hospital. A recent report commissioned by the hospital district showed that Cleveland Clinic has invested nearly $100 million into the Indian River Hospital campus and facilities over the last five years. In addition, Cleveland Clinic funded operating deficits of more than $100 million following the pandemic.

Our objective is to ensure that we continue to provide care to all patients, including the underserved, in partnership with the district. We have begun articulating a solution where the hospital would cover approximately 80-85% of unfunded care or around $80 million over the next four years, while the district would fund the remaining, up to approximately $13.6 million over the same period.

Cleveland Clinic Indian River Hospital is a cornerstone of the community. Medically, we provide nearly half a million outpatient visits and 50,000 emergency department visits annually. Economically, the hospital is the largest employer in Indian River County, employing more than 2,500 caregivers. It is one of the top 25 hospitals in the State of Florida.

I recognize the challenges and opportunities before us. My team and I are committed to improving how we deliver healthcare in Indian River County and providing care to the underserved.

I remain optimistic about the future of healthcare, and we are committed to continue to reimagine this care for all residents in Indian River County.

Richard Rothman, MD

Vice President and Chief Medical Officer

Cleveland Clinic Indian River Hospital