Bristol Hospital President and CEO Kurt Barwis has been sending policymakers a report that paints a grim picture of the future of small community hospitals like the one he runs.
Based on more than a year of research, the report from the Massachusetts Health Policy Commission suggests community hospitals in that state face something of a downward spiral: Patients are increasingly seeking routine care at large academic medical centers or teaching hospitals, drawn by perceptions of quality or referred by doctors who are now affiliated with the larger hospitals.
With fewer patients, the community hospitals lose bargaining leverage with insurers when negotiating payment rates. And with fewer patients and lower payment rates, the hospitals struggle to invest in programs, staff, marketing or the infrastructure needed to adapt to the changing health care system.
