Annapolis, MD – Two influential state legislators are sponsoring a new law that would make it easier for community hospitals throughout Maryland to shut down.
State Senator Thomas Middleton and Delegate Peter A. Hammen say it will simply allow hospitals to convert into outpatient and emergency ambulatory clinics, which are far more in demand. Opponents say that not only will it cost some healthcare workers their jobs, but that it will shutter much-needed hospitals without community input.
“We recognize why they want to do this, but we can’t see how this is in any way collaborative,” said Claudia Balog, a senior researcher with the SEIU labor union, which opposes the legislation. “We want to see that the community will have a voice in what their health care looks like.”
In the last decade, the number of people admitted to Maryland hospitals overnight has declined by 15%, or 100,000 patients. According to the Maryland Hospital Association, that’s because hospitals are trying to avoid more costly inpatient patients whenever possible, instead referring them to lower-cost healthcare providers in the community.
The future of healthcare clinics in Maryland could soon look much more like the Bowie Health Center. Mark Aresnault, the vice president of Bowie Health Center, believes future healthcare providers will be much smaller than the community hospitals most people are familiar with today.
Despite the growing demand for these types of stand-alone ambulatory centers, there are currently just three in the state. Arsenault says the center recently added a new CT scanner and is currently adding new rooms that will double its capacity.
Rather than being admitted for costly overnight stays, hospitals are instead pushing patients to these types of ambulatory centers. In decades past, patients would have to go to a hospital for treatments like CAT scans, whereas in 2016 they would likely be referred to an outpatient imaging center.
In theory, these kind of outpatient facilities can provide communities more preventative care, reducing healthcare costs and inpatient admissions in the long run. For instance, modern day CAT scan machines combine thousands of X-rays into 3D models, and can more accurately detect lung and breast cancers before they spread. New medical guidelines call for early screening for at-risk patients, and Maryland hospitals want the freedom to convert some or all of their operations into these types of stand-alone outpatient centers.
The new legislation would allow them to do just that.
“Hospitals aren’t going anywhere, but they’re going to shrink,” said Arsenault. “They’re going to be much smaller.”
Senator Middleton says the legislation is also necessary to help state hospitals meet the requirements of Maryland’s unique Medicare program. Maryland is the only state in the country with the power to set the rates hospitals charge both private insurers and Medicare. However, a new update to this agreement requires hospitals to shift focus to cost cutting and preventative care.
To do that, Middleton says they need the flexibility to convert some or all of their operations into ambulatory centers. And despite some opposition, the Baltimore Sun reports that the proposed legislation will require hospitals to solicit community input, after which the Maryland Health Care Commission would have up to 45 days to consider the proposal. Currently, it can take years for a hospital to receive the necessary approval to convert into an outpatient center.