2013 Report on Community Benet Duke University Health System

$291 million
$69 million
CHARITY CARE AT COST
All gures for scal year ended June 30, 2012.

TOTAL COMMUNITY BENEFIT AND INVESTMENT

A legacy of commitment to our community

Healthcare has evolved greatly since James B. Duke set out his vision more than 80 years ago for what would become Duke University Health System, the Duke University School of Medicine and Duke University Hospital. Today we are in a time of particularly signicant change. What remains unchanged, however, is our founding vision to provide highquality, compassionate and safe medical care to the people of the communities we serve. One reection of that commitment is community benet as dened by the federal government and detailed in this annual summary report. For the scal year ended June 30, 2012, Duke provided $291 million in community benet and community investment. Of that gure, $170 million represents the community benet categories identied by the Internal Revenue Service. In one of these categories, charity care at cost, Duke provided $69 million in medical services at a discount or without charge for patients from every corner of North Carolina. And when government programs dont completely cover the cost of care, Duke makes up all or part of the di erence. As always, Duke remains committed to continually improving quality and safety as well as access to healthcare, not only through improvements to our hospitals and clinics, but also through innovative breakthrough collaborations with our many community and government partners. Together, we can carry forward our founding vision into the future.

Victor J. Dzau, MD
Chancellor for Health Affairs, Duke University President and CEO, Duke University Health System

Community health
Duke University Health System remains rmly committed to working collaboratively with its community partners to identify, understand and address the healthcare needs of the communities it serves. For years through its two hospitals in Durham and one in Raleigh, Duke has worked with the health departments in Durham and Wake counties, community members, and numerous community partner organizations to conduct regular community health needs assessments. New federal requirements e ective in the 2013 scal year formalize the assessment, reporting and implementation planning process. Links to the Durham and Wake County Community Health Needs Assessments and to each hospitals report will be posted to www.dukemedicine.org.

Other IRS-dened categories of community benet

$11.28 million
Community groups
Over many years, Duke has developed productive partnerships with community organizations working toward the common goal of eliminating health disparities and improving residents access to high quality medical care. In the 2012 scal year, Duke provided a total of $11.28 million in cash and in-kind support for community groups, including $6.89 million for Lincoln Community Health Center in Durham and its satellite community clinics, which serve an overwhelmingly poor and uninsured population; more than $2.22 million for Durham Countys Emergency Medical Services operation; and nearly $2.22 million in cash contributions to other organizations.

$55.8 million
Health professions education
Dukes health professions education programs are recognized among the best, most innovative in the United States. Duke requires that its health professions students participate in rotations in community clinics, school wellness centers and in-home care programs for elderly or home-bound people. In addition to the valuable experience health professions students gain in its three hospitals, this community outreach prepares doctors, nurses, advanced practice providers, physical therapists, and other health professionals to work and lead in an increasingly communityfocused healthcare delivery system. In the 2012 scal year, Duke invested $55.8 million in its health professions education programs.

Charity care and other unreimbursed expenses

Providing quality care regardless of a patients ability to pay
Dukes commitment is to provide high quality, e ective care with a consistently high level of dignity, respect and skill to each of our patients, regardless of their ability to pay. In the scal year that ended June 30, 2012, Duke provided charity care at cost totaling $69 million. Of this amount, Duke provided charity care of $65 million to 168,158 patients from 96 North Carolina counties. All patients who do not have insurance, or who because of nancial hardship cannot pay for the urgent or emergent medical care they receive, are eligible under Duke policies to receive care at a discount or without charge. In addition to providing primary care at no charge, Duke physicians donate specialty care services to eligible uninsured patients through a program called Project Access. Nearly 12 percent of all discharged adult patients, 6 percent of hospital outpatient surgery and clinic visits, and nearly 71 percent of all visits to Duke emergency departments received some level of charity care. Duke works with patients by informing them about and helping them access the nancial assistance to which they are entitled. And when government programs do not completely cover the cost of their care, Duke makes up some or all of the di erence.

BY THE NUMBERS $69 million

Charity care at cost

$34 million Unreimbursed Medicaid costs covered by Duke $96 million

Unreimbursed Medicare costs covered by Duke

$25 million Unrecoverable patient debt

All dollar gures are at cost for the scal year ended June 30, 2012.

Charity care by county

Duke provided $65 million in charity care at cost to more than 168,000 patients from North Carolina.

Durham County ($35 million) Wake County ($14 million) $900,000 to 2.5 million (5 counties) $300,000 to $900,000 (6 counties) $15,000 to $300,000 (48 counties) less than $15,000 (39 counties)
All dollar gures are at cost for the scal year ended June 30, 2012.

Highlights of Dukes charity care and discounted care polices

Dukes commitment is to care for all patients with a high level of dignity, respect, and skill. Duke provides a discount to all patients of limited means who do not have health insurance for every medical service except cosmetic procedures. Duke provides assistance to patients whose medical hardship makes it di cult for them to pay basic living expenses. Duke assists patients in applying for any additional nancial programs for which they may qualify. Dukes complete charity care and uninsured discounted care policies are available at www.dukehealth.org

Every single doctor Ive seen thanks to Duke and Project Access has been amazing and has treated me so well. I have had the best of the best. Theres no mention of my not having insurance in fact, I feel like I have been treated better than someone with insurance. You guys are awesome.
BETTY MATHIS PROJECT ACCESS CLIENT

DUKE UNIVERSITY HEALTH SYSTEMAN OVERVIEW

Duke University Health System is a world-class provider of healthcare services based in Durham, North Carolina. As an integrated healthcare system, Duke operates Duke University Hospital, Durham Regional Hospital and Duke Raleigh Hospital, as well as an extensive network of primary care clinics and ambulatory care centers, and a statewide homecare and hospice service.

one dot = one inpatient discharge

one dot = 20 patient encounters

Adult inpatient discharges

scal year ended June 30, 2012

Outpatient visits
scal year ended June 30, 2012

Duke University Health System provided care for 60,758 adult inpatient discharges in 2012, more than 90 percent involving North Carolina residents. Top 3 North Carolina counties by volume were: Durham: 19,647 Wake: 10,023 Orange: 2,577

Duke University Health System provided care during 2,016,470 outpatient encounters in 2012; nearly 91 percent were from North Carolina residents. Top 3 North Carolina counties by volume were: Durham: 724,194 Wake: 426,118 Orange: 124,511

Duke-trained healthcare professionals in North Carolina

Nearly 6,000 Duke-trained healthcare professionals live in North Carolina. Physicians Nurses Physician Assistants 2,880 2,106 601 Physical Therapists Pathology Assistants Total 234 28 5,849

Duke clinics and care locations

Duke University Health System has nearly 240 locations in communities in North Carolina and Virginia, including: Apex Burlington Cary Chapel Hill Clayton Creedmoor Danville, VA Durham Fayetteville Greensboro Henderson Hillsborough Holly Springs Knightdale Laurinburg Lumberton Mebane Morrisville Oxford Pittsboro Raleigh Roanoke Rapids Roxboro Sanford Smitheld South Hill, VA Wake Forest Whiteville Winston-Salem

Ofce of Community Relations DUMC Box 3701 Durham, NC 27710

communityrelations.duhs.duke.edu 919-668-3792
Produced by the Office of Marketing and Communications. Copyright DUHS, 2013. 9813