When to close a hospital
A state's largest hospital shutdown in a decade is more a decentralizing of primary and outpatient services
The 124-year-old Quincy Medical Center is set to shut down by the end of the year, in what will be the largest hospital closure in Massachusetts in a decade.
In some parts of the country, the ebbs and flows of healthcare seem to suggest an oversupply of inpatient hospital services, leaving some health systems trying to reorganize and right-size.
In eastern Massachusetts, Steward Health Care is closing the 196-bed Quincy Medical Center, amid continuing financial losses, competition from rivals and a decentralization of traditional hospital care.
Steward, a for-profit system created through the acquisition of Caritas Christi Health Care, purchased the Quincy Medical Center in bankruptcy in 2011, a year it lost $18 million. Steward invested $100 million and remained bullish on its long-term prospects, along with other community medical centers in its 10 hospital system.
Last year, Steward leaders said that suburban community hospitals like Quincy Medical Center were part of a twin strategy to right-size and “right-site” healthcare and plug the “leakage” of locals heading to academic medical centers in the city — and that they would be generating profits in two years. Now, the 124-year-old Quincy Medical Center is set to shut down by the end of the year, in what will be the largest hospital closure in Massachusetts in a decade.
[See also: Financial modeling a key step in mergers.]
Other health systems are taking a right-siting strategy similar to Steward, including Beth Israel Deaconess Medical Center and Atrius Health. The Quincy Medical Center lost about $20 million last year, and this year is on track to lose another $20 million.
“While Quincy Medical Center earns top quality and safety ratings, competition from Boston-area medical centers, significant cuts to Medicare reimbursements, continued Medicaid underfunding, continued rate disparity, and precipitously declining inpatient volume have made QMC unsustainable.” said Mark Girard, MD, president of Steward Hospitals. “On an average day, only one-fifth of all beds are occupied and it has become abundantly clear that local residents no longer seek inpatient services from Quincy Medical Center.”
In place of the hospital in Quincy, Steward is going to operate a 24-hour emergency department, outpatient urgent care center in another part of the city, primary care offices, a multi-speciality clinic and imaging center, along with transportation services.
Although more than 600 employees face job uncertainty and the Quincy city government may see a decrease in property taxes, for residents, the closure may not be a huge loss. Within 10 miles of Quincy there are 15 hospitals, including some Steward facilities and competitors that only recently have become part of larger academic health systems. Beth Israel Deaconess’ Milton Hospital is just four miles west of seaside Quincy, and seven miles south in Weymouth, the South Shore Hospital could soon be owned by Partners HealthCare, the state’s largest and most prestigious health system.
In greater Boston, despite the close-to-home marketing, many patients are migrating from community hospitals to academic medical centers for a range of services, but particularly when they need inpatient hospital care. In Quincy, only 16 percent of residents sought inpatient hospital care at the city’s medical center, according to Steward.
[See also: When a hospital closes.]
Also, the “vast majority of patients who use the QMC Emergency Department have non-urgent healthcare needs,” with almost 80 percent being sent home the same day, according to Steward. All patients that do come with trauma, burn and cardiac emergencies are already sent other hospitals.
“We believe that our patients will be better served by our new network of services in Quincy,“ said Girard, an interventional radiologist who came to the company with Caritas. “At the same time, we are taking great care to ensure that our Quincy Medical Center employees receive an unprecedented level of support and opportunities during this transition. We are going above and beyond what other hospitals have done in similar circumstances.”
