Large safety-net hospitals in urban areas are struggling to navigate their futures and find partners that would make them viable in the long term.
For instance, United Medical Center, which has been under the control of the District of Columbia since 2007, has been unable to find a partner, according to The Washington Post. D.C. officials will likely have to pour more cash into the facility in the next several weeks, even though they have already pumped some $100 million into the hospital, the Post reported.
The number of patients served by the hospital rose 13 percent over the past year, but 90 percent are covered by government programs or are uninsured, making its financial situation precarious, the article noted.
Similarly, University Hospital in Newark, N.J., is poised to split from the University of Dentistry and Medicine as part of a reorganization overseen by Gov. Chris Christie, according to the Newark Star-Ledger. However, the 519-bed hospital has had difficulties finding a partner because of ongoing losses and nearly $117 million in debt.
Alan Sager, a Boston University professor of healthcare policy and management, has performed research indicating that safety-net hospitals such as United Medical Center and University Hospital are much more likely to close than partner with better-financed teaching hospitals.
Sager, who presented his findings at the annual Association of Health Care Journalists meeting in Boston last week, noted that institutions are far more vulnerable if they are catering to a poor population with few insured patients. And once a hospital closes, it often impacts other nearby facilities.
"It can have a domino effect," he said.