Americans think hospitals are too focused on profits while rural independent hospitals go bankrupt
Also: NC health system executives made $1.75b in a decade, protecting healthcare workers from violence, finding roaches in a Florida OR, and delivering medical supplies to Ukraine.
Top of the Week
A national survey by Arc Insights and Jarrard showed that more than half (53%) of Americans think hospitals put profits over patients. This perception is understandable, as medical debt is the most common cause of personal bankruptcy and the media reports avidly about health systems’ financial tactics.
However, the profits vs patients question misses huge financial differences between well-funded urban health systems and struggling rural hospitals. Nonprofit health system Ascension, for example, was criticized by Senator Tammy Baldwin for “operating like a private equity fund for aggressively pursuing investment opportunities while staffing and services falter at its hospitals.” A JAMA article from this week showed significantly increased prices for surgical procedures at hospital systems compared with independent hospitals.
Deep dives by Kauffman Hall show the dire financial condition of hospitals in poorer regions. In Alabama, average hospital operating margins in 2022 were 79% below that of 2019 (before the pandemic). 50% of Alabama hospitals had negative operating margins in 2022. In Tennessee, in 2022 average hospital operating margins decreased by 68% compared with 2019. 59% of Tennessee hospitals had negative operating margins in 2022.
When legislators make hospital-related funding decisions, will they think more about stories of North Carolina health systems paying executives over $1.75 billion in a decade or more about the plight of the nine rural NC hospitals at “immediate risk” of closing?
EM Practice
The Skeptics’ Guide To Emergency Medicine podcast reviewed the article, “Rising high-acuity emergency care services independently billed by advanced practice providers, 2013 to 2019.” Conclusion: In 2019, APPs billed independent services for approximately 1 in 6 high-acuity ED encounters in rural geographies and 1 in 11 high-acuity ED encounters in urban geographies, and well over one-third of the average APPs’ encounters were for high-acuity E/M services.
A bipartisan bill is working its way through the Virginia legislature to protect hospital workers from violence. Violence against ED nurses, APPs, and physicians is a worsening problem across the country.
A call to HHS and CMS to address the underlying causes of hospital boarding.
House of Medicine
Disrupting the PCP-patient relationship is expensive. Per this study, healthcare expenditures increased by $189 per year on average for Medicare patients who lost their primary care doctor.
Wall Street Journal: Walgreens CEO Bets on Doctors Over Drugstores in Search for Growth
Envision Healthcare has defaulted on two consecutive term loans.
Hospitals & Health Systems
American College of Healthcare Executives survey: workforce challenges cited by CEOs as the top issue confronting hospitals this year.
Residents at the University of Pennsylvania Health System voted to unionize.
Chartis: Top 100 Rural & Community Hospitals 2023 & Top 100 Critical Access Hospitals.
A scathing report from NBC about conditions at HCA Florida Bayonet Point, including “roaches in the operating room.”
Lown Institute report shows that several New York nonprofit hospitals are underinvesting in their communities, putting their tax breaks at risk.
Nursing & Allied Health
Five state legislatures are considering nurse-to-patient ratio bills: Minnesota, Washington, Connecticut, Oregon, and Massachusetts.
American Hospital Association testimony to the Senate about workforce issues. “Data from a forthcoming Syntellis Performance Solutions/AHA report will show that travel nurse full-time equivalents (FTEs) per patient day rose over 183.4% from 2019 to 2022… Contract labor as a share of total labor expenses rose 178.6% from 2019 to 2022.”
The Dispo
Dr. Doug Davis, of Germantown, Wisconsin has worked with the Wisconsin Rotary to deliver 50 tons of medical relief supplies to Ukraine.