The foundation of institutional health care for the metro Atlanta area suffered a serious crack with the announcement earlier this month that Wellstar plans to close the Atlanta Medical Center, a major component of the city’s overall hospital strategy.
Since 2016, AMC has been one of only two Level 1 Trauma Centers in Atlanta, joining Grady with that high-level emergency care designation. It also has served a high percentage of indigent and low-income patients who now will have to find care elsewhere, if at all.
And lest you think it’s just an Atlanta problem, the domino effect of hospitals being forced to pick up the slack is sure to extend far from the city.
While state and city officials protested the closing plans and the lack of discussions with Wellstar, in the current health care climate can any of us really be surprised when a hospital plans to shut down? Georgia has seen a number of rural hospitals close in recent years, and the aftereffects of the COVID pandemic and the resulting economic turmoil makes it likely there will be more.
Some critics have accused Wellstar of putting profits ahead of patient care, noting the not-for-profit hospital system’s healthy financial bottom line. The company said it has invested some $350 million in AMC over the past six years, in capital improvements and to cover losses, but that it is not financially viable to keep the hospital open.
The company said AMC lost some $107 million in the past year alone. Wellstar said some 16% of all expenses at the hospital were to provide uncompensated care to patients who could not pay themselves, well above a national mean of 3%.
In addition to an influx of indigent care patients who will be looking for help come Nov. 1, there is the issue of loss of one of only two Level 1 Trauma Centers serving Atlanta. The Level 1 designation, awarded by the American College of Surgeons Committee on Trauma, recognizes that a hospital offers the highest level of emergency medical care and is capable of dealing with the most serious of trauma cases.
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There currently are only five Level 1 Trauma Centers in the entire state. Soon there will be only four.
Gov. Brian Kemp on Thursday announced the state, along with local governments and private contributors, will provide more than $130 million in new funding for Grady to attempt to meet the immediate need of increased patient beds and emergency care. But even with that sort of cash infusion Grady is going to continue to face the same sort of significant financial challenges that beleaguer other medical facilities across the state.
As with everything these days, the sudden plans to close AMC have become fodder for debate in the political arena. Kemp has been criticized for years for refusing to expand Medicaid coverage in the state, which would result in more federal dollars for health care coming to Georgia, but also less control at the state level in how those dollars are managed and controlled.
Wellstar has said expanded Medicaid dollars alone would not have been sufficient to save the hospital from closing.
The sudden announcement of plans to close AMC, which dates back to 1921 when it was Georgia Baptist Hospital, shows just how fragile the state’s health care network really is. Hospitals across the state are operated by a combination of for-profit and not-for-profit companies, which independently are responsible for making decisions of economic viability for the facilities they operate.
Over the past decade, eight rural hospitals have closed in Georgia, which reflects a nationwide trend. According to the University of North Carolina, where closures are tracked through its health research center, some 182 rural hospitals have closed across the country since 2005. Most of those were prior to the COVID pandemic.
Now we can add a solidly metro hospital to the closures in Georgia. What’s more concerning is the knowledge that others trying to emerge from the financial ravages of the COVID area may have to follow a similar path.
The pending closure of AMC also reminds us of how important the Northeast Georgia Health System is throughout our area and of the vital role it plays in the community.
In looking at how the state should plan for life after AMC, it would be wise to recognize that of the four remaining Level 1 Trauma Centers in Georgia, none of them are north of Grady, despite the millions of people who live on this side of the city’s core.
With the commitment of local health care officials, and financial support from the state, it’s not out of the question to think that Northeast Georgia Medical Center, with a new emergency department expected to open in 2025, could reach that level of trauma care capability and help to provide badly needed relief for Grady. The possibility is certainly one worth exploring.