A consultant is recommending Nashville expand its healthcare safety net for people who can’t afford treatment.

Metro hired that consultant in May to find ways to run General Hospital and two smaller facilities more efficiently. Now Metro’s finance director says that means getting more bang for the city’s buck – not shrinking the city’s subsidy.

Each year Nashville gives some $50 million to the Hospital Authority, which oversees Metro General, as well as Bordeaux Long-Term Care and Knowles assisted-living home. Even so, the Authority struggles with an annual deficit. In spring the city hired Boston-based John Snow Inc. to find ways to make the city’s health facilities “more cost-effective.”

Now Metro Finance Director Rich Riebeling says that doesn’t mean cutting subsidies.

“Cost effective doesn’t necessarily mean less money; it means more efficient use of the monies to make sure that more people are being served.”

To that end, consultants recommend the city clearly define its safety net’s purpose, and dedicate long-range funds accordingly. And they want the city to expand primary care and preventive medicine.

For full disclosure, Rich Riebeling is a member of WPLN’s Board of Directors.

WPLN’s Daniel Potter gets reaction from Rich Riebeling: