Mazzoni Center CEO on how Philly’s largest LGBTQ health agency is turning its finances around post-pandemic

The Mazzoni Center, Philadelphia’s largest LGBTQ health-care agency, has taken wide-ranging steps in the past year to shore up its troubled finances, from expanding services, such as testing for anal cancer, to seeking federal resources for communities where many cannot afford health care, CEO Sultan Shakir says.

The center’s financials audits raised alarms in recent years. After reviewing Mazzoni’s finances for fiscal year 2022, auditors noted the center had lost money for two years in a row and issued a rare warning that it might not be able to meet its financial obligations, such as debt payments, for more than a year.

Mazzoni’s financial troubles, growing out of the pandemic, tracked with trends seen throughout health care, but other hospitals and systems had since stabilized. Mazzoni faced the added turmoil of years of ongoing leadership changes, due to a string of controversies and resignations.

Now Shakir, who has led the organization since 2022, feels optimistic. He says the financial audit for the fiscal year that ended last month will show that the center is likely back in the black. (The audit for the most recent fiscal year is not available until the fall.)

The Inquirer spoke to Shakir about Mazzoni’s finances, and the steps the center took to improve them, in an interview edited for clarity and length.

Mazzoni reported losses of millions in recent fiscal years since the start of the pandemic in 2020. What happened?

Mazzoni Center, like most health centers, really had to look at how we were seeing patients during the pandemic. We had to ensure that there was additional time and care spent cleaning each visit room in between patients coming in, and so we really scaled back operations.

So we both had to scale back our main operations, while also scaling up pandemic-related operations.

Three years later, where is Mazzoni now?

We’re optimistic that fiscal year 2024 is ending in the black. And I say optimistic because I don’t like to guarantee things before the audit and all the financial numbers have come in.

And it is going back to the black while also keeping patient care high. Because there is a way to get health centers into the black by just cramming patients in as quickly as you can. And we’re clear that that’s not the way we want to do it.

Mazzoni became a federally qualified health center look-alike last year. What does that mean?

It means you meet around 100 different benchmarks, everything from your quality to having representation on your board from patients to ensuring that it’s really patient-driven to having communication in English and Spanish. These different things ensure that your health center is not only a high-quality health center, but one that’s serving people who have a high need. (A significant portion of Mazzoni’s patients come from communities that are underserved by the health-care system.)

So it was pretty much a no-brainer for Mazzoni to get that designation, and that really opens the center up to additional resources.

What kind of incentives do you get now that you have the designation?

For example, allowing us to purchase drugs from pharmaceutical companies at a discount and then sell it back on the exchange at the normal rate. So when someone comes and uses their insurance at the pharmacy, they’re actually purchasing a drug that we purchased for cheaper that it would normally be. That’s a way for health centers like Mazzoni to get additional revenue. It’s effectively having pharmaceutical companies help meet some of the burden of providing care to individuals at need.

As a federally qualified health center, we’re able to access that program for all visits.

The other incentive is a higher reimbursement rate for Medicare and Medicaid visits.

What are some other steps Mazzoni has taken to grow?

We looked at the care that we are providing, and asked, is there additional care that we can provide? And one of the things we’ve been working on is integrating our medical and our behavioral health programs.

We are also launching a high-resolution anoscopy program. When you look at anal cancer, it’s more prevalent for those who are HIV-positive. Now that there are medications to help people [with HIV] live full lives, we’re seeing a higher need for that.

With a lot of our patients and clients, we know that if we ask them to go somewhere else to get a test, they are less likely to do it. So given the need for our patients to have access to this service, we decided to bring it on at the Mazzoni Center.

We also got a $1.8 million grant from Pew Charitable Truststhat’s going to allow us to serve youth and also underserved zip codes.

Do you ever worry about the future of Mazzoni, given that large health systems in Philly are investing more in LGBTQ health?

We definitely think it’s great when other health centers develop LGBTQ-competent programming. It’s important that there are a number of options for people to get care, in addition to the Mazzoni Center.

And we’re really glad that more and more people look around at their options and choose to come to Mazzoni, largely because of the history we have with the community — and the fact that you know that when you’re coming to Mazzoni, you’re taken care of by someone who really understands your needs.