The Mazzoni Center, Philadelphia’s largest LGBTQ health care organization, has taken a wide range of steps over the past year to turn around its struggling finances, from expanding services like anal cancer screenings to seeking federal funding for a neighborhood where many can’t afford health care, said CEO Sultan Shakir.
The center’s financial audits have sounded alarm bells in recent years: After reviewing Mazzoni’s 2022 finances, auditors noted the center has posted losses for two consecutive years and issued an unusual warning that it may not be able to meet debt repayments and other financial obligations for more than a year.
Mazzoni’s financial difficulties, exacerbated by the pandemic, were in line with trends across the health care industry as other hospitals and systems have since stabilized. Mazzoni faced further turmoil with a series of controversies and resignations that led to a years-long leadership transition.
Shakir, who has led the organization since 2022, is now optimistic: He says a financial audit of the fiscal year that ended last month will show the center has a good chance of returning to the black. (The results of the audit for the most recent fiscal year won’t be made public until the fall.)
The Inquirer spoke with Shakir about Mazzoni’s financial situation and the steps the center has taken to improve it. The interview has been edited for clarity and length.
» READ MORE: Philadelphia’s largest LGBTQ medical practice receives financial red flag in audit
Mazzoni has reported millions of dollars in losses over recent years since the pandemic began in 2020. What happened?
The Mazzoni Center, like many other medical centers, has had to think hard about how to see patients during the pandemic, drastically scaling back operations to ensure they have extra time and attention to clean each exam room after each patient.
As a result, we have had to scale back our primary operations while simultaneously expanding our pandemic-related operations.
Three years later, where is Mazzoni now?
We are optimistic that we will finish fiscal 2024 in the black. I say optimistic because I don’t like to guarantee things before the audits are done and all the financial numbers are in.
And we’re trying to be profitable while keeping the quality of patient care high, because there are ways that you can make a medical center profitable by cramming patients in as quickly as possible, but we know that’s clearly not the way we want to be.
Mazzoni became a Federally Qualified Medical Center-like Facility last year. What does this mean?
That means meeting about 100 different standards, from quality, to whether they have patient representatives on their board, to being patient-led, to being able to communicate in English and Spanish. These various criteria ensure that the medical center is not only a quality medical center, but also serves a population with high needs. (The majority of Mazzoni’s patients come from communities that are underserved by the health care system.)
So receiving that designation was almost a no-brainer for Mazzoni, and it allows the center to tap into additional resources.
» READ MORE: Mazzoni Center appoints new top doctor to oversee LGBTQ medical care
What incentives do I get for being certified?
For example, they could buy drugs from pharmaceutical companies at a discount and then allow them to sell it on the exchange at the regular price, so that people who use their insurance at the pharmacy end up actually buying the drugs that we would normally buy cheaper. This is how medical centers like Mazzoni make additional revenue. In effect, they get pharmaceutical companies to shoulder some of the burden of providing medical care to individuals in need.
As a federally qualified health center, we have access to that program for every appointment.
Another incentive is increased reimbursement rates for Medicare and Medicaid visits.
What other steps has Mazzoni taken to grow?
We looked at the care that we were providing and asked ourselves, what more can we provide? And one of the things we’re doing is integrating our medical programs with our behavioral health programs.
We’re also going to start a high-resolution anoscopy program. Anal cancer is more prevalent in people who are HIV positive. Now we have drugs that can help people. [with HIV] I feel that this is becoming increasingly necessary in order to live a fulfilling life.
We know that many of our patients and clients would be less likely to get tested if we asked them to get tested somewhere else, so given the need to make this service available to our patients, we decided to launch this service at the Mazzoni Center.
We also received a $1.8 million grant from The Pew Charitable Trusts, which will enable us to reach young people and underserved communities.
Given that Philadelphia’s large health care system is investing more in LGBTQ health, have you ever worried about Mazzoni’s future?
We think it’s great to see other medical centers develop LGBTQ-inclusive programs, and it’s important that people have plenty of options for receiving care beyond the Mazzoni Center.
» READ MORE: New program launches in Jefferson to provide care for LGBTQ seniors
And we’re really happy that more and more people are considering their options and choosing to come to Mazzoni, and that’s mainly because of the history that we have with the community and the fact that when you come to Mazzoni, you know you’re going to be taken care of by someone who really understands your needs.
