Can hospitals be saved? Some fresh ideas

No matter what you do, there will always be people who consume more hospital resources than others, notably the chronically-ill poor with spotty access to ongoing care.  They’re sicker, over a longer time, and to boot have no way to pay their bills.  In that situation, everyone loses.

But is there a way to solve this problem without going broke?  Maybe.  Here at nextHospital we’ve been intrigued by news of a couple of proposals intended to help patients AND ensure hospital solvency:

*  Redeveloping commercial property around urban hospitals and leveraging it to bring a flow of traffic, personnel and physicians to the door. This would bring urgent care/retail clinics, primary care practices and other support mechanisms to the hospital’s doorstep. Ultimately, the idea is to tend to the of the sickest, most expensive patients first — the weakest link, if you will — freeing up more resources to improve care for everyone else.

*  Bringing together community healthcare organizations (including  hospitals) together into a self-sufficient economic unit which can afford to turn away managed care contracts — and offer affordable care. (See an overview by Dr. Jonathan James of Community MedPAC here:

We don’t yet know enough about these models to predict whether they’ll work or not, and to our knowledge, neither has been fully implemented. However, there’s no question that there’s a big payoff, both financially and ethically, for those who can improve access to care while reducing financial strains to the system.

Are there other hospital care financing models which look like they can change the game?  If you’ve found any, we’d love to hear about it.

About the author

Anne Zieger

Anne Zieger

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.


  • I believe the second bullet about bypassing MCO’s has huge potential. The two sectors that are hammered hardest by health reform are the hospitals and the employers…somehow these two need to team together, at a community level, and craft comprehensive models where costs are spread appropriately.

    There’s no getting away from employers being charged with managing coverage for working people, and there’s no getting away from hospitals being relegated to turning into critical care providers only.

    Community partnerships founded by local employers and hospitals could improve care delivery at the local level, and ungroup distinct issues making for more easily defined solutions.

    Creating a one-size-fits-all, a universal standard for healthcare is scary because communities in the Midwest are not the same as they are in New Jersey, no matter what Dartmouth says.

  • I am a strong proponent of direct contract where it makes sense. I just brought home a journal from the office that came this week, from Employee Benefits News on direct contracting. It seems the HR folks are with us on this Corey. It’s just a matter of time. Accountable Care Networks will contract for a reasonable fair market fee for high quality service and insurance companies can do the excess loss coverage for catastrophic cases.

    Somehow we have to reform technology costs, pharma research and development costs, professional liability and tort liability, and reform the silos into a truly integrated system of healthcare delivery for the right service and the right level, at the right time, by the right provider -and if there’s a deviation, to be open to whatever the explanation is since medicine is not yet an exact science.

  • Folks, for what it’s worth I share your belief that direct contracting has definitely come of age. That being said, I think the hospital urban redevelopment model has a great deal of promise as well. I think you may come to agree when I write up a full-length item on this — but I guess we’ll see.

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