How is your local/nearest hospital making out?

[dado potato]

The September 15, 2017 edition of Beckers Hospital Review listed 22 healthcare bankruptcies thus far in 2017. Also I note that bonds of various hospitals are being downgraded by SP, Moodys and Fitch, to junk, and to lower-grade junk.

I am aware of 2 problems that are squeezing the cash flow of hospitals, and forcing some to close or restructure in bankruptcy.

1. Over the past 2 years, according to a press release by Acadiana Management Group (AMG), the operator of 16 post-acute hospitals in IN, IL, OK, KS, and AL, they experienced a 40% reduction in Medicare Reimbursement Rates.

2. The Affordable Care Act contained a mandate, so it was assumed that all patients admitted to hospitals would have insurance coverage. Therefore, there would no longer be a need to subsidize hospitals for the uncompensated care they performed for the uninsured. The problem arose when individual health insurance premiums increased. From 2013 to 2017 the average increase was 113%, with the greatest increases in the states of AL 225%, AK and OK 200%, AZ 180%, TN and NC 175%. In response, consumers opted for higher-deductible policies, culminating in more bad debt for the hospitals... and no more subsidy.

It is not my intention to "blame" government (or anybody) for this state of affairs. I am starting this thread to see what people's perceptions are. Is the quality of life in your community threatened, or diminished because local healthcare facilities are less than able to make it as going concerns? None of us are getting any younger, so we probably will need more, rather than less healthcare.

Also, I would hope to hear of communities where healthcare is actually improving and increasing in availability. Maybe there's an app for that! <wink>

[Tybee]

Our hospital seems to be thriving. They are adding a parking garage and seem economically very viable.

[pinkytoe]

Seems like the corporate type specialty hospitals around here are very healthy (DaVita, etc).

[Yppej]

It closed years ago and the building is now used as an urgent care center and medical offices among other things.

[Tammy]

We're growing where I work. http://mihs.org/

[SteveinMN]

In our city, frankly, we are "over-hospitaled" -- three full-size hospitals operating within a radius of maybe two miles at most. Each is a member of a different healthcare group so people from just outside city limits are steered to one hospital or another by their health coverage, and the hospitals do have specialties (trauma, coronary care, etc.). One hospital is the default destination for emergency responders finding a John/Jane Doe laying on a sidewalk, disaster, etc. None of them seem to be in any financial pinch. But almost certainly any rational healthcare approach would eliminate at least one of them (maybe not two because the remaining hospital may not be able to expand sufficiently physically to handle the influx from the other two closing).

In the metro area, there are few hospitals which are looking to change affiliations or merge with other systems. Outstate, however, is almost under-served, a function less of health insurance than the particular expenses of providing top-rank care to a population spread over a wide (rural) area. Very little change here over the past several years.

[catherine]

Hospitals in my area, and across the nation, are adapting to change by consolidating services into IDNs (Integrated Delivery Networks). They are turning private physicians into employees, and providing comprehensive services under one umbrella--inpatient services as well as out-patient procedures, rehabs, clinics, you name it.

I do hear grumblings by Hospital Administration that they are really counting pennies these days, but that was pre-Obamacare, too. Thanks to Obamacare, there is greater accountability and incentives for patient outcomes, like penalizing the hospital if the patient is readmitted within 30 days. Maybe some will see that as too much government interference, but it's one of many initiatives toward accountable care.

Our little Princeton hospital where my daughter was born relocated to a medical center on a large campus that cost 1.2 billion to build. My husband goes to a different hospital for his procedures. It's also brand new--built in 2011.

[Tybee]

Catherine, thanks for that explanation in the first paragraph. Now that I think of our area and the healthcare providers, and I think of my son's area in Maine, this is exactly what is happening. I did not understand, but now I see that "they are turning private physicians into employees, etc." That is exactly what is happening here with our hospital.

[Gardnr]

We're all busy and we're all adding on and/or building new facilities. Our population continues to grow at a rapid pace and we often find ourselves without a bed for a patient who needs one(weekly not monthly). We do more outpatient surgery than projected. It is not easy to find a doctor's appt when needed. Illness is not scheduled in advance-why can't we fix that? We have a lot of urgent care facilities and that helps decrease ER visits. Cheaper than an ER. More expensive than a doctor visit but at least we can get care.

People can say what they will but a great many positive things have occurred in healthcare due to the Affordable Care Act. Yes, IDNs have grown tremendously. Risk-pool insurance programs have improved outcomes and access to care needed. Many services have popped up that are no charge to improve health in populations. I'm sad to see some of the current President's rollbacks of ACA mandates. They have been very positive.

We have a long way to go....................

[Float On]

I think ours are doing well and there is a new one being built by Mercy about a mile from the Cox one. Retirement area means a lot of specialized healthcare in the area.