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When a Hospital Re-opens, Will Patients Return?

All eyes are turned to new L.A.-area facility

Amid questions about how hospital closures affect patient outcomes, the Los Angeles area is about to provide a case study for the next step in that process –– when a once-closed hospital reopens in an altered health care environment.

When the Martin Luther King Jr./Drew Medical Center closed its doors in 2007 after a series of treatment lapses earned it the nickname “Killer King” and caused the federal government to pull its funding, tens of thousands of South Los Angeles patients scrambled to find somewhere else to go, the Los Angeles Times reports. The facility had been a pillar of L.A.’s black community, at one point treating 47,000 patients per year in its emergency department.

Many officials predicted that surrounding hospitals, some with already-strained emergency rooms (ERs), would be flooded. Indeed, a new Times analysis of state data found that two public and three private hospitals in the area experienced an increase of more than 20% in outpatient ED visits, some well after the troubled King/Drew closed.

St. Francis Medical Center, just 3 miles away, had an immediate 24% ER bump. A year later, White Memorial Medical Center in Boyle Heights also saw visits rise 24%, according to the analysis, while county-owned Harbor–UCLA Medical Center in Torrance saw a 35% increase.

But despite fears, the county’s ER system didn’t collapse. For the most part, hospital ERs — several of which added doctors and nurses — were able to handle the load.

ERs are a primary source of patients — and revenue — for hospitals, accounting for roughly half of admissions, by some estimates. So with financial projections already uncertain amid changes in the way hospitals are paid under the Patient Protection and Affordable Care Act (PPACA), a loss of ER patients could be worrisome, the article says.

In addition, whereas many of the previously uninsured patients from Martin Luther King Jr./Drew Medical Center posed a financial burden wherever they went because they could not pay, they now have coverage under the PPACA.

So, as a rebooted Martin Luther King Jr. Community Hospital prepares to open in a new health care landscape, county and hospital administrators are trying to gauge whether former King/Drew patients will want to go back.

Despite the expanded coverage under the PPACA, many patients with Medi-Cal still aren’t going to primary care doctors because they can’t get appointments, said Steve Valentine, president of Camden Group, a national healthcare consulting firm based in El Segundo that worked on the new hospital project.

Many doctors say they can’t afford to stay in business if they treat patients for a Medi-Cal reimbursement, which is sometimes less than $20 a visit.

“They can't find a doctor, so they still go into the ER,” Valentine said. “So we fully expect that the ER will become very busy at MLK.”

Sources: Los Angeles Times; May 4, 2015; and FierceHealthcare; May 5, 2015.

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