According to a December 2008 survey conducted by the Hospital & Healthsystem Association of Pennsylvania, the state's hospitals are being hurt by the national recession, and patients are feeling the effects.
"Pennsylvania's hospitals are critical to the physical and fiscal well-being of our communities," said Carolyn F. Scanlan, HAP president and CEO. "They are $84 billion-a-year contributors to the state's economic health. The current economic crisis imperils hospitals and the patients who depend on them."
The survey of the state's general acute-care hospitals revealed that the economic crisis is significantly affecting the financial stability of Pennsylvania's hospitals and health systems.
Forty-two percent of the hospitals surveyed reported a moderate to significant effect on the day-to-day financial operation of their facilities, and 75 percent of hospitals and health systems are forecasting a moderate to significant effect on the financial stability of their facilities through December 2009.
Pennsylvania hospitals also reported that the recession has jeopardized their access to capital. Forty-five percent of hospitals and health systems reported increased expenses in accessing capital, while 15 percent are facing greater requirements in accessing capital. Fifteen percent have also experienced difficulty in refinancing debt and 15 percent have not been able to issue bonds.
Most hospitals that planned to renovate or upgrade facilities and equipment are postponing or delaying capital spending. Forty-eight percent are reconsidering or postponing renovation or upgrading of inpatient facilities. Fifty-four percent are reconsidering or postponing renovation or building of new outpatient facilities, and 64 percent are delaying or reconsidering the purchase or upgrading of clinical and health information technology and equipment.
Eighty-three percent of Pennsylvania hospitals and health systems also reported significant declines in investment income.
The study reveals that Pennsylvania patients are being affected by the growing economic crisis. Fifty percent of hospitals surveyed report a moderate to significant decrease in admissions, particularly elective procedures, while 20 percent report increases in emergency department visits, and 17 percent report an increase in patients with behavioral healthcare needs.
Scanlan said uncompensated care provided by hospitals and health systems in Pennsylvania is growing. Fifty-one percent reported a moderate to significant increase in uncompensated care, and 38 percent reported a moderate to significant increase in patients needing financial assistance.
"Even before this fall's economic downturn, Pennsylvania hospitals faced the challenges of growing uncompensated care; rising labor, technology, and utility costs; ongoing high medical liability insurance costs; the cost of physician shortages and Medicaid and Medicare underfunding," Scanlan said.
She speculated that, as more people lose jobs and access to health insurance, the financial burden on hospitals would increase.
"From a human perspective, the implications are worse," said Scanlan. "More patients will postpone preventive and routine healthcare, and they will be put at risk for more serious illnesses and complications before they seek care. The result will be sicker Pennsylvanians at a higher cost."
According to HAP, Pennsylvania's hospitals directly employ more than 288,000 people, and another 250,000-plus are employed by businesses that depend on hospitals for their existence - such as laundry and food service companies.
"Failure to protect Pennsylvania's hospitals during this economic crisis will reduce the availability of healthcare and devastate the economies of our communities," Scanlan said. "It is imperative that reimbursement from Medicaid and Medicare not be reduced any further, and that critical funding for burn centers, trauma centers and obstetrical services be preserved, even as government payers face their own financial squeeze in 2009."
HAP is a statewide membership services organization that advocates for approximately 250 Pennsylvania acute and specialty care, primary care, subacute care, long-term care, home health and hospice providers.