{"id":432482,"date":"2020-05-11T16:48:46","date_gmt":"2020-05-11T20:48:46","guid":{"rendered":"http:\/\/www.rochester.edu\/newscenter\/?p=432482"},"modified":"2020-05-12T09:42:57","modified_gmt":"2020-05-12T13:42:57","slug":"covid-19-hospitals-business-model-432482","status":"publish","type":"post","link":"https:\/\/www.rochester.edu\/newscenter\/covid-19-hospitals-business-model-432482\/","title":{"rendered":"COVID-19 demands a reckoning with hospitals\u2019 fee-for-service business model"},"content":{"rendered":"

American hospitals have to operate at near-maximum capacity when it comes to patients and procedures\u2014just to remain financially viable.<\/p>\n

Now, many hospitals are facing a budget crisis, revealing \u201cthe extent to which their business model is structured to reward high-cost surgeries over the very type of routine care that COVID-19 is demanding,\u201d argues physician and historian<\/a> Mical Raz<\/a>, the Charles E. and Dale L. Phelps Professor in Public Policy and Health at the University of Rochester<\/a>.<\/p>\n

The pandemic has made clear that a health care system that prioritizes volume\u2014specifically of procedures\u2014\u201cis structurally incapable of sustainably responding and adapting to such an unprecedented challenge,\u201d Raz writes in a Washington Post<\/em> op-ed<\/a>, published in the newspaper\u2019s Made by History<\/em> section.<\/p>\n

Financial considerations slowed the decision by many hospitals to postpone elective medical interventions. Raz notes:<\/p>\n

In mid-March, a month and a half after the first diagnosis of COVID-19 in the United States, Surgeon General Jerome M. Adams urged specialists to reschedule elective procedures when possible and medically safe. Such a pause promised to free up operating rooms and post-surgical units for COVID-19 patients and to direct limited resources, including personal protective equipment (PPE), to front-line providers.<\/p>\n

Yet, initially, this suggestion provoked backlash from powerful groups that represent hospitals and medical colleges, because the revenue from such procedures is critical for their financial survival.<\/p><\/blockquote>\n

As the country opens back up and procedures are scheduled, she concludes that \u201cit is important to consider the often invisible structures of our health-care system, and how we might restructure them to create a more adaptive system less based on volume and the political battles of the 20th century.\u201d<\/p>\n

Raz, an expert in public policy and health, is the author of What\u2019s Wrong with the Poor? Psychiatry, Race and the War on Poverty<\/em> (University of North Carolina Press, 2013) and The Lobotomy Letters: The Making of American Psychosurgery<\/em> (University of Rochester, 2013). Her third book, Abusive Policies: How the American Child Welfare System Lost Its Way<\/em><\/a> (UNC Press), is forthcoming.<\/p>\n