As the coronavirus pandemic progresses, the Yale New Haven Health System faces financial challenges due to increased demand for personal protective equipment, or PPE, and cutbacks in elective surgeries.
When the pandemic started, hospital management had to reorganize their hospital units, close the ambulatory surgical areas and stop elective surgeries. The demand for PPE rose almost fiftyfold, which was not accounted for in the hospital’s budget. Both of these factors placed Yale New Haven Hospital, or YNHH, in a revenue deficit that is just now starting to heal.
“Our financial status [before the coronavirus] was actually very stable and on track from a budgetary standpoint,” said Keith Churchwell, the newly appointed president of Yale New Haven Hospital. “Then the pandemic comes, and it’s a perfect financial storm.”
According to Churchwell, some of the hospital’s main costs were the new technological and electronic requirements that were necessary for managing the patient influx. The hospital doubled their intensive care unit capacity, which meant an increased demand for respirators and video conferencing facilities for both doctors and patients to communicate with family members. This put the hospital in a deficit of “hundreds of millions of dollars.”
YNHH Director of Infection Prevention Richard Martinello said his department has worked closely with the supply team in order to guarantee the necessary equipment for workers.
“Since the beginning of the year there’s been a very clear commitment that, whatever our staff may need, we have made that investment in purchasing,” Martinello said. “PPE is not an area where there have been any corners cut.”
Martinello said that there was a deficit buildup from the peak months of the pandemic when elective surgeries were cancelled, thereby affecting one of the hospital’s main sources of revenue.
The hospital system is just now returning to its original capacity, after months of patients avoiding preventative care or elective operations due to fears about COVID-19.
“I think the biggest impact to the health care system was the lockdown, and since then everything has been reopened and our volume has come back to 100 percent, as units catch up in providing patients with the care that they missed over the last several months,” Martinello explained.
In a remote press conference on Sept. 30, YNHH CEO Marna Borgstrom SPH ’79 and Chief Medical Officer Thomas Balcezak discussed the next steps for the hospital system as they recover from the emergency state caused by the pandemic.
“Yale New Haven Hospital is at capacity, and we are actively working to reassign units that were taken over during COVID,” Borgstrom said “There were some 30 patients awaiting beds this morning.”
Borgstrom also highlighted new developments in the institution’s telemedicine program. Patients’ reluctance to go to the hospital and be exposed to the virus led to a rapid adoption of telemedicine.
Churchwell stated that the health system had already put together significant infrastructure for a telehealth system before the pandemic, which has allowed over 340,000 patients to be treated from their homes since March.
When asked about the possibility of a second wave of coronavirus, Martinello said the hospital administration was concerned but also prepared. At the beginning of August, YNHH saw the lowest COVID-19 rates since the start of the pandemic, but the last week of September had the most sustained uptick in patient numbers since then, according to Balcezak.
According to Martinello, the hospital staff are prepared to respond in a similar way to what was done in the peak of the pandemic “with some refinements based on what we’ve learned.”
Balcezak also emphasized the importance of having patients with chronic illnesses come back to the hospital for treatment, which they were avoiding at the start of the pandemic.
“Our environments are safe, our physicians are here to take care of you, you don’t want to put off something that is gonna have a negative impact for you later,” Balcezak said during the press conference.
Churchwell also showed commitment to maintain standards of patient care and to decrease the overall cost of maintaining the COVID-19 patient units in order to prepare for a possible second wave.
“We’ve been working through every single day to understand the degree of our financial deficit,” he said. “From a health system perspective, we made a commitment to no layoffs, no furloughs of any of our employees.”
Yale New Haven Hospital is located on 20 York St.
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