I have posted frequently on the high level of profitability — and the lack of accountability for that profitability — among Virginia’s nonprofit hospitals. The Virginia Hospital and Healthcare Association (VHHA) responds that, while the hospital industry as a whole may be profitable, many individual hospitals are not.
A case in point is the Pioneer Community Hospital in Patrick County, which closed in September due to financial difficulties. The Virginia House of Delegates voted unanimously Monday, in the words of the Richmond Times-Dispatch, to extend the license of the shuttered hospital in the hope of speeding the process of finding a new operator and reopening the facility.
The VHHA has a point: Many of Virginia’s rural hospitals are in trouble. When a hospital like Pioneer Community shuts down, thousands of people find it far more difficult to access health care.
The question is: what do we do about it? Do we enact blunderbuss legislation (such as Medicaid expansion) under the pretext of helping rural hospitals even though most Medicaid dollars will go to urban and suburban hospitals? Do we craft a narrow-bore approach that focuses scarce public resources on rural hospitals, or, more specifically, ailing rural hospitals?
Or, to really think outside the box, do we acknowledge that a “hospital” is simply a bundle of diverse, often unrelated, medical services served under one roof, and that perhaps it makes economic sense to de-bundle those services and provide them in the format of free-standing urgent care clinics, ambulatory surgery centers, and other outpatient facilities? Do we acknowledge that, even though it may require Patrick County residents to drive to a hospital in Martinsville or Roanoke or Winston-Salem for a few more procedures than otherwise, some procedures are more efficiently handled, and have better outcomes, when performed on a volume basis in a larger, urban hospital? Shouldn’t we allow medical services in Patrick County restructure in a way that is more financially self sustaining?
Just asking the questions no one else dares to ask….There are currently no comments highlighted.