By Theodore Lewis
Hope for Guam's health care
Having another hospital in Guam's medical portfolio has brought several advantages to the island’s residents
At the end of 2019 prior to the pandemic, things were looking up for the Guam Memorial Hospital.
With a new management team in place, and its major competitor, the Guam Regional Medical City, having closed the GRMC Maternal Child and Urgent Care units, GMH finally regained the inpatient market share after more than three years of losing it.
GRMC’s Medicare Cost Report for the January to December 2019 period is now available. Combining the GRMC Medicare Cost Report information along with the published GMH annual audited statements, we can now evaluate the total civilian hospital major indicators for fiscal years ending Sept. 30, 2019 for GMH and Dec. 31, 2019 for GRMC and see the comparative changes in 2019 from 2018.
The inpatient admission is a core foundation of hospitals. From its startup in 2015 through 2018, GRMC had systematically taken about 40 percent of the inpatient market share away from GMH, which devastated the government hospital’s operations.
This trend was reversed in 2019 when GMH’s inpatient admissions increased by 1,924 while GRMC’s admissions decreased by 1,753. This was the result of GRMC’s closure of its Maternal Child and Urgent Care units.
The total number of inpatient admissions on Guam was virtually the same in 2019 (13,114) with two hospitals as it was in 2014 (13,117) when GMH was the only civilian hospital on island. (The Guam Naval Hospital serves only the military community.)
One of the goals of the second civilian hospital was to provide medical services to local patients, who would otherwise seek treatment off-island. In this respect, however, GRMC has not succeeded.
Seventy-one percent of GRMC's 3,532 inpatient admissions were either Medicare or Medicaid patients. Only 29 percent of its inpatients were not in the Medicare-Medicaid categories.
GRMC benefits from unique federal reimbursements available to territorial hospitals that are cost-based. Most U.S. hospitals get reimbursed for inpatient care based on prospective diagnosis-related groups.
Having another hospital in Guam's medical portfolio has brought several advantages to the island’s residents. Additional specialists and outpatient services offered by GRMC have given those living on Guam options they didn't have before.
Also, Guam's economy has seen a 51 percent increase in total healthcare jobs employed by the two hospitals compared to pre-GRMC days (1,662 in 2019 versus 1,101 in 2014). In the same fashion, there has been a significant increase in the work for vendors on Guam that support hospital services.
During the pandemic year, having two hospitals has been a godsend.
With an additional hospital provider on Guam, the unique and unanticipated scenario of a pandemic has given the island additional resources and expertise to help in the fight against a devastating virus.
While Covid-19 has been devastating to the utilization, finances and overall operations of Guam hospitals, the unique crisis has brought an unanticipated potential benefit. Significant funding (through the federal government’s pandemic relief allocations to Guam) will cover a sizable portion of the construction cost of a new hospital. Based on the Army Corps of Engineers’ projection, it will cost $743 million to build a new medical facility comparable to GMH.
This potential funding gives us hope that the government will succeed in developing a new hospital.
Let's hope that they will also be successful with the more immediate challenges of current building repair and meeting Centers for Medicare & Medicaid Services’ requirements and accreditation standards.
When it comes to GMH, hope springs eternal.
Theodore Lewis is former CEO of Guam Memorial Hospital and has a health care consulting business based out of Portland, Maine. He is collecting stories about lessons learned in life and can be reached at firstname.lastname@example.org.