Two Temple-area congressmen have proposed separate plans to protect patients and providers from hospital closings in the wake of Hahnemann University Hospital’s shuttering last year.
United States Rep. Dwight Evans, D-Philadelphia, whose district encompasses parts of Main Campus and the Health Sciences Campus, is meeting with legislators and hospital leaders to consider how Congress could adapt Pennsylvania’s Rural Health Model to boost urban hospitals’ finances, his office announced on Jan. 29.
U.S. Rep. Brendan Boyle, D-Philadelphia, whose district also encompasses parts of Main Campus and the Health Sciences Campus, introduced the Protecting Communities from Hospital Closures Act, which would require hospitals to provide 180 days notice to the federal government before closing, on Jan. 27.
Hahnemann’s owners announced the hospital’s closure in July 2019, eliciting outcry from staff, patients and legislators who claimed it would cause a public health emergency, WHYY reported. Shutting down the hospital, which was more than 170 years old, forced more than 550 medical residents to find a new program within weeks, The Temple News reported.
While some predicted the closing would cause a crisis for nearby hospitals, the influx of new patients benefited Temple University Hospital by alleviating some of its fixed costs, the Philadelphia Inquirer reported in Sept. 2019.
Ten Philadelphia hospitals have closed in the last 20 years, causing a 33-percent drop in the number of licensed acute-care hospital beds, the Inquirer reported.
Here is a summary of what each Congressman has proposed.
Evans’ proposal
Since November, Evans has met twice with legislators and health care leaders, including ones from Temple, to discuss how to protect the viability of hospitals’ finances, he said.
“What we’re trying to do is to be at the forefront, to prevent these things to occur,” Evans said. “We can’t sit idly by.”
Evans’ plan is to adapt the Pennsylvania Rural Health Model, which changes the way that hospitals are paid by insurers, to fit the needs of urban hospitals. Pennsylvania’s model launched last year with five hospitals and five payers, according to the Pennsylvania Department of Health.
Typically, insurers and the government pay hospitals on a per-service basis, wrote Nate Wardle, a spokesperson for the PA Department of Health. If not enough patients receive services, the hospital can struggle, he wrote.
Under Pennsylvania’s model, rural hospitals are paid a fixed amount of funds determined in advance to cover their services, according to the Centers for Medicare and Medicaid Services.
Though the model is designed for rural hospitals, urban hospitals face similar financial challenges, Wardle wrote.
“It is important to realize that just because an urban area is thriving and the health care facilities seem to be doing well, that doesn’t mean they all are doing well,” he wrote.
Stuart Fine, a health services administration and policy professor, said Evans’ proposal does not make sense because urban hospitals, unlike rural ones, are often not the only source of health care for patients within miles.
“It does not make sense to me to necessarily protect a failing enterprise, a hospital, when there’s another hospital blocks away,” said Fine, former CEO of Lexington Memorial Hospital in Lexington, North Carolina, and Grand View Hospital in Sellersville, Pennsylvania.
The real concern of hospitals closing has to do with the loss of jobs, Fine added. Approximately 2,500 workers at Hahnemann lost their jobs as a result of the closing, the Inquirer reported.
“If those inner-city hospitals close, is the issue that people are going without care, or the issue is that people who had good-paying solid jobs are now unemployed,” Fine asked. “And that’s important. I’m not saying it’s not important. But that’s not health policy. That’s economic policy.”
Protecting hospitals is important for preserving jobs, ensuring that patients have access to services and alleviating the financial pressure on surrounding hospitals, Evans said.
“This is a crisis, not made up by me or anybody,” he said.
“Medicare and Medicaid payments must be fair and adequate to ensure access to high quality, effective and efficient medical care for our vulnerable communities,” wrote Jeremy Walter, a spokesperson for Temple University Health System, in an email to The Temple News.
Boyle’s Proposal
In addition to compelling hospitals to provide 180-days notice before closing, Boyle’s bill requires shuttering providers to submit a detailed plan outlining their timeline for closure and written agreements from other providers who accept responsibility for caring for displaced patients, according to the bill.
The bill also allows the federal government increased oversight into how the plan is implemented.
“We should do everything we can to preserve high quality, timely care for patients, both in Philadelphia and across the country,” Boyle said, according to a Jan. 27 release.
Temple did not respond to a request for comment on Boyle’s bill.
The legislation is modeled after a nearly identical bill approved by Philadelphia City Council in December 2019.
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