Franklin County hospital leaders say the amount of free care they provide to the uninsured poor has increased 163 percent over five years, a trend they call unsustainable.”Our health-care systems are at risk if we’re unable to figure out a way to deal with the rising number of uninsured we continue to see at the hospital,” said Dr. Steve Allen, chief executive at Nationwide Children’s Hospital.This is a problem the county’s four health systems share and one of the issues highlighted in a new report by the Central Ohio Hospital Council.The hospital council, which was created last year, brings together the four competitors to work together on projects and solve common problems.Jeff Klinger, president of the hospital council, one of six regional groups statewide, said hospital executives in Franklin County work well together.”There are parts of the state where people will have separate meetings on an issue because people won’t come in the same room with the other competitors,” said Klinger, who used to work at the Ohio Hospital Association.Some of the issues the four hospital systems are collaborating on include reducing premature birth rates, coordinating childhood vaccinations, reducing obesity rates and maintaining the city’s blood supply.The nonprofit systems also participate in a daily conference call to report open psychiatric beds so mental-health patients don’t have to spend their days in emergency departments.They’re also working to address economic hazards — the increasing number of poor, uninsured patients and for-profit ambulatory surgical and imaging centers that siphon off business.”The threats we’re seeing in central Ohio aren’t unique to central Ohio, but we need to be proactive,” Klinger said.One way is to educate the public about what they do.For years, individual hospital systems have published community-benefit reports that highlight programs and explain the free care they provide. This year, the four central Ohio systems issued a report as a group.”I don’t think people fully understand the things that we do beyond those things that are within our mission,” said Claus von Zychlin, chief executive of Mount Carmel Health System.”When you look at our outreach a lot of us are doing things in the community.”In 2008, the four systems reported providing $398 million in community benefit, which includes money spent on research, education for future medical workers and free care to the poor.This charity care, according to the report, increased 163 percent from 2004 to 2008.”It really isn’t sustainable, that’s the problem,” said Dr. Steven G. Gabbe, senior vice president for Health Sciences at Ohio State University and chief executive of the OSU Medical Center.”The government is not providing increased payments for Medicaid patients, and more patients in our region are losing insurance.”Hospital leaders hope national health-care reform will help.If government health-insurance payments don’t increase, some of the programs hospitals offer — health screenings, free clinics, reduced-cost medicines — could be cut, Allen said.Hospital leaders say they understand that local employers already are financially stretched trying to provide health insurance for their workers. They hope this report will explain how the hospital systems turn no one away.Unlike in other cities in Ohio and nationwide, there’s no designated tax for hospitals or for treating the poor and uninsured.”We have four hospital systems that have collectively worked to share that financial expense,” said Ty Marsh, chief executive of the Columbus Chamber.The new report also intends to help businesses understand the economic impact the hospital systems have in the area.”I look at the $3 billion of new investments being made in central Ohio over the next five years, the collaboration and the direct economic impact,” said Alex Fisher, chief executive of the Columbus Partnership, a civic organization of local CEOs.”As individuals, any one of them is huge. But when you group them together, you have the ability to leverage future technology.”Working together helps hospitals and patients, said David Blom, chief executive of OhioHealth.”Predatory competition between health-care systems drives up costs,” he said. “These institutions are ultimately owned by the overall community.”It’s important that we act that way.”