Washington, D.C., Hospitals Strained by End of Inpatient Care at D.C. General Hospital, Executives Say

Washington, D.C., Mayor Anthony Williams' (D) decision to privatize the city's indigent health care system has financially "strained" area hospitals and has impacted access to care, health officials told the mayor at a Dec. 9 meeting, the Washington Post reports. Last year, Williams closed D.C. General Hospital, formerly the primary provider of the care for the city's indigent, and replaced it with the D.C. Healthcare Alliance, a privatized consortium of health providers. Under the plan, Greater Southeast Hospital became the primary facility for patients enrolled in the alliance who require hospitalization or trauma care (Goldstein, Washington Post, 12/10). However, Greater Southeast filed for bankruptcy last month after its parent company, Doctors Community Healthcare, also filed for bankruptcy on Nov. 20, following the collapse of health care lender National Century Financial Enterprises on Nov. 18. National Century filed for Chapter 11 bankruptcy protection because it owed approximately $3.6 billion to bondholders, large money-management firms that buy bonds and other creditors. Doctors Community is the general contractor for the D.C. Healthcare Alliance (Kaiser Daily Health Policy Report, 12/3).

Increasing Pressure on Private Facilities
Critics told the mayor that downgrading D.C. General into an urgent care facility and the collapse of Greater Southeast has led to an increase of uninsured patients at private hospitals around the area. Further, hospital executives said that crowded emergency rooms have forced facilities to divert ambulances to less crowded facilities (Washington Post, 12/10). Williams defended the privatization plan, but he acknowledged that the alliance "must be more effective" in reimbursing hospitals for services and "must assess the effect" of indigent patients on city emergency rooms and ambulance diversions on EMS services, the Washington Times reports. During the meeting, health providers and officials identified solutions to reforming the system, including recruiting, training and retaining medical personnel, reimbursing hospitals expediently, streamlining eligibility under the system and dealing with "overwhelmed emergency rooms" (Bhatti, Washington Times, 12/10).