By almost any measure, central Ohioâ€™s pediatric hospital is on a growth spurt that would rival that of any of its adolescent patients.
Revenue might have reached $2 billion for the first time in 2015. Annual surpluses from operations nearly doubled, to a record $285 million in 2014.
Where I-70 skirts Downtown, the steel skeleton of a six-story outpatient care center stands as the latest evidence of a decade-long building boom â€” an investment of roughly $1 billion by the nonprofit hospital on and near its main campus.
Hiring, already brisk, shows no sign of abating. The Columbus City Council last month approved a $15 million income tax break for the hospital, which plans to add the equivalent of 1,500 full-time jobs by 2030. Hospital officials say the anticipated average salary is $78,000.
The hospital employs the equivalent of more than 8,300 full-time workers.
â€œThe place is really humming,â€ said Dr. Steve Allen, the hospitalâ€™s chief executive officer.
Nationwide Childrenâ€™s investment in research also has vaulted to record levels: $50 million in 2015, up from $34 million two years earlier. That spending excludes roughly $70 million per year that the hospital receives from the National Institutes of Health.
But it includes philanthropy, most notably recent donations of $10 million annually from the hospitalâ€™s namesake, Nationwide, for genomics research.
â€œItâ€™s all about whether you read the textbooks or you write the textbooks,â€ Allen said. â€œAnd we intend to be a place that writes the textbooks.
â€œAnd you can only do that if youâ€™re out there discovering new cures and treatments, and also investing in understanding how it is or why it is that children get sick.â€
Officials give much credit to the hospitalâ€™s accountable-care organization, Partners for Kids, for its performance in 2014, which Moodyâ€™s Investors Service described as â€œextraordinary.â€
The hospital hasnâ€™t been the only beneficiary of that organizationâ€™s work; taxpayers have, too.
Partners for Kids is the intermediary between Ohioâ€™s five Medicaid managed-care plans and roughly 320,000 children in southeastern and central Ohio enrolled in those plans.
The organization works with more than 1,000 doctors, providing incentives for them to intervene in a childâ€™s health and head off illnesses that otherwise must be treated in more costly ways.
Key to lowering costs has been coordinating care for young patients and making doctors aware of medications that might be just as effective but less expensive; pharmacy spending per Partners For Kids patient dropped 1 percent in 2014.
Partners for Kids also is working to put into practice guidelines for the care of newborns in hospitals: how best to feed them, avoid the potential complications of prematurity and help babies born to narcotic-addicted parents through the difficulties of withdrawal more quickly, said Dr. Sean Gleeson, the organizationâ€™s president.
Several long-term care initiatives such as those wiped out tens of millions of dollars in losses that the hospital had recorded each year as a result of caring for Medicaid patients, said chief financial officer Tim Robinson. Rather than a shortfall, the hospital in 2014 recorded a surplus on its Medicaid patients.
That shift, in turn, has led to lower payment rates per Medicaid-enrolled child in 2016, saving taxpayers about $30 million, Robinson said.
Nationwide Childrenâ€™s performance stands out among its peers, including Cincinnati Childrenâ€™s Hospital Medical Center, which also ranks among the nationâ€™s top childrenâ€™s hospitals.
For example, revenue exceeded expenses by 17 percent at Nationwide Childrenâ€™s in 2014, compared with 9.5 percent at Cincinnati Childrenâ€™s in its most recent fiscal year, according to a Dispatch review of their audits.
Through a spokesman, officials at nonprofit Cincinnati Childrenâ€™s last week declined to grant an interview about that hospitalâ€™s financial performance.
Nationwide Childrenâ€™s is seeing larger surpluses and reserves at a time when its burden of uncompensated care is shrinking. The cost of its charity care, already low since few children are uninsured, shrank in 2014 to $7.5 million.
Should the hospitalâ€™s tax-exempt status be reconsidered in light of that? Hospital officials donâ€™t think so.
â€œWe see all kids regardless of the ability to pay. There is never anyone denied care,â€ Robinson said. â€œThe fact weâ€™re (delivering care) more efficiently doesnâ€™t make us less of a nonprofit.â€
Hospital officials also said that the large surpluses donâ€™t undermine the case for an income-tax break for the hospital.
The childrenâ€™s hospital has invested heavily in capital and the communityâ€™s employment base, and its high-tech research creates spinoff potential, they said.
The hospitalâ€™s average daily census swelled last year to 480 from 407, stretching the staff and forcing more overtime. That hasnâ€™t dampened employee morale, Robinson said, though officials declined to share data from employee surveys to support that assertion.
â€œPeople have really had to work hard this year,â€ Robinson said. â€œThis year (2015) was unprecedented in terms of the spike of growth. Weâ€™ve worked really hard to remedy that, and I think we have.â€