Now that Beth Israel Hospital is a month away from shutting its doors, its remaining patients must seek care at surrounding medical centers. Hospitals say that the shift won’t necessarily bolster their finances.
A judge dismissed the lawsuit blocking Beth Israel’s closure on Monday, clearing the way for Mount Sinai to ramp down operations at its 16th Street hospital by its target date of March 26. Neighboring hospitals have been preparing for the closure for months, as patients were transferred to other facilities during months of legal battles and a dragged-out approval from the state.
When a hospital closes, it’s up to neighboring health care facilities to absorb the patients who would have gone there. In this case, that’s Bellevue Hospital, NYU Langone’s flagship facility in Kips Bay, New York-Presbyterian Lower Manhattan and Lenox Health Greenwich Village. But Beth Israel’s patients – more than 80% of which are enrolled in Medicare and Medicaid – aren’t likely to offer a lucrative boost to surrounding facilities.
The bulk of Beth Israel’s cases arrive through the emergency department, which treated 64,000 patients in 2022, according to a Health Department analysis of the hospital closure. A relatively small portion are placed in a hospital bed, with 86% of all patients that show up in the emergency room characterized by the agency as “treat-and-release” – meaning their ailments didn’t require advanced care.
Health officials estimated that most of the patients who were previously treated at Beth Israel could go to urgent care centers instead, and Mount Sinai expects the majority to transfer over to an urgent care clinic it plans to open at New York Eye and Ear Infirmary. Still, NYU Langone, New York-Presbyterian and Bellevue have already seen increases in volume and anticipate that they’ll treat more patients when Beth Israel closes for good.
A representative from Northwell Health declined to comment on the impacts on Lenox Health Greenwich Village.
The increased volume doesn’t necessarily translate to increased revenue. Although emergency visits at NYU’s Tisch Hospital increased 26% between January and August of last year, the increase has contributed to a negative operating margin, said Steve Ritea, a hospital spokesman.
The fiscal pressures stem from the fact that 83% of Beth Israel’s patients are covered by Medicare or Medicaid, which pay hospitals a lower rate than private insurance companies, Ritea said. The surge has also increased staffing costs and created the need for seven inpatient beds and two emergency room bays to keep up with the influx, he added.
Bellevue Hospital, part of the city’s public hospital system, is expected to take in the largest number of emergency room patients from Beth Israel because of its requirement to take patients regardless of income or insurance status, Dr. Douglas Fish, medical director at the Department of Health, said in court documents.
The public hospital system has long anticipated the impacts of the Beth Israel closure. Dr. Mitchell Katz, president and CEO of New York City Health + Hospitals, said at a City Council hearing last year that H+H would have to renovate a ward at Bellevue to take between 50 and 70 additional patients and expand the emergency department if the hospital closed.
“I am very concerned for capital costs for Bellevue because it’s such an old building,” Katz said during testimony. A new ward “could easily cost” H+H somewhere between $40 and $50 million, he added.
“The closure of Mount Sinai Beth Israel underscores the importance of investing capital funds into the city’s public hospitals,” said H+H spokeswoman Stephanie Buhle, adding that the public hospital system’s infrastructure is 17 years old on average compared to 9 years old for other local hospitals.
Mount Sinai has agreed to invest $28 million to expand Bellevue’s emergency department, part of the Health Department’s requirements to close Beth Israel. Buhle said that H+H will continue to advocate for funding for Bellevue and its other hospitals from city, state and federal officials.
