Last month a marathon hearing took place in Hartford and by Zoom, with the fate of Sharon Hospital’s labor and delivery services at stake.
On one side, in favor of closing, were the evasive leaders of Danbury Hospital, which has morphed into something called “Nuvance Health,” the current owner of Sharon. The evasive leaders were accompanied by confused staff who were unable to articulate how a plan was actually going to work, a plan to close obstetrics in a rural location, far from any other hospitals, without compromising the care of area residents who had been served by that hospital for more than a century.
On the other side was the Save Sharon Hospital organization and the community. They contended that there is a crisis in rural health care, and especially in maternal morbidity and mortality in the USA, with “maternity deserts” blossoming, and this crisis has come to Connecticut, where no fewer than five hospitals have closed or are closing labor and delivery.
The parties that testified in support of saving labor and delivery represented a true cross section of community including medical professionals, elected officials and industry leaders.
Here is the source of the crisis facing those five smaller hospitals in Connecticut. The unit cost (expense) of running the smaller or rural hospital is basically similar to the expense of running a metropolitan hospital. This is because the people, space, equipment and supplies basically cost the same in larger or smaller hospitals. However, the unit revenues are lower, primarily because commercial health insurers believe they don’t need all hospitals in their “networks” in order to sell insurance, so pay less to the smaller ones.
The structure of American payment for hospitals is unlikely to change, and continues to create inequities. Therefore, new sources of revenue to maintain the services of low-volume hospitals in smaller communities are needed. Since this is an ever-growing national problem, many states have sought solutions.
California, Florida, Texas and many other states in the south and Midwest recognize this, and have created hospital districts to acquire and lease back nonprofit hospitals. These hospital districts are authorized in state statutes and operated through local communities, which have chosen to implement such strategies. Often the hospitals so supported “give back” through discounts to residents of communities contributing tax funds.
Georgia offers the Georgia Heart Hospital Tax credit program. The Georgia Department of Community Health qualified certain hospitals as rural hospital organizations to which individuals and corporate taxpayers may contribute and receive a 100% Georgia income tax credit.
The status quo no longer works nor will following ‘trend’ that has created a new problem we now need to tackle. Success is most likely to be found in unity and collaboration with the state, the community and the ownership of the hospital itself.
When we work together with a common purpose, we lift all parties up, especially the most vulnerable and needing of care. This is how rural life works, and is why the community continues to fight for over 15 years to maintain full services at our hospital. It is what everyone needs.
Deborah Moore lives in Sharon.