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Speaker Welch says his own top legislative priority this spring is stopping hospital closures in low-income communities

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Illinois

A new report underscores just how much small hospitals on Chicago’s South and West sides struggle financially, and what can be done to prevent them from closing.

These small so-called “safety net” hospitals tend to be staples in their communities. They typically treat low-income and elderly Black and Latino patients, and often don’t have enough money flowing in to make ends meet.

A new study commissioned by the Health Care Council of Chicago estimates that by 2024, a dozen of these hospitals could lose at least $1.8 billion combined. And that doesn’t even account for money hospitals lost during the COVID-19 pandemic, as they suspended money-generating surgeries and shifted patients to video and phone visits to help slow the spread of the coronavirus.

“We cannot do this for another three or four years and expect that we are not going to see the threat of more hospital closures, more job loss, while health does not get better,” said David Smith, CEO of Third Horizon Strategies and lead author of the paper. “This does not have to be our future.”

The report comes as one safety net, Mercy Hospital in Bronzeville on the Near South Side, recently filed for bankruptcy protection and has been preparing to close this spring.

The report is here.

* House Speaker Chris Welch was asked by Greg Hinz the other day what issue was personally important to him to address this session and he talked about hospital closures…

Welch: You and I have talked a number of times, because you personally witnessed my fight to save Westlake Hospital out here in my area, and to watch and see what’s going on with Mercy Hospital. I was warning people back then that this was just the tip of the iceberg. We really need to do something about hospitals closing, particularly in black and brown communities. The disparities already are so wide, you can drive a Mack truck through them. They’re only going to grow if we continue to allow hospitals to close in poor communities. How does a hospital like Mercy post 6$05 million profits in a quarter and then file bankruptcy? It’s crazy. Allowing these hospitals to close is something that we need to take a good long look at and protect communities like the one that I serve and like the one that Rep. Lamont Robinson serves out on the South Side where now Mercy Hospital is threatening to close his doors. This is something that I really want to take a look at. And we can address it this session that would be great.

Hinz: Is the problem that there was not adequate public help for these facilities to keep them open or is the problem that people who operate some of these hospitals are not acting in the public interest, or is it both?

Welch: I think there’s a combination. I certainly think government can do do better. As I told you earlier, our budget is a moral document. I think on the federal level on the state level, we can probably do more to help these these hospital systems. But I certainly think that the hospital industry has changed. Healthcare shouldn’t be a for-profit industry. Unfortunately, it’s become a for-profit industry. And it should be about care and compassionate, compassion, and healing. And unfortunately now it’s about dollars and cents. That’s really unfortunate. And to leave poor communities with gaping holes for access to healthcare has been the byproduct of the healthcare industry becoming a for-profit industry. We have to correct that. That’s a serious issue that has to be corrected.

Hinz: There’s already laws on the books as you know that says before you close a hospital facility have to go to a board, and the board has to sign off on it and the board usually goes along that way. What more should the state be doing?

Welch: I think we have to give that board some more teeth to the law. Because right now it’s more like a ratification a check the box type of process. You talk about an entire community, heartbreaking. That process that we went through at Westlake Hospital was demoralizing and heartbreaking. And people really loved that community hospital. It provided care to folks who otherwise otherwise aren’t getting it. There’s a hole now that they’re not getting that care. And so, watching, I was in Bolingbrook when the board met. And you know, it was more like checking the box because there was really nothing they can do other than grant the application. […] The last thing I want to see is another hospital closing in a low income community. I want to see them opening up, not closing.

posted by Rich Miller
Tuesday, Mar 2, 21 @ 12:09 pm

Comments

Again, until change the systemic way of doing business in illinois this will be the norm. We can throw money at it as always but the question of ” why aren’t they profitable ” is never asked and as a result no solutions are provided.

Comment by Masker Tuesday, Mar 2, 21 @ 12:26 pm
Healthcare and profit-driven markets are not a natural fit. Never have been. We’ve known this since the beginning of civilizations until the Reagan era.

Comment by walker Tuesday, Mar 2, 21 @ 12:31 pm
I think there’s a chance for public employers to hire poorer hospitals directly to provide services — especially primary care — without billing is a creative solution worth exploring. We spend a lot of money on public employee and retiree health care. (city, feds, county not just state). As buyers, we can dump the broken fee-for-service model and move towards a more just, humane and rational system.

Comment by Dan Johnson Tuesday, Mar 2, 21 @ 12:35 pm
I’ve noticed that there are several legislators who sit on the boards of some of these hospitals. Does anyone know if those are paid board positions?

Comment by D. Hume Tuesday, Mar 2, 21 @ 12:48 pm
Given the low, low Medicaid reimbursement in Illinois, the hit they’ve taken from coronavirus and the resources the HMOs are scraping away from hospitals without coordinating care, I would expect more of these hospital closures, not less.

Comment by Get What You Pay For Tuesday, Mar 2, 21 @ 12:49 pm
- Masker - Tuesday, Mar 2, 21 @ 12:26 pm:

They’re posting massive profits

Comment by Precinct Captain Tuesday, Mar 2, 21 @ 12:54 pm
Interesting to see what “teeth” he thinks he can give a committee to stop a business from going out of business. The whole thing about needing permission to close the hospital never made much sense to me.

Comment by Perrid Tuesday, Mar 2, 21 @ 1:39 pm
Yes, another committee will do the trick. Let’s put them in the same building next to the property tax committee from last year.

Comment by FranklinCounty Tuesday, Mar 2, 21 @ 2:00 pm
Definitely. And while we’re looking at this issue, we should also examine whether the use of the TIF money to pay those trial lawyers was actually an appropriate use of those funds, as well as which law firms and legislators were benefiting from it and how those arrangements came to be.

Comment by Uh oh. Tuesday, Mar 2, 21 @ 2:01 pm
For profit health care is a wrongful scheme.

Comment by Dotnonymous Tuesday, Mar 2, 21 @ 2:06 pm
“I certainly think government can do do better.”

What would be the price the State would pay for these bankrupt, money-losing hospitals? You could buy the assets out of bankruptcy, pay the creditors ten cents on the dollar, start with a clean balance sheet, and then implement the cost-savings and healthcare delivery programs that the State is so good at. /sarc

Comment by Occam Tuesday, Mar 2, 21 @ 2:08 pm
To Dan Johnson’s point (Hi, Dan!) –

I haven’t looked into this recently, but I believe that other states own and operate hospital systems. The staff are state employees.

We don’t do that here — which is one of the reasons our state employee per capita number is so very low.

But if we were willing to give up that talking point, we could probably save money and improve outcomes by running state hospitals, similar to cook county.

Comment by Soccermom Tuesday, Mar 2, 21 @ 2:34 pm
Soccermom, Illinois does run some specialized hospitals. State psychiatric hospitals, for one. The vets homes and developmental centers - while sometimes rightly criticized as expensive, inadequate and/or anachronistic - also provide a lot of medical care. They don’t “make money” but local and state elected officials on both sides, across the state, seem to agree they are a needed safety net.

Comment by Chuck Button Tuesday, Mar 2, 21 @ 2:49 pm
“I certainly think government can do do better.”

I present Cook County Hospital and the subsequent Stroger Hospital as poster children have poorly run government hospitals.

In 2018 Cook County health system lost $165 million due to employee errors and other billing issues.

https://www.chicagotribune.com/politics/ct-met-cook-county-hospitals-billing-errors-20180510-story.html

Comment by Huh? Tuesday, Mar 2, 21 @ 5:55 pm