Is the end near for small community hospitals?

Are the days numbered for Salem Community Hospital and other community hospitals around the country? Recently, a local story happened that made me think of this.

The announcement was made that the Akron General Health System was being purchased by a joint venture of Cleveland Clinic and Community Health Systems (CHS). CHS is a Tennessee-based hospital operator who also owns three other hospitals in the Northeastern Ohio area where I live.

Six months ago, Akron City Hospital along with the rest of the Summa Health System announced that they were joining Catholic Health Partners (CHP), the largest hospital system in Ohio.  CHP owns a hospital in the Youngstown, Ohio market, close to where I live.

There are two hospitals in Columbiana County: Salem Community Hospital and East Liverpool City Hospital. As of this second, these two hospitals are still independently owned and operated, but for how long?

I am by no means a hospital policy expert. But, it’s not hard to see that across country, smaller hospitals are either being bought or joining larger hospital systems. This has already played out in Ohio’s larger cities of Cleveland, Toledo, and Columbus.

Salem Community Hospital (SCH) is in the midst of building a new patient tower with 87 private rooms. SCH also boasts the area’s only 3T open MRI unit between Cleveland and Pittsburgh. On the negative side, SCH recently announced the resignation of their CEO, but states that current leadership is still committed to the future. Will all that be enough to sustain hospital independence, or is aligning with a larger hospital system (like Cleveland Clinic, CHS, CHP, or even University of Pittsburgh Medical Center) inevitable at some point?

Why one-third of hospitals will close by 2020” is an essay that says, “What hospitals are about to enter is the place Americans cherish: the open competitive market. We know what happens in this environment. There are winners and losers.”

Not so fast says Becker’s Hospital Review in an article entitled, “Hometown Healthcare Isn’t Dead: Why (Most) Smart Community Hospitals Can Still Thrive.” The hidden strengths of community hospitals, according to the article, include nimbleness to adapt to change and the ability to achieve higher quality, greater patient engagement, and lower cost — easier than the larger hospitals.

What will be the ultimate fate of Salem Community Hospital and others like it? Some say that the hospital industry will be like the airline industry where there will be a few large players nationally and the small companies will merge or fail.

I think the community hospital model will be similar to the banking industry. There will always be that locally owned community bank that the community gets behind and supports because it is neighbors helping neighbors. The only way small community hospitals will survive is if the community finds value in it and will continue to support the hospital, not only in its hospital services, but also with word of mouth and positive community reputation. Without that, you might as well pick who you’re going to merge with, or close up the hospital altogether.

Mike Sevilla is a family physician who blogs at his self-titled site, Dr. Mike Sevilla.

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