PUBLIC OPINION SURVEY RESULTS

October 2012

Alison Peters Consulting

RESEARCH OBJECTIVES
Are residents aware they live in a hospital district and do they want to preser ve this system, either for their personal benefit or the benefit of the community? How is Valley Medical Center perceived by the community in comparison to other health providers? Has awareness of Valley Medical Centers af filiation with UW Medicine increased and, if so, what does the community think of this relationship? Is it producing positive results? Is there awareness of changes to Board governance as a result of the af filiation? What changes does the community agree or disagree with? Looking ahead, how should Valley Medical Center make decisions regarding administrative pay, debt and continuing to be part of a district system? What are the communitys priorities?
2

METHODOLOGY

Sample Universe Field Dates Sample Size Survey Length Phone Types Margin of Error

King County Public Hospital District #1 September 10-16, 2012 N=500 20 minutes Landlines and Cell Phones 4.5%, larger for subgroups

Interviewing was completed locally, at Pacific Market Research, in Renton, WA

SAMPLE PROFILE
GENDER
Male Female AGE 18-24 25-34 35-49 50-64 65+ REF. 46% 54%

ETHNICITY White Non-White LEG. DISTRICT 4% 9% 16% 38% 31% 2% 36% 64% 5th 11th 33rd 37th 41st 47th INCOME Under $50,000 Over $50,000 28% 59% 2% 34% 13% 7% 7% 36% 79% 21%

PATIENT? Yes, self Yes, other Yes, both No HOUSEHOLD Single, no children Couple, no children Single, with children Couple, with children EDUCATION College Non-College 51% 48%
4

27% 19% 16% 38% 26% 38% 5% 31%

PARENT
Yes No

PATIENT PROFILE
50-65 years old Non-College 65+ years old

Under $50K Income

Women
5

KEY FINDINGS
1. The hospital district system is highly valued, not only by patients, but, after education, by potential patients to Valley Medical. The community does not want to see the district sold to pay off its debt. 2. Over 40 percent of residents do not know they live in the hospital district boundary. It is common for younger people, non-whites and parents to be more confused by this. In comparison, a higher percentage of residents know about the affiliation with UW Medicine (67%). 3. Satisfaction with the medical care provided by Valley Medical is high and unchanged since the 2011 Elway survey. 4. However, strong majorities of residents also say affiliation has made no impact on the cost of care, access to research, access to specialists, personal attention from providers or the hospitals community involvement. 6

KEY FINDINGS
5. 82 percent of survey participants said they had no knowledge of changes to Board structure or governance since the affiliation with UW Medicine. 6. There is consensus that changes to board structure (size, process of expansion) should require a public vote and that voting members live in the district. The community also believes the community can best provide input to the Board through an Advisory Committee, without expanding the full voting board to include new members. 7. Furthermore, there is consensus that administrator pay align with executive pay at other area hospitals.

THE CURRENT LANDSCAPE

RESIDENTS VALUE THEIR COMMUNIT Y HOSPITAL

How valuable are these community institutions? 35% 30% 25% 20% 15% 10% 5% 0% Your community hospital Your school district Your fire services Your local Your libraries roads/transit
9

29%

26%

26%

16%

4%

COMMUNIT Y HOSPITALS HAVE THE GREATEST VALUE TO OLDER RESIDENTS, PAST PATIENTS AND WOMEN
I would like you to tell me how valuable your community hospital is to you personally (Give a ranking of 1-5). ?
65+ years old

43%

29%

Non-College

36% 34% 33% 25% 23% 25% 20% 30% 30% 28% 40%

31% 31% 32%

Ranked #1 Ranked #2

Patients of VMC

Women

Groups that Rank Hospitals Lower: Men Residents Under 50 Couples with Kids Singles with Kids Non-Patients of VMC

Under 50

College

Men

0%

60%

80%

10

AWARENESS OF BEING IN A HOSPITAL DISTRICT

Percentage of Residents that Know They Reside in a Hospital District

36% 54% 10%

Yes No Don't Know

11

PARENTS, YOUNG PEOPLE AND NON-WHITES ARE THE LEAST INFORMED ABOUT BEING IN A DISTRICT
Do you know if you live within the boundary of a public hospital district?

Percentage Who Said Dont Know

18-34 year olds 35 to 49 year olds Non-whites Couples with kids Single with kids Total 0% 10% 43% 41% 39% 36% 20% 30% 40% 50% 60%
12

55% 52%

WHAT RESIDENTS THINK ABOUT BEING IN A HOSPITAL DISTRICT

Some people have been to Valley Medical Center as a patient and some have not. Please listen and tell me which of these statements comes closest to the way you feel. 60% 50% 40% 30% 20% 10% 0%
I support public hospitals like I consider Valley Medical I don't consider Valley Medical Valley Medical Center; they Center my local hospital; they Center my local hospital or care for the uninsured and care about this community value public hospital districts provide for the common good

50% 35%

12% 3%
Don't Know

13

SINGLES AND NON-WHITES ARE LESS LIKELY TO NAME VMC AS THEIR LOCAL HOSPITAL
Total % Considering VMC their Local Hospital
Patient White Couple, no kids Total Single, no kids Non-white Non-Patient 0% 10% 20% 30% 39% 35% 40% 50% 60% 70%
14

59% 52% 52% 50% 44%

Income, geography, gender and education did not matter!

ECONOMIC INDICATORS
Overall, do you think the economy in your area is:

Getting better

27%

The same

47%

Getting worse
0% 10% 20%

23%
30% 40% 50% 60% 70% 80%

15

LOCAL THERMOMETER READINGS

Id like you to rate your feelings toward some people, groups and ideas with 100 meaning a very WARM, favorable feeling and 0 meaning a very COLD, unfavorable feeling.
UW Medicine The main hospital at Valley Medical Center Nurses at Valley Medical Center Harborview Medical Center Valley Medical Center's urgent care clinics Swedish Hospital Valley Medical's primary care clinics Virginia Mason Medical Center Overlake Hospital MultiCare Health System Hospital administrators at Valley Medical Center St. Francis Hospital Highline Community Hospital Auburn Regional Medical Center Rich Roodman, CEO of Valley Medical Center

75 74 74 74 72 72 71 68 66 62 59 55 54 51 49 0 10 20 30 40 50 60 70 80
16

LOCAL THERMOMETER READINGS

Percentage of Residents Who Havent Heard of Each Hospital/Provider
St. Francis Hospital Highline Community Hospital Auburn Regional Medical Center MultiCare Health System Overlake Hospital Virginia Mason Medical Center Valley Medical's primary care clinics Harborview Medical Center Swedish Hospital Valley Medical Center's urgent care clinics UW Medicine Nurses at Valley Medical Center The main hospital at Valley Medical Center

40% 53% 37% 40% 40% 39% 31% 37% 25% 32% 31% 25% 22% 19% 14% 18% 12% 14% 11% 12% 19% 8% 12% 6% 9% 4% 20% 40% 60% 80% 100%
17

0%
65+ years old 18-34 years old

SATISFACTION WITH MEDICAL CARE

Based on your experience, tell me whether you would rate the quality of medical treatment provided at Valley Medical Center as Very Good, Good, Average or Poor? TOTAL Very good Good TOTAL Average Poor Dont Know 51% 27% 78% 11% 5% 6% Seniors Under Over 65 50 61% 21% 82% 9% 4% 5% 43% 38% 81% 9% 3% 7% Parents with Kids 47% 35% 82% 10% 3% 4% Patient White 59% 28% 87% 8% 4% 1% 56% 25% 81% 10% 5% 4% Non-white 33% 37% 70% 13% 5% 12%

NO CHANGE IN SATISFACTION: In 2011 (Elway Poll), 75% of all respondents rated the quality of medical treatment provided was Very Good or Good.

18

ASSESSMENT OF REPUTATION
How would you rate the overall reputation of Valley Medical Center in your community? Would you say it is Very Good, Good, Average or Poor? TOTAL Very good Good TOTAL Average Poor Dont Know 48% 30% 78% 14% 7% 2% Seniors Under Over 65 50 57% 19% 76% 14% 7% 3% 37% 44% 81% 15% 4% 0% Parents with Kids 41% 42% 83% 12% 5% 0% Patient 53% 30% 83% 12% 5% 1% White 50% 29% 79% 13% 7% 2% Non-White 41% 33% 74% 17% 6% 2%

SLIGHT DROP IN REPUTATION: In 2011 (Elway Poll), 83% of all respondents rated the overall reputation of VMC was Very Good or Good.

19

THE MAJORIT Y OF RESIDENTS CHOOSE VALLEY AS THEIR HOSPITAL IN AN EMERGENCY

Would Valley Medical Center be your first choice hospital in an emergency?
Valley Medical Center/ UW

72% This Group Is:

NOT A PAST PATIENT (+17) SINGLE PARENTS (+16) NON-WHITE (+4) DISTRICT 9/DUNN (+4)

Somewhere Else

23%

DK or It Depends

5%
0% 20% 40% 60% 80%
20

THERE IS NO CLEAR SECOND CHOICE HOSPITAL, JUST PERSONAL PREFERENCE

Which hospital would you ask to go to? (N=136) 14% 12% 10% 8% 6% 4% 2% 0% Swedish Hospital Group Health Highline Harborview Auburn Regional Medical Center Medical Center Medical Center 12% 10% 8% 7%

6%

21

AWARENESS OF AFFILIATION

AWARENESS OF AFFILIATION
Prior to this call, were you aware that Valley Medical Center is now affiliated with UW Medicine? Yes 67% In 2011 (Elway Poll), 55% were aware of the affiliation with UW Medicine 32% No Don't know

80% 70% 60% 50% 40% 30% 20% 10% 0%

1% Yes No Don't know

23

THERE ARE GAPS IN AWARENESS OF THE AFFILIATION

Prior to this call, were you aware that Valley Medical Center is now affiliated with UW Medicine? ?

+35

71% 56% 44%

70%

+ 63% 61%

36% 29% 29%

38%

Under 50 years old

Over 50 years old

Women

Men

Non-White

24

AWARENESS OF AFFILIATION
How informed would you say you are about Valley Medical Centers affiliation with UW? 40% 35% 30% 25% 20% 15% 10% 5% 0% Extremely well Well informed Somewhat well informed informed Not well informed Never heard of
25

34% 26% 18% 17%

5%

SOME GROUPS (RIGHT BOX) HAVE NOT HEARD AS MUCH ABOUT THE AFFILIATION
Most Informed
All Voters Well Informed or Extremely Well Informed Seniors Over 65 Patients College Women Over $50K Income Total 28% 28% 27% 26% 25% 23% Men Non-College 35-49 year olds 18-34 year olds Under $50K Income Non-Patients

Least Informed
All Voters Well Informed or Extremely Well Informed 20% 20% 18% 16% 16% 15%
26

ALMOST 50 PERCENT SAY THE AFFILIATION WITH UW MEDICINE HAS MADE NO IMPACT
Thinking about the following areas, has the affiliation made a positive or negative impact or have you not observed a significant difference?
Access to research Cost of health care Programs/Community involvement Access to specialists Personal attention Quality of care Ability to remain a community hospital Competitiveness

25% 1% 26% 31% 36% 37% 38% 40% 42% 8% 2% 3% 4% 4% 2% 2%

61% 58% 57% 55% 53% 52% 51% 48% 100%

Answers from patients were not significantly different.
27

Positive Negative No difference

0%

50%

AWARENESS OF CHANGES IN GOVERNANCE

Are you aware of any changes to the Board of Commissioners or hospital decision-making as a result of the affiliation? 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Yes No Don't know 13% 5%
No subgroups expressed higher-thanaverage awareness of changes to Board governance.
28

82%

Yes No Don't know

ATTITUDES ON BOARD GOVERNANCE

WHERE WE HAVE CONSENSUS

AGREE DISAGREE

Hospital administration salaries at Valley Medical Center should be comparable with other public hospitals in this area The best way for the community to provide guidance and insights is to create a Community Advisory Group to advise the Board of Commissioners Every voting member of the Board must reside within the boundaries of the hospital district The hospital CEO has been serving in his position for 25 years; so its time to think about new leadership As part of the affiliation, UW should have some responsibility for paying down the hospitals debt There should be a public vote before any changes are made to the duties or structure of the board running the hospital Only individuals elected by the public should have decisionmaking authority for a public hospital district

91% 78% 74%

6% 13% 21% 18%

68%

68% 71%

20% 25%

60%

34%

SUBTLE DIFFERENCES IN ATTITUDES

In just about all cases, the following subgroups were more likely to AGREE with what was being proposed (i.e. Comparable administrative salaries, a residency requirement, public votes before changes taking place) PATIENTS OF VALLEY MEDICAL CENTER WOMEN PEOPLE WHO NAMED VALLEY MEDICAL CENTER AS THEIR FIRST CHOICE HOSPITAL PEOPLE WHO WERE AWARE OF THE AFFILIATION WITH UW MEDICINE
31

OVERALL REACTION TO PAY/BENEFIT PACKAGE OF HOSPITAL ADMINISTRATORS

Now that you know more, what of these statements comes closest to your opinion?

4% 19%

The salaries are not justified. Hospital administrative pay needs to be competitive, but also aligned with other public hospitals in the area The salaries of the CEO and other leaders are justified. The pay and incentives help retain top talent and provide stable leadership

77%

Don't Know

32

A SIMILAR REACTION FROM WOMEN AND PATIENTS

Which one of these statements comes closest to your own? 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0%
The salaries are not justified. Pay needs to be competitive, but also aligned with other area hospitals. The pay is justified. It helps retain top talent and provide stable leadership. 33

77%

76%

75%

Total Women Patients 19% 18% 21%

INTEREST IN PAYING DOWN DEBT OR REINVESTMENT?

What should be the top priority: to pay down the hospitals debt or save those funds for reinvestment or other needs?

11%
Hospital should pay down some of its debt Hospital should save funds for reinvestment/other needs

17% 71%

Don't Know

34

FUTURE OF THE HOSPITAL DISTRICT?

Its possible that VMC and its clinic system could be sold for $341M to pay off the bonds owed and eliminate the hospital district. What would you think of this option? Should this be considered yes or no?

80% 70% 60% 50% 40% 30% 20% 10% 0% Strongly yes Somewhat yes Somewhat no Strongly no Don't Know 35 8% 17% 18% 10% 25% 65% 47%

FINAL CONCLUSIONS
AWARENESS OF HOSPITAL DISTRICT/PRESERVATION -Public education to parents, non-whites (perhaps in non-English language materials) and young people will help them identify with their hospital districts. DO RESIDENTS IDENTIFY VALLEY AS THEIR LOCAL HOSPITAL? -Perceptions of VMC are strong across the board, but patient loyalty is truly the more accurate benchmark to track. As more younger people, parents and non-whites become patients, their likelihood of identifying VMC as their local hospital increases. AWARENESS OF AFFILIATION - Awareness of Valleys af filiation with UW has grown from 55% to 67% in one year. However, the public does not know why the af filiation happened, the goals or what has changed.
36

FINAL CONCLUSIONS
AWARENESS OF CHANGES TO BOARD GOVERNANCE -Very few residents know of changes to the Boards duties and structure since the affiliation took place. That being said, there is widespread community support and validation for past Board resolutions regarding executive pay. -There is also a high level of community support if the Board pursues a renegotiation of roles and responsibilities with UW Medicine. COMMUNIT YS PRIORITIES -There was consensus around paying down the hospitals debt and very little support around selling the hospitals clinic system to eliminate the hospital district.
37

THANK YOU! CONTACT INFO:

PH: 206-229-4981 EMAIL: ALISON@ALISONPETERSCONSULTING.COM

October 2012

Alison Peters Consulting