Are hospital closures necessary to fix healthcare?

Clarification: This article initially attributed sentiments to the panel discussion that were original to Molly Gamble's linked Becker's Hospital Review post. Those passages have been amended to reflect proper attribution. .

To fix the healthcare system, providers must accept and embrace the necessity of hospital closures, healthcare experts said during a recent panel discussion as part of the Aspen Ideas Festival.

One of the primary obstacles to accountability within healthcare is the fact that the country has too many hospitals, panelists said. Today, hospital occupancy is 65 percent, Cleveland Clinic CEO Toby Cosgrove said, adding that there were a million hospital beds in the country 20 years ago; today, he said, it's fallen to 800,000 and there are still too many beds.

Athenahealth founder and CEO Jonathan Bush went further, calling for patients and families to halt their donations to hospitals. "I don't care if they name a pavilion after you," he said. "You're a murderer if you donate."

"[W]hat he's saying is this: If a hospital can't stay open and offer high-quality care by its own merits … maybe it deserves to close," Molly Gamble said in a Becker's Hospital Review blog post. "Donations may keep subpar, even low-quality hospitals on life support. Patients go to these places for care, but also for medical errors and patient safety issues, which can ultimately kill them."

Rather than relying on a subpar community hospital, Cosgrove said, patients need access to specialty care suited specifically to their needs. "Move the patients to the place [they need to be]," he said. "Have a system that coordinates it." The idea of the community hospital is largely a relic of a time when transportation was far more limited, he said. For example, Cosgrove's own institution draws patients from all across the country.

Cosgrove emphasized how the Cleveland Clinic has put this commitment to quality into effect: at the Clinic, physicians are subject to yearly contracts and performance reviews.

To learn more:
- watch the panel discussion [relevant portion begins around 41:00] 
- read the blog post

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