City of Worcester, MA in the winter

Impact - Worcester City Hospital

The Issue

Vintage image of Worcester City HospitalBy 1990, Worcester City Hospital, which had played a long and distinguished role in the City's health care system since it had been built in 1871, was in serious financial trouble. It had a total deficit of more than $30 million.

The Research Bureau conducted a two-part study. The first part documented the long-term trends that made it impossible for the Hospital to survive as an acute care facility, and recommended that it to be closed. The second suggested that the Family Health and Social Service Center (now the Family Health Center), a private, nonprofit community health center, relocate its operations from Main Street to Worcester City Hospital so that residents of Main South could have expanded access to primary care and ancillary services.

In its first report, the Research Bureau found that Worcester City Hospital had the lowest occupancy rate (46%) of all hospitals in the City, the longest length of stay (25% - 30% higher than the other hospitals), and the highest costs per discharge (about 100% higher than other hospitals). It had the highest percentage of patients on Medicare, Medicaid and uncompensated care, and a rapidly declining patient base with private health insurance, making it impossible for its revenues from this patient mix to sustain the cost of providing services. Finally, fewer than one-quarter of total inpatients from the adjacent Main South area were opting to use Worcester City Hospital. In brief, Worcester City Hospital suffered the same problems as most public hospitals nationwide once Medicare and Medicaid enabled the indigent and the elderly to get care at any hospital. The introduction of cost containment measures also made it difficult for public hospitals to compete.

The Results

In 1991, the Commonwealth's Secretary of Health and Human Services David Forsberg, negotiated an arrangement that closed Worcester City Hospital as an acute care hospital and transferred operational responsibilities to the University of Massachusetts Medical School and Hospital. (When the Medical School and UMass Hospital were separated in 1998, UMass Memorial Healthcare assumed responsibility for the Campus.) UMass Memorial rents space to the Family Health Center to provide ambulatory comprehensive primary health care as recommended in the Research Bureau report. In addition to providing primary care to families, the Center offers many specialty services, including care for mental health, HIV, diabetes, teen pregnancy, and dental services. It also includes lab, radiology (mammography and ultrasound) and pharmacy. School-based health centers run by the Family Health Center in four area schools and dental services in southern Worcester County provide further outreach. As a site for the University of Massachusetts Medical School's Family Practice Residency Program, Family Health Center is a teaching facility and one of the few medical residency programs in the country that is based in a community health center. It now hosts a dental residency program as well. The West Building of the former hospital was renovated and the Center occupies three floors employing about 250 skilled The Center's annual operating budget of $15.5 million supports more than 83,000 annual patient visits. The former City Hospital campus is also home to Community Healthlink, the mental health agency of UMass Memorial.

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