Hahnemann is too important to close. Our leaders must fight for it | Opinion

August 14, 2019 6:30 am

By Syed Z. Kaleem, Clarissa O’Conor, Susan Bowes, Shanna Hobson, and Jenna Mechalas

Two days after a successful 10-year agreement between UPMC and Highmark in Pittsburgh, tragedy struck in Philadelphia when Hahnemann University Hospital announced its decision to close by September.

With only weeks left to avoid a disaster for underserved Philadelphians, we cannot allow this hospital to shut down. As long as we do not have universal coverage in this country, our state leaders must advance the fight for Hahnemann’s long-term stability and increase its funding because Philadelphians vitally depend on it.

Hahnemann University Hospital is a historic place that has served Philadelphia since 1848. It sits in Center City, a prime location for serving the underserved and executing its role as one of the region’s largest safety-net hospitals. With 496-beds, it had 17,179 in-patient stays and 53,136 emergency department visits in 2017, according to data from the Pennsylvania Department of Health.

Hahnemann’s emergency department houses essential public health programs targeted for the local community, like Healing Hurt People (HHP).

This group targets urban violence by helping victims cope with the effects of trauma and use their unique situations to make productive changes in their lives. It connects victims of urban violence with social services and Community Health Worker Peers, who graduated from the program and understand the circumstances these patients come from.

Since its establishment, HHP has become a model for programs in Portland, Ore., and Chicago, Ill. This is one of the invaluable resources in Center City that is threatened by the instability of Hahnemann University Hospital.

The hospital has seen numerous rounds of administrative leadership due to its place in Philadelphia as a for-profit safety-net hospital and the difficulties that conflicting status inherently presents. This is the crux of the issue for keeping Hahnemann running. Without universal coverage, a for-profit hospital will naturally discontinue care for a community that cannot afford its high costs.

Safety-net hospitals are vital centers that serve primarily low-income, underserved communities. In Philadelphia, the emergency room serves an important, albeit unintended, role in providing primary care to many patients.

Patients reported choosing the ER over a private office because of cheaper care, a better perception of quality of care, and easier transportation, according to a 2013 Robert Wood Johnson Foundation study conducted in Philadelphia. Yet, Hahnemann stopped admitting patients to its ER weeks ago.

Additionally, most of the patients served by Hahnemann receive health coverage via Medicaid and Medicare. Medicaid reimburses for two-thirds the rate of Medicare, usually making it a loss for the hospital to serve Medicaid-covered patients.

Even Medicare reimburses hospitals less than the billed amount, so Hahnemann’s for-profit business model of taking on government-covered patients for almost two-thirds of its admissions was broken from the start. A hospital serving this population cannot feasibly sustain itself on its own. We must increase Hahnemann’s funding now and push for a long-term solution in universal coverage.

Hahnemann is neighbor to another safety-net system – Temple University Hospital. Temple has found avenues to sustainability through continued negotiations with the state and by adopting a non-profit 501c(3) tax status.

Temple’s state supplementary payments for its Medicaid admissions have only gone up over the past decade, reaching over $155 million in 2018, allowing the hospital to continue providing for its predominantly underserved patients.

And that is the point – like Temple, Hahnemann University Hospital should not be expected to serve its community alone.

While the state has already allowed Hahnemann’s administration to delay payments for the Philadelphia and Statewide Hospital Assessments, and even mobilized $15 million for the hospital weeks ago, more action is required to overcome this crisis.

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With $300 million in operating deficits, the $15 million from state officials will only maintain some operations – the hospital’s closing is still the plan. With such poor progress in keeping Hahnemann’s services operating, even its maternity ward closed weeks ago. We must act now if we are to restore healthcare access for the tens of thousands who rely on Hahnemann every year.

We medical students at Drexel University College of Medicine and nurses at Pennsylvania Association of Staff Nurses and Allied Professionals (PASNAP) call on Gov. Tom Wolf to increase public funding for Hahnemann so it remains open past September.

We also urge Philadelphia Mayor Jim Kenney to live up to his office’s ideals and call for immediate action alongside us.

Finally, we emphasize to all Philadelphians that you can do something, too – call Wolf’s office and let him know how Hahnemann’s closing is an issue that has left tragedy behind for you or your loved ones.

Share your story by calling Wolf’s office at 717-787-2500. Until we have universal health coverage, Hahnemann’s closing is a disaster we must avoid at all costs.

With the hospital’s history of providing for Philadelphia for more than 170 years, it is a moral imperative for Pennsylvania’s leaders to actively secure Hahnemann’s financial success.

Without them, almost two centuries of progress in improving public health and ensuring health care for all in Philadelphia will be completely lost.

Syed Z. Kaleem and Clarissa O’Conor are medical students at Drexel University College of Medicine. Syed Z. Kaleem is a member of Doctors for America. @ZaneKaleem on Twitter. Susan Bowes, Shanna Hobson, and Jenna Mechalas are nurses at Hahnemann University Hospital. They are members of the Pennsylvania Association of Staff Nurses and Allied Professionals. They write from Philadelphia.

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