0920_September Comstock's Magazine September 2020 | Page 44

HEALTH CARE Daniel Wolcott, president of Adventist Health Lodi Memorial hospital and president and CEO of Dameron Hospital, oversees the latter’s transition to possibly being taken over by Roseville-based Adventist Health. this story either declined to speak or didn’t respond to requests for comment. One of those, Doctors Hospital of Manteca, is a 73-bed facility in San Joaquin County. It lost $11 million in 2018, the latest year for which data are available. Two others — 111-bed Barton Memorial Hospital in South Lake Tahoe and 152-bed San Joaquin General in French Camp — posted solid income gains for 2016, 2017 and 2018. No state data are available for 50-bed NorthBay VacaValley Hospital in Vacaville. As bad as the financial impacts have been in the first months of the pandemic, the long term could be worse. “The timeline is even more scary than you might think,” says Orlov. The summer case spike wasn’t the much-feared second wave but the second peak of the first wave. When infection rates dropped in May and June, getting people to come back to the hospital for elective surgeries went slower than hoped, he says. So if a second wave hits and elective surgeries have to be curtailed again, “when do (hospitals) get a break? I am becoming skeptical — and I don’t have data to support it — I am becoming skeptical that even a year from now that we’re going to see a return to historical levels of hospital and physician utilization.” Then there’s the problem of more patients who can’t pay. An April 3 analysis by consulting firm Health Management Associates reported that in an unemployment scenario in the midrange of projections — 17.5 percent — the number of California’s uninsured would grow by almost 200,000. Nationally, hospitals’ bad debt and charity care in March 2020 increased 13 percent over March 2019 and are expected to rise further, according to an April Kaufman Hall report. The long-term outlook Even if small independent hospitals don’t close, they have tough decisions that will likely mean cutting services. Wipfli’s Johnson says they’ll need to figure out which service lines to keep and which to cut because their margins are low or negative. Subspecialties like orthopedics or physical therapy might get axed, he says. More hospitals with cratering revenues also means that area businesses may need to budget for higher insurance costs next year: Hospitals and other providers could pass along some of their losses to private insurers. In March, Covered California warned that a lack of federal help could mean 40-percent hikes in insurance rates in the individual and employer markets next year. In June, a UC Berkeley School of Public Health study showed that the pandemic had cost California insurers about $2.4 billion for testing and treatment, six times the annual cost to treat the seasonal flu. Only two companies filed requests for health insurance rate changes with the state’s Department of Insurance between April and June. On June 1, Health Net requested a 4.1-percent annual average 44 comstocksmag.com | September 2020