More space for hospital means higher costs |

More space for hospital means higher costs

Dear Editor:

I have been a Pitkin County resident and taxpayer in the Aspen Valley Hospital District since 1982. I have a master’s degree in public health and worked as a regional health planner and consultant in Phoenix. Additionally, I was business manager for my late husband’s office for the past 18 years of his medical career. My husband, a Boarded Anesthesiologist, was director of Emergency Services at the University of Michigan in the 1970s. He then practiced in Phoenix in multiple hospitals, large and small, including the Mayo Clinic.

On Monday, the Aspen City Council will consider approval of the final two phases of their expansion, which includes updating the Emergency Services. I do wholeheartedly support renovation of the Emergency Services. However, I have concern, going forward, if there will be adequate patient revenue to sustain the hospital.

Consider the following:

• Patient volume at Aspen Valley Hospital has been “flat” for many years, and is expected to remain so. Concomitantly, job growth in the area is flat.

• The shift of the year-round population downvalley has led to increased utilization of downvalley medical services.

• Part-time residents and tourists may use emergency-room or acute-care services seasonally but may return “home” for regular or elective services.

• Insurance reimbursements to both hospitals and doctors are decreasing, with the prospect that implementation of Obamacare will further depress revenue.

• Many doctors in Aspen no longer accept Medicare, pushing those patients out of the area for care.

• The completed hospital expansion will have added roughly 150,000 square feet of building space to maintain.

In light of the above, taxpayers should be concerned that hospital charges well might have to be increased. Hospitals typically lump all expenses together and then determine patient charges according to expected revenue. Hospitals notably adjust their bills in two ways: 1) to compensate for lost revenue from unoccupied beds or low patient volume; and 2) to allow for deficit in insurance reimbursements, which typically amount to 80 percent of what the insurance companies allow.

There has been alarm around the country that, with changes in reimbursement for health care, many medical facilities are overbuilt and will go bankrupt or shut down partially, if not completely.

Aspen needs a new emergency room, but perhaps a return to the drawing board would help avert financial disaster for Aspen Valley Hospital. Why not ask the hospital to take a step back: renovate the emergency room, reallocate some of the already-constructed new space for most pressing needs, otherwise skip additional expansion?

Ann Smock, MPH


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