Beebe, Bayhealth look to add emergency departments

Officials at both Bayhealth and Beebe Healthcare are waiting for the July 25 decision by Delaware’s Health Resources Board to approve or deny applications from each to build freestanding emergency departments within a few miles of each other.

Bayhealth is hoping to put a 35,000-square-foot complex — including doctors’ offices with extended hours and that accept walk-ins — at Route 9 and Hudson Road in Harbeson, said John Van Gorp, senior vice president of Planning & Business Development at Dover-based Bayhealth. It would open in 2021 and cost between $15.5 million and $17.2 million.

Beebe’s plan is to build a 14,000-square-foot, $20 million freestanding emergency department (ED) on Route 404 in Georgetown, about 7 miles from Bayhealth’s proposed site. According to Beebe representatives, 63 people, including doctors, would be hired. It would open in the summer of 2021.

Beebe is already building a free-standing ED in Millville, which would be closer to Ocean View and other local towns. Costing $48 million, it is expected to open in January 2020, offering services including CAT scans, ultrasound and imaging.

Certain healthcare facilities and projects that are reviewable through a certificate of public review must be approved by the State, Van Gorp explained. They include in-patient beds, catheterization labs and emergency departments.

The Health Resources Board assigned three committee members to review the requests. That subcommittee has recommended denying the applications, largely because Gov. John Carney wants to cut healthcare costs by lessening ED use, unless it is absolutely necessary.

“Typically, the board does take the advice of the smaller committee,” Van Gorp told the Coastal Point, adding that he has only seen one time in the past dozen years that the subcommittee’s recommendation was overruled.

“I feel like it’s an uphill challenge to overturn the sub-committee’s recommendation. Anything can happen. It has happened in the past and it can happen again,” he said.

“One concern is if you have an additional free-standing ER, it will allow people to use it more. If they are using it more, then there will be more ER visits. That drives up the cost of care. The State is a payer for health services. They are the largest employer in the state and oversee the Medicaid program. So, they are concerned about the cost of care, as are we. But we’re doing everything we can to work with them to control cost and utilization,” Van Gorp said.

“How do you improve access to services to a community? When we look at that area, there are significant issues on Route 9, especially as you approach Route 1. In-season, it is very difficult to get access to Beebe’s emergency department. There is not a lot of healthcare between Route 1” and the proposal’s target area.

“We aren’t looking at just a freestanding ER. We are looking at an ambulatory center, including a primary-care physician, specialist physicians, full-service lab, diagnostic imaging center, as well as a freestanding ER,” Van Gorp said.

Even if Bayhealth’s proposal is denied, it still intends to open the doctors’ office, with extended hours and services for walk-in patients.

It’s true that emergency room care is more expensive, he said, because emergency departments have to be staffed around the clock, every day of the week, provide diagnostics and accept every patient — even the uninsured. But the high retiree population, which is only growing, must be taken into consideration, he said.

“This is one of the fastest-growing areas in the state. So, with retirees — and Medicare patients are higher users of emergency services and more susceptible to having access — what if they have difficulty driving? They might not have family members in the immediate area. This would help make access so much easier,” he said.

Beebe Chief Strategist Alex Sydnor said Beebe officials were “very disappointed the sub-committee did not see value in providing better access to emergency medicine,” although there is a right to appeal, if the request is denied.

“We remain optimistic, but the Review Committee did vote to decline both applications, so it would take some different consideration by the Health Resources Board to come to a different conclusion. We already have a walk-in center in Georgetown and Millsboro. We’ve seen substantial growth to our walk-in centers in Millsboro and Georgetown, as well as other areas. It helps make people not go to the ER if they don’t have a real emergency,” he said.

Sydnor said he doesn’t believe both EDs are needed. He called it “a redundancy” and stated his opinion on the application.

“If you have a condition that can be treated in a primary-care office or walk-in clinic, it can be less expensive, but what happens to all those people who are experiencing a true emergency? That is where there is a big hole, although we would never encourage people to use the ER if they don’t have true emergencies.

“The cost could be higher in the emergency room. That is why we invested in walk-in care. We put those on adjacent sites. If you know you don’t have a true emergency, that is the preferred site,” he said.

True ER emergencies include not only life-and-death situations, but injuries, broken bones, head trauma and suspicion of concussion, he said.

If both ED’s are approved, “We will move forward and adjust the best we can to the fact that there is another ER,” Van Gorp said.

“Our goal, our mission, is to improve access to the community. We are extremely hopeful that the Health Resources Board does revisit the criteria that was reviewed and, hopefully, by looking at it … they will see there is enough information to overturn the committee’s decision,” he said.

 

By Susan Canfora

Point Reporter