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Community hospitals: What happens if they close?

The Connecticut Post takes a hard look at the challenges facing community hospitals in general and those in Connecticut in particular.

Among the observations:

“Based on more than a year of research, {a} report from the Massachusetts Health Policy Commission suggests community hospitals in that state face something of a downward spiral: Patients are increasingly seeking routine care at large academic medical centers or teaching hospitals, drawn by perceptions of quality or referred by doctors who are now affiliated with the larger hospitals.

“With fewer patients, the community hospitals lose bargaining leverage with insurers when negotiating payment rates. And with fewer patients and lower payment rates, the hospitals struggle to invest in programs, staff, marketing or the infrastructure needed to adapt to the changing health care system.

“’These challenges form a self-reinforcing cycle and make the traditional community hospital business and operating model unsustainable,’ the authors wrote.”

“But if community hospitals close, they added, the consequences for the health care system could be significant. Not only would local access to care be reduced, but overall health care spending would rise. That’s because community hospitals tend to deliver care at lower costs than academic medical centers, which generally have higher cost structures that go along with their advanced capabilities. And if the lower-cost community hospitals closed, more patients would get care at higher-cost facilities, while reduced competition could result in higher prices at the remaining hospitals.”

Bristol  (Conn.) Hospital President and CEO Kurt Barwis said the report is also “a great portrait of what’s happening in Connecticut.”

To read the article,  which includes very useful graphics, please hit this link.

Community hospital leaders look at their present and future


In this Becker’s Hospital Review piece, panelists from four community hospitals discuss the challenges of staying independent  and on “maintaining relationships with larger systems and competitors”; contracting with payers; capital investments, and healthcare IT. They also speculate on where their institutions will be in a decade.








Community hospitals need to boost fundraising


“The Old Beggar,” by Louis Dewis.

This article in HealthAffairs looks at the need for not-for-profit hospitals to dramatically increase the flow of philanthropic funds into their institutions. The piece starts out:

“Across the country, hospitals face the challenge of finding new strategies to address capital needs in an era of shrinking operating margins. Particularly for nonprofit community hospitals, the solution is being found in philanthropy. Philanthropy was once simply ‘nice to have,’ but discussions regarding its role and strategic imperative can now be heard regularly at hospitals. More institutions are incorporating explicit expectations of fundraising into their financial planning and now consider fundraising a ‘must’ for survival. This paper explores why philanthropy is needed, the challenges hospitals face, and what institutions must do to build an internal culture supporting this new imperative.

“Particularly for nonprofit community hospitals, fundraising is becoming a strategic imperative.”

What makes a ‘community hospital’?

Becker’s Hospital Review looks at  what makes an institution a  “community hospital”?

It says that Truven Health Analytics, for example, “divides hospitals into five comparison groups when forming its 100 Top Hospitals list: major teaching hospitals, teaching hospitals, large community hospitals, medium community hospitals and small community hospitals.

But the broader definition of  community hospital goes beyond the number of beds  and medical-scho0l connections or absence of same.

Important in the definition would be: the care-access provided,  the geographical locati0n of the facility; governance structure; partnerships; the hospital’s economic role in the community, and such intangibles as how members of community feel about it,  with a “sense of community”  making community hospitals stand out from academic medical centers.

The Becker’s piece also looks at the future of such institutions in the context of changing reimbursement and other policies.





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