An Open Letter to the Residents of St. Johns County and Neighboring Communities

In February 2019, Flagler Hospital announced its expansion to become Flagler Health+. This embodies our commitment to advancing the physical, social, and economic health of the communities we serve. As an organization that has been caring for area residents since 1889, we are well known for the clinical care we deliver, and we are proud of this; but we recognize that is not enough. Our responsibility includes all aspects of well-being, including
financial health.

What does that mean? At Flagler Health+, it means ensuring people receive the right care, at the right time, in the right place. While you see other health systems building free-standing emergency centers throughout Northeast Florida, we are not. Encouraging people to utilize one of the highest-cost points of care when it is not absolutely necessary just doesn’t make sense. According to a study by UnitedHealth Group, the vast majority of free-standing emergency visits are for non-emergency care, and these visits cost average of 22 times more than a physician office and 19 times more than an urgent care center. Alternatively, our new Flagler Health+ Villages will include extended hours for primary care, urgent care on-site and at select Publix locations, and we have also introduced virtual visits that can be accessed from anywhere.

When it comes to helping our patients predict and understand healthcare costs, co-pays and insurance coverage, we know there is a lot of work to be done. Health insurance plans are expensive, complex and varied. To further add to the challenge, every patient’s experience is unique even in instances where the same procedure or test is being performed. At Flagler Health+ we are focused on improving financial literacy, increasing price transparency and developing better engagement tools. We are not there yet. We have, however, posted an easily searchable list of the most common tests, procedures and inpatient hospitalizations on our website. We also have financial counselors to help with out-of-pocket estimations based on a review of your specific insurance policy. For those with no health insurance coverage, we will help you make a plan to meet your financial obligations, support Medicaid enrollments and/or access to charity care resources. Flagler Health+ provides more than $35 million in charity care to our community every year.

To further support social and economic health, which we know are tied together, we have established Flagler Health+ Care Connect – a community alliance that connects area residents with available services and addresses social determinants of health in a coordinated way throughout all of St. Johns County. We are connecting people with food banks, free prescriptions, transportation, rental assistance, financial counseling, housing and other vital services. Care Connect also serves as the lead agency for the Continuum of Care with a goal to end homelessness in our community. By addressing social determinants, we are keeping people healthier and ultimately out of the hospital, reducing costs to the overall healthcare system.

Finally, we know how important it is for small and self-insured businesses to control healthcare costs. The best way to achieve this is by improving employee health. Our CareSteps program delivers personalized programming to help employees achieve their wellness goals. Health assessments, preventive care, exercise programs, behavioral health services and chronic disease management offerings – combined with a focus on utilizing the most appropriate care setting - are helping us effectively drive down healthcare costs at Flagler, and we hope to help local businesses do the same.

At Flagler Health+, when we say we are a true healthcare partner on life’s journey, we mean it. We know there is much work to be done to improve on the costly, complex system that exists as healthcare in America today. You have our word that Flagler Health+ is working on it.


Murray S. Marsh, Jr.
Executive Vice President & Chief Financial Officer