This article originally appeared on Realclearhealth.com on April 11, 2024. Read it here.
America’s hospitals and health systems are the heart of 24/7 health care in our country. Patients and communities count on their local hospitals to care for them and their loved ones whenever they need it. When an emergency strikes, or when a complex condition needs treatment, the hospital is where we turn. But across the nation, these vital institutions are under serious threat.
Even before the recent Change Healthcare cyberattack that has left some hospitals fronting millions of dollars in extra costs, a perfect storm of complex factors was already threatening the future of high-quality patient care—and misguided proposals from policymakers risk making things even worse.
I lead the Carilion Clinic, which serves nearly one million people in Virginia. I also chair the Coalition to Strengthen America’s Healthcare, an organization committed to strengthening the 24/7 access to high-quality care that the American people expect and deserve.
Patient care is deeply personal to me. As a teenager, I needed a number of surgeries. The care I received was so exceptional, it propelled me to become the first in my family to finish high school, then college, then pursue a career in nursing. Today, Carilion is especially focused on serving smaller and rural communities. Our newest practice for family and community medicine opened in Bluefield, Virginia — population 5,096.
Powerful special interests are trying to persuade policymakers that health care providers are interchangeable and there is nothing special about our nation’s hospitals. But anyone who’s ever been a patient, a health care provider, or both knows that simply isn’t true.
The data make it clear: America’s hospitals and health systems treat sicker patients, lower-income patients, and patients with more complex conditions than other types of providers. Hospitals are often the only place patients can turn for life-or-death emergency treatments, specialty services, or complex, coordinated care — from trauma care and burn units to NICUs and inpatient psychiatric care. The American people visited emergency departments nearly 140 million times in 2022 alone.
And hospitals and health systems aren’t just the front lines of 24/7 patient care. They backstop our nation’s entire health care system.
Where other sites of care sometimes turn patients away, hospitals care for every patient who comes through their doors, including the most vulnerable. They are the key workforce training grounds for generation after generation of new doctors, nurses, and caregivers. And hospitals are engines of innovation and progress that drive the entire health care field forward toward new treatments, better clinical outcomes, and greater patient safety. As I write, Carilion Clinic is working with local partners to determine how drones can be used to improve health care delivery in our service area.
Hospitals and health systems play a central, irreplaceable role in our society. That’s why it is so concerning that hospitals are being squeezed by a huge array of financial pressures—from inflation and skyrocketing drug prices to the cost of medical supplies and equipment, critical workforce shortages, and labor costs.
And while the costs of providing care have skyrocketed, the reimbursements flowing into hospitals have not kept up. The federal government is one major offender: Medicare only reimburses hospitals at 82 cents on the dollar, totaling $99.2 billion in underpayments in 2022 alone. At the same time, while many corporate insurance companies bank record profits for themselves, their approval delays and coverage denials frequently leave hospitals and patients on the hook.
Policymakers have been asking our hospitals to do more and more with less and less. The math just isn’t adding up. A majority of our nation’s hospitals operated at a financial loss in 2022. Nearly 150 rural hospitals and counting have had to cut services or close their doors over the last decade. Many more are at risk of following suit.
The status quo cannot continue. Our current trajectory could leave fewer patients with 24/7 access to high-quality, complex care. It could leave our nation with less health innovation and less preparation for future needs like another pandemic. Even worse, big-spending special interests—including corporate insurers—are lobbying policymakers to enact huge additional Medicare cuts that would reduce funding for care even further. This campaign to cut patient care relies on the false notion that hospitals are no different than other kinds of health care facilities.
Patients and caregivers know hospitals are unique and vital. And the data prove that hospitals are unique and vital. Policymakers must understand this, too.