When Hahnemann University Hospital’s demise was announced in late June, politicians, union leaders, and others predicted a crisis for patients, saying that other hospitals wouldn’t be able to handle the influx of patients.
Hahnemann’s closure attracted national attention, with the New England Journal of Medicine weighing in with an August article on the meaning of Hahnemann’s loss and presidential candidate Bernie Sanders at a July rally decrying the private equity owner’s decision to ignore the health-care needs of thousands of people.
So far, there’s no sign of crisis, according to Philadelphia hospital and city officials.
At Temple University Hospital, for example, the emergency department is busier, but the North Philadelphia institution is having no difficulty absorbing the additional patients that likely would have gone to Hahnemann, executives told bond investors this week on a conference call.
“We clearly have remaining capacity. I don’t feel like we’ve overstretched anybody,” Temple University Health System’s outgoing chief executive, Larry Kaiser, said on the call.
Hahnemann stopped admitting patients through its emergency department on July 17. The hospital discharged its last inpatient two months ago.
Since then Temple has added about 30 inpatients a day, officials said. In 2018, Hahnemann averaged 254 inpatients a day, about half of its capacity. No details were available on where other Hahnemann patients have gone.
In terms of the financial impact on Temple, “it’s actually been favorable for the first two months, helping to cover fixed costs,” said Mike Young, CEO of Temple’s flagship hospital at 3401 N. Broad St.
Einstein Healthcare Network, Jefferson Health, and University of Pennsylvania Health System, other systems expected to pick up patients from Hahnemann, said they had increased patient volumes, but said less about the financial impact.
“It is too soon to have a clear picture of the financial impact of this uptick in volume,” Einstein said.
Without providing details, Jefferson said it was meeting budget projections.
Penn did not address the financial question, but provided data on emergency department volumes. At Pennsylvania Hospital, total visits were up more than 14% in July and August compared with the average for those months in the three previous years. Emergency ambulance arrivals were up 40% in July and 67% in August compared to those months in 2016, Penn said.
The four Philadelphia health systems took on 249 of Hahnemann’s orphaned doctors-in-training and had hired more than 350 of Hahnemann’s 2,500 employees as of early this month.
Health-care experts were not surprised that Temple was seeing a benefit from Hahnemann’s closure.
More than half of a hospital’s costs are fixed, said Joshua Nemzoff, a hospital finance expert in New Hope, so a few additional patients does not make much difference.
“Your debt service is the same. Your interest for the debt is the same. Your labor costs are virtually the same for administration, your IT department, and the pharmacy," Nemzoff said. "If one more patient shows up on a floor, you probably don’t have any incremental cost. You might have some extra cost for giving them some medication or some food, but your incremental costs are hardly anything.”
That changes if the volume of additional patients is significant enough.
“Had Hahnemann’s patient volumes been greater, then Temple Health and others would have had to 'scale up’ to absorb those volumes. That could have resulted in increased financial losses,” Stuart Fine, a professor in Temple’s College of Public Health, said in an email.
As to whether Hahnemann’s closure means patients are going without care, Philadelphia Health Commissioner Thomas Farley issued this statement Thursday:
“While the Philadelphia Department of Health does not have a systematic method for monitoring the receipt of medical care by former Hahnemann patients, informal reports suggest that these patients are receiving care at other area hospitals and clinics without major disruptions in care. Many of the former Hahnemann and Drexel medical staff are now working for these other hospitals and, in some cases, seeing the same patients in the new facilities.”