Impending Death of Hospitals | The Business of Healthcare

Hospital Becomes Hole in Ground. ASC Takes up the Slack.

In what might seem to some like ancient history and to others as a clarion call, in June 2010, New York City’s approximately 400 bed, 160 year old St. Vincent hospital, the last Roman Catholic general hospital in the city, closed its doors for the last time.

In late 2017, a competing non-profit opened the modern variant of a replacement “hospital” right across the street: a 6 O.R. ambulatory surgery center located in a facility with an emergency department, an imaging facility, physician offices, and other healthcare services.

Other than in respect of the freestanding emergency room, which, depending on state law may or may not be possible to license (or even wanted), there’s nothing in the concept of the replacement facility that couldn’t be created by you as a physician-led, physician-owned, for profit venture. In fact, it’s exactly along the lines of what I’ve termed a Massive Outpatient Center™:  A combination of an ASC, a medical office building, and one or more of a menu of complementary offerings.

For some, thinking becomes ossified along historic lines: “Hospitals build hospitals.” “Physicians just practice medicine.” “Physicians can’t own hospitals.” But none of these is necessarily true.  But, even if they were, opportunity is more malleable. What’s functionally like a hospital need not be a hospital.

If I were wrong about this, St. Vincent’s would be celebrating its 168th anniversary. It’s not. A 200-unit condo complex stands in its place.

Comment or contact me if you’d like to discuss this post.

Mark F. Weiss

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Hospital-Centric Healthcare

The Walking Dead: Is Your Group Actually in Business?

You have been coming into work every day for years. Now there’s no need to come in tomorrow because your group no longer exists.

You see, although your group collected over $20 million over the past year, and you and your fellow partners earned a tidy sum, it turns out that your group was simply a service to one hospital, not a real business. When the hospital chose to obtain that service from someone else, proof, there went your group.

There are many things your group can be doing to create leverage to prevent its demise. And they all start with telling the truth about your present situation and with imagining the future as you want it, not as “the hospital” wants it.

Right now, the chances are almost certain that there’s someone – in fact many someones – who want your group’s contract.

Are you going to let them have it?

Comment or contact me if you’d like to discuss this post.

Mark F. Weiss

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