Washington, D.C.-based Providence Health System fired most of its 12-member board of directors via email last week as the hospital transitions away from acute care services to focus on population health efforts. The board members had voted to rescind approval of the transition plan, saying they didn't know how extensive it was when they voted to approve.
The Ascension-owned hospital with more than 280 beds announced in July that it planned to change its care delivery to a "community-focused approach." That change includes moving away from inpatient care and going to care coordination, telehealth, primary and urgent care, home care, community-based behavioral healthcare and senior care.
Providence staff and patients recently protested the change, raising concerns it would leave surrounding neighborhoods without needed access to care. The hospital has maintained that it "will continue to have an important presence in the District of Columbia."
Ascension and Providence are far from the only healthcare companies trying to figure out how to survive in an industry with lower reimbursements from payers and fewer inpatient admissions. Some health systems have moved more services to outpatient care and some have looked to incorporate social determinants of health into their practices. While those attempts are promising, the jury is still out on the financial impacts of including those services.
Providence sees population health and tackling social determinants of health as key to its revamped focus. In a prepared statement to Healthcare Dive on Tuesday, Providence said the changes to the board are part of "transforming to better align the services" with the Washington area's needs.
"The new board will help guide this transformation under the same three core principles that has served as a foundation throughout this process: commitment to the mission, that Providence is not leaving the district and that Providence will be transitioning to best serve the needs of the community," the statements reads.
After facing protests last week, Providence released an additional statement defending its change. The company said there are more than twice the number of hospitals beds in the district as the national average and the area's acute care service needs are being met by providers. Instead, what district patients need is help outside of facilities through population health programs, according to the hospital.
"We know that 15 percent of a person's life is spent in actual healthcare, which means the remaining 85 percent is spent in other areas that either positively or negatively impact their overall well-being," Keith Vander Kolk, Providence CEO, said in a statement. "That is where the greatest opportunity to make meaningful change exists and we must put our focus and energy on advancing a model of transformation that will serve the district in new and lasting ways."
Larger healthcare companies proposing to revamp or close local hospitals have frequently faced pushback from the community. When HCA first announced its just-completed acquisition of Mission Health, residents said they worried the for-profit ownership would result in closed facilities or a decline in services. Mayo Clinic was another recipient of backlash when it introduced a plan to consolidate services at two Minnesota hospitals about 25 miles apart.