Shift in health care climate a source of Memorial woes
Health care landscape shifts
Economic forces working against traditional hospitals
PAWTUCKET – While they say it is disappointing to see an institution such as Memorial Hospital of Rhode Island – a fixture on Brewster Street since its founding in 1894 – be forced to close its doors, officials from Blackstone Valley Community Health Care were not taken by surprise, as they say they are seeing a shift in the future of health care.
Raymond Lavoie, BVCHC’s Executive Director, and Michael Fine, Senior Population Health and Clinical Services Officer, agreed that there’s been an evolution in health care both locally and nationally, straying away from hospital care and trending toward a more personalized primary care.
A federally-qualified health center, Blackstone Valley Community Health Care has been serving Pawtucket and Central Falls since 1976. Separate entities in Pawtucket and Central Falls in 1990 merged to one cohesive unit and since then, BVCHC has expanded to seven sites across the two cities, with construction ongoing for a 47,000square-foot Neighborhood Health Station in Central Falls.
Fine, who formerly served as the director of the Rhode Island Department of Health, said that the impending closure of Memorial is personal to him, as he trained there from 1983 to 1986.
“It was a hospital that knew and was of its community, it is an era that is lost,” Fine said. However, he added that from a public health perspective, the financial distress of hospitals is showing the evolution of primary care, public health, and new technologies.
“Primary care represents the future of public health, so while it is the passing of an era, it’s the marker of a transition to personal, rational, effective care,” Fine said.
Care New England’s Board of Directors on Monday night authorized the termination of the negotiations with Prime Healthcare Foundation over the latter’s planned purchase of the hospital, as CNE officials said that both sides were unable to reach “mutually acceptable terms.”
The board also authorized CNE management to prepare necessary plans and filings with the Rhode Island Department of Health to maintain access to primary care and outpatient services, while closing Memorial’s inpatient units and emergency department.
CNE officials attributed the closure to “chronic financial losses” incurred at the hospital, which they say has been ongoing for the past 10 years. CNE officials said the hospital has averaged a daily input of 15 to 20 patients within the 294-bed hospital, resulting in a $23 million operating loss in the past fiscal year. CNE additionally recorded a $68 million loss from operations in the 2016 fiscal year and is projected to show a $49 million operating loss for the fiscal year that ended on Sept. 30.
Fine said that even though Memorial is a 294bed community hospital servicing urban communities, he does not envision its closure to have a significantly deleterious impact on public health in the area, as the hospital was not coming close to filling to capacity.
“In the last year or two, Memorial Hospital was hospitalizing 30 to 50 people a day,” Fine said. “We’re lucky in Central Falls and Pawtucket to have evolved the system of care … We’re seeing this, where out of the ashes of hospitals like Memorial Hospital will come a new health care system that will let us better care for the public, be more affordable and more effective.”
By comparison, BVCHC last year served 18,500 people in its seven sites in Central Falls and Pawtucket, the officials said.
The restructuring of Memorial Hospital has been ongoing for more than a year. Last year, plans were announced to close the birthing center, a surgical department, and intensive care at the hospital. Memorial last August permanently ceased the operations of its birthing center.
Earlier this year, it appeared as though Memorial Hospital could be saved, as Care New England and Prime Healthcare Foundation in April announced that they agreed to a letter of intent for Prime to acquire the financiallychallenged hospital. Monday’s board meeting, though, ultimately terminated those sale negotiations.
Additionally, as Care New England was attempting to unload Memorial Hospital from under its umbrella, the health care system announced that it signed a letter of intent with the Massachusetts-based Partners HealthCare – a nonprofit health system founded by Brigham and Women’s Hospital and Massachusetts General Hospital – to explore an affiliation.
Lavoie echoed Fine’s sentiment, saying the hospital system represents sick care, while centers such as BVCHC represent “real health care.” He said that many years ago, if a person smoked and developed pneumonia, they’d end up in a hospital for up to 10 days. However, as time has changed and health care has evolved, he said that a similar situation today could be taken care of in home with supervised care or primary care resources.
“Much of what used to happen in a hospital for 10 days to two weeks doesn’t happen today due to the success of primary care or prevention,” he said. “Or if it does happen, we can deliver necessary care.”