As hospitalizations drops, Beebe decides not to build tower, add beds

Beebe Healthcare is dropping plans to add more beds to its Lewes campus after officials realized fewer people are being admitted to the hospital than in previous years.

Officials don't believe this is a sign of a struggling business, but rather the changing of an ideology in the healthcare industry:

The goal now is to keep people as healthy as possible, not just treat sick people.

"When you look at how hospitals have been paid historically, basically patients were sick and they needed some kind of procedure," said Beebe CEO Jeffrey Fried. "We never got paid to keep people healthy and out of the hospital.

"It's the most exciting thing, to keep people healthy." 

Dr. Kara Odom Walker, secretary of the Division of Health and Social Services, applauded the move and praised Beebe's executives for thinking about the needs of their patients. 

Last July, Beebe Healthcare announced it was going add an additional 60 beds in a four-story tower on its Lewes campus. At the time, hospital officials said this would help accommodate the growing population of people relocating to the Delaware beaches, many of whom are retiring at the beaches.

Beebe planned to spend $103 million on the expansion and begin construction in 2018. It also received a $10 million donation for the project, which was the largest in the hospital's and Sussex County's history. 

Yet in the past year, the hospital's census showed that the daily average number of patients has gone down from 156 in 2017 to 143 so far in 2018. The number of inpatient surgeries has decreased, too.

Walker believes the system's willingness to adapt its plan reflects an understanding of where healthcare is headed, which is hospitals being compensated based on patient outcomes instead of the number of services. For many, that may be focusing on outpatient services and primary care rather than offering more beds, she said.  

"We encourage all hospital systems to think about what people need," Walker said. "More patient-centered care and coordinated care leads to better health outcomes."

Beebe's decision follows a national trend among hospital systems, several of which have downsized or focused more outpatient care do to a decrease in inpatient stays. The Agency for Healthcare Research and Quality reported in June 2017 that the number of inpatient stays for all hospitalization types decreased by 6.6 percent from 2005 to 2014. 

"Growing efforts to reduce unnecessary hospitalizations, greater use of chronic disease management programs, and a shift toward outpatient treatment may result in a decrease in hospital stays," the report said. 

This announcement comes at a time when the state is trying to reduce the amount of money Delaware spends on health care. Officials believe establishing a benchmark would help them see where those dollars are being spent.  

Fried said an increase in home health services, such as nursing care or physical therapy, has helped reduce readmission rates and keep people out of the hospital.  

There has been significant change in the number of inpatient surgeries versus outpatient surgeries, he said. Data shows that general surgery inpatient cases declined by 70 while the number of outpatient cases increased by 329 in the last year.

Orthopedic inpatient surgeries went down by 110 while outpatient procedures went up by 52. 

This means "significant savings" for patients, Fried said. For an inpatient surgery, the hospital is typically reimbursed $20,000, while for an outpatient procedure the hospital is paid an average of $2,000, he said. 

With Beebe cancelling its plans to build the tower, which hadn't broken ground yet, the money will be spent on other ongoing projects, Fried said. 

The $10 million donation from The Ma-Ran Foundation will now go toward expanding the West Lobby on Lewes' campus, creating more parking spaces and remodeling some of the patient rooms. Construction will start this fall on a new campus in Millville, which will include an emergency department and will be a second location for the hospital system's cancer program.

Construction for a specialty surgical hospital on the Rehoboth Beach campus is expected to begin in 2019. It will be a space for inpatient and outpatient surgeries and Beebe's labor and delivery department.

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Contact Meredith Newman at (302) 324-2386 or mnewman@delawareonline.com and on Twitter @MereNewman.