Study: Some safety-net hospitals putting income over mission

Anne Zieger — Tue, 12 Aug 2008 21:36:14 -0400

In today's brutally-competitive hospital marketplace, every hospital has to focus on finding profitable services to deliver and minimizing bad debt. Unfortunately, being profit-driven can sometimes conflict with a hospital's mission. This is especially the case for safety-net hospitals, according to a new study by the Center for Studying Health System Change. The study, which appears in Health Affairs, concludes that efforts like specialty-service marketing and new construction could compromise the hospitals' other efforts. Overall, safety-net hospitals aren't as financially healthy as an average hospital (which, given the state of the industry, is a sad commentary). About one-third of all safety-net hospitals lost money in 2005, according to the study's authors, who tracked 12 regions for over a decade.

Many safety-net hospitals have gone the route of Seattle's Harborview Medical Center, which has built out its campus and aggressively advertised "centers of emphasis" like neurosciences, orthopedic reconstructive procedures and spinal surgery. Execs there say they need 40 percent of their patients to be commercially-insured to stay financially viable, and that pushing higher-end services like these helps them to stay afloat where others have failed. Meanwhile, Harborview has taken some steps to limit transfers of uninsured patients, something the study's authors say subjects patients to a "wallet biopsy."

To learn more about this study:
- read this piece from The Seattle Times

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Study: Some safety-net hospitals putting income over mission