The Georgia Scroll
January 1998
Health Care Provider
Impact During
the 1996 Atlanta Olympic Games
By: Bruce McClearen
When Atlanta, Georgia was selected as the site for the 1996 Summer Olympic Games, the city and surrounding area became infected with excitement and anticipation. The Olympic Games is a grand event, and we were all proud that Atlanta had been chosen. The Georgia Chapter of HFMA was no exception, and in March 1994, with the games just two years away, the Georgia Chapter of the Healthcare Financial Management Association began looking for ways to contribute and participate in the Games. Our Chapter, with its tradition of volunteer effort and community involvement would certainly want to offer our services and support to this exciting event. The Chapter Public Relations Team was assigned the task of exploring potential service opportunities, bringing back ideas, and making recommendations.
First, the Public Relations Team identified the individual at ACOG who was responsible for organizing the medical services aspect of the games. This effort introduced HFMA to Elizabeth Martin, ACOG’s Program Director for Medical Services. Two members of the Chapter visited with Ms. Martin in hopes of gaining better understanding of how ACOG and HFMA could work together. One of the first things we learned in this process was that the Olympic Organizing Committee had an excellent security system. It took some weeks to get through the security process in order to have the meeting.
Elizabeth Martin was extremely helpful. In talking with her, we learned about the Olympic Committee’s system for identifying and utilizing qualified volunteers, which covers all aspects of the games and is one of the cornerstones of the Olympic Committee’s success. The program focuses on working with individual volunteers rather than organizations or associations and requires a very high level of commitment on the part of volunteers. Individual volunteers had to be able to give large blocks of time to the committee, when and where the committee needed it. An organization like HFMA could not provide that level of commitment on behalf of the total membership. Individuals within the organization could certainly commit themselves, and many did, but it was clear that working with ACOG as a group would not be as easy as we had expected. Ms. Martin did recommend one project that ACOG needed help with, and it turned out that the Georgia HFMA Chapter was perfectly qualified to complete it. ACOG needed pricing and vendor information for a wide range of medical equipment that would be used to stock medical aid stations, which would be located through out the venues. Everything from splints, ventilators, resuscitators, shock suits, trauma kits, and intravenous solutions needed to be identified and priced. A small team was put together and, within a week we were able to provide ACOG with the data that was needed for this project.
Because this project was simple and short-lived, our Chapter wanted to do more. The Public Relations committee began looking for other possible ways to contribute to the Games. The team came up with the idea of conducting a study with patient accounts managers across Georgia to measure provider impact across the state in terms of Olympic-related healthcare admissions during the period of the Games. The study would be designed to measure the number of admissions and the cost for the services provided, and to determine whether providers were reimbursed. We were also interested in determining how much Olympic-related care was uncompensated, in order to evaluate the efficiency of the Games for providers and the community.
Prior to beginning this project, HFMA looked at some of the previous games to see if anyone had previously attempted to measure such information. We were able to contact a number of individuals in healthcare who had been close to the games in both Los Angeles and Barcelona. We believed hospital admissions data from previous Games could serve as a point of comparison for our study and might be useful in preparing Georgia’s Healthcare Providers for what was to come. After numerous phone calls, however, we could find no one who was aware of any similar effort in the past. It appeared that no provider impact data had been collected at any of the previous Games, and no such study had ever been conducted. Some reports from health care professionals working in Los Angeles during the Olympic Games suggested that, overall, admissions were reduced, and the impact of the Games on providers was minimal. Others reported a different impression of the Games in general. Many shared that the much anticipated traffic jams did not occur in Los Angeles because many people left town or curtailed their work schedules. From a healthcare provider perspective, many believed they had not come out very well, but, for lack of relevant data, could not prove it. Having learned this, the Georgia Chapter of HFMA decided the provider impact survey looked like a good opportunity, and decided to conduct our own.
Our initial planning step was to investigate the structure and organization of medical service and systems for the Games as designed by ACOG and the OOC. The process of planning an Olympic Games event is extensive and involved, and the Olympic Organizing Committee has many years of experience putting on the Games throughout the world. ACOG has developed a global strategic operations plan that serves as the road map for all aspects of the Games. Every conceivable consideration for the Olympics, including the logistics of transportation, housing, and medical care, is dealt with using knowledge gained from experience in past Games.
Medical services are an important aspect of the overall plan for the Games. In Atlanta, Elizabeth Martin worked closely with Dr. John Cantwell, ACOG’s Chief Medical Officer, and together they were responsible for managing the medical service strategies of the Games. The Olympic Medical Support Group was led by a group of primarily local physicians who, together with ACOG, considered a wide variety of possible disaster scenarios, including terrorism. They were to be prepared for all eventualities. All care was provided free, and many of the supplies were donated. The primary strategy, developed through analysis of previous Olympic Games, was designed to minimize the impact on the existing infrastructure of the Host City. This system required creating a network of Medical Aid Stations (much like military field hospitals) and placing them throughout the Games venues. The hub of the system was a "polyclinic" with a pharmacy lab and other special features for athletes and team members at the Olympic Village. Each separate venue featured separate stations serving athletes and Olympic Family members. These stations were manned by medical volunteers (physicians, nurses, and technicians) who provided on site-medical care. The Medical Aid Stations served as a "front-line" designed to provide the major portion of medical care and minimize the impact to local providers.
The Olympic Organizing Committee also has a secondary medical service strategy that utilizes a hospital support network to provide additional services as needed. Eight area hospitals were selected to serve as the Olympic Support Network in Atlanta, each of which was assigned a specific set of venues to cover. Participating athletes and members of the Olympic family had special insurance, and would utilize these specific hospitals for any health care needs that might arise. Georgia Baptist’s life flight helicopter (backed up by two more helicopters belonging to the Department of Defense), along with ten emergency medical service companies, were on hand.
This medical infrastructure was designed to span a 33 day operation period and serve over two million spectators, three thousand Olympic committee members, fifteen thousand athletes, coaches and team members, forty thousand volunteers, fifteen thousand media, and several thousand other members of the Olympic Family. (The Olympic Family includes International Olympic Officials and dignitaries).
HFMA’s provider impact study had special needs because it was conceived more than a year (March 1995) prior to the Games and project completion was optimistically projected for around November 1996. A team to initiate and manage the impact study was assembled through Georgia HFMA’s Public Relations committee. HFMA teams typically rotate annually, so one person was designated to follow the project through to its conclusion. The key challenge was collecting meaningful data from providers who might be impacted by the Games. During the early months of the project, the team communicated with patient accounts managers, controllers, and CFOs across the state to begin the process of setting up our project. Through direct phone calls and letters and within the quarterly Georgia HFMA meetings, the word was spread about the project. The Olympic Support Network and the training provided to the Network by ACOG seemed well thought out and complete. If the reports from Los Angeles and Barcelona were accurate, we could expect that there would be little, if any, provider impact beyond the medical support network.
After the Games were over, the more tedious task of collecting the information began. After the Games ended our committee again sent letters to CFOs and patient account managers and followed up with phone calls reminding each of our need to collect data. While the actual admissions data was fairly easy to collect, we knew that it would take some time for us to see how well we came out with respect to reimbursement. It turned out that the last data needed for completion of the project was not received until the Fall of 1997; our project time stretched to over two and a half years.
It has taken a little over a year to collect all of the data needed to complete this project. While provider reporting was not 100%, we got close to that goal and are now happy to share our findings. According to ACOG, the medical support network served over 40,000 people at the medical aid stations. Many of the supplies were donated, and care was provided by volunteers. While ACOG has not shared their data regarding the types and degree of severity of the cases, the costs associated with this care are assumed to be minimal. With this information and the data collected, it appears that ACOG successfully achieved the goal of providing the majority of care, thus reducing the impact to local providers. Without the aid stations, many of these individuals would have sought care within the local provider system.
ACOG was not able to handle every case, and admissions data from those hospitals impacted provides some interesting information. Seventeen hospitals reported admissions during the 33-day period of the Olympic Games. Those hospitals reported a total of 366 admissions, which they classified as Olympics related. The total charges for those admissions were $863,655.00. To date, these providers have been reimbursed a total of 40% of their charges. The range of reimbursement was from 0% to 53%.
There was also a large active duty military contingent assigned to Atlanta for the Olympic Games. Eighty-five members of this contingent required some form of medical care during the games. Their care was provided in an outpatient setting by the VA hospital. The cost for this care was $14,828 of which 100% was reimbursed by the Department of Defense. Because the expenses were covered by the DOD, the admissions/services are not included with the data provided by the local providers.
Of all the providers impacted, the data suggests that Grady Health System may have fared the worst. Grady had 32 admissions that were a result of the Olympic Bombing incident and incurred $310,000 in charges for their care. To date this public hospital has only received $54,708 or 17% reimbursement for these expenses.
Georgia’s healthcare providers were also asked to generally comment whether they felt the impact of the Games to their hospital was positive or negative. The majority indicated that the impact was minimal, neither positive nor negative. Three providers indicated that the impact was very negative and none suggested it was positive.
The results of Georgia’s HFMA study to measure admissions and financial impacts to providers during the 33 days of the Olympics seem to confirm what we heard from Los Angeles and Barcelona. The Olympic Committee’s planning system, in particular as it relates to healthcare delivery, is well thought out and organized. The impact to local providers is minimal considering the volume of people in the city during that time. Providers that are impacted, although small in number, appear not to fare very well with respect to reimbursement. Overall, the Games and the events surrounding them were an outstanding experience and made it all seem worthwhile.
Bruce McClearen is Vice President of Tyler & Company in Atlanta, Ga.