8 Reasons Why Hospitals Should Reduce Bed Volume

Cheryl Clark, for HealthLeaders Media , October 6, 2011

There are nearly one million hospital beds in the United States. But I've been wondering, what are we going to do with all the empty ones if the healthcare industry successfully achieves the goals of reform?

Should hospitals start thinking about closing them down? That's anathema to the premise under which the industry has functioned for decades, which holds that the number of services, buildings and patients must grow to stay in play and maintain respect in the community.

Before you ask what I've been smoking, (nothing!) hear me out:

1. One in five or six patients is now readmitted within 30 days, but penalties and incentive programs can dramatically prevent those readmissions. A one-third reduction is not an unreasonable achievement, Elliott Fisher, MD, director of the Dartmouth Institute's Center for Population Health, told me last week.

Fisher lamented how hospitals that have successfully reduced readmissions have turned around and launched questionable service lines that don't improve care, such as spine surgeries. Hospitals are expanding volumes for procedures that, given correct and balanced information about their effectiveness and their alternatives, he says, patients would choose not to have.

"With hospitals that are dependent on fees for maintaining hospital margins, reducing unnecessary readmissions and avoidable admissions causes revenue losses, which will lead them to admit other patients to the hospital" for these elective procedures, he said.

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3 comments on "8 Reasons Why Hospitals Should Reduce Bed Volume"

OR MD MBA (10/8/2011 at 9:04 AM)
So lets take a routine patient. Grandma's not acting right, ends up being a mild UTI. Probably could go home by many standards but family is insistent. She was just in 3 wks ago with a generalized weakness/UTI so in reality it's a social admission b/c family can't deal with her right now. So, do I readmit her and get dinged or do I refuse the admission and piss off the family and get low satisfaction scores under HCAHPS. Oh, and while I'm spending all this time explaining why she can't be admitted, the waiting room is backing up increasing my wait times which is a new P4P CMS metric. Or better yet, I cave in and re-admit her and because there's less beds, she is now a hold in my ER. Can't wait for your rose colored healthcare world.

Lewis Allen (10/7/2011 at 9:26 PM)
I've performed laboratory work for a few decades now and believe you've missed the mark regarding hospitals and census counts. Hospitals are already closing beds, rooms and entire wings. Insurance providers have been forcing these closures for years as they decrease reimbursement for hospital services, jack up rates and/or deny coverage to patients, while ensuring they themselves receive 100 cents on the dollar as payment (ala Blue Cross/Blue Shield). Insurance providers have become the "attack dogs" for Socialist government policy, whose goal is to consolidate medical services into few, huge, "Centers of Excellence", where they can pay as little as possible for such "excellence". I assure you that patients are ill-served by having to travel 3 or 4 hours to a "center of excellence" for regular medical care. And let's not forget intense, Lawyer Greed, that has crippled physicians abilities to pay enormous premiums to simply "go to work". Physicians are forced to pass costs along or be forced into retirement. Fewer practicing physicians means worsening and unhealthy outcomes for needy patients.

JRG MD MBA (10/6/2011 at 7:56 PM)
Most of your analysis sounds like either wish fulfillment or you have been smoking something. Have you ever spent as much as a day providing any sort fo medical care?




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