Central Ohio is in the midst of a hospital building boom. All four major hospitals are expanding or planning to expand in the coming years. The $2 billion in new construction comes as health care reformers are trying to control medical costs. In the first of a two part series WOSU looks at the impact of the projects.
Metal and other scrap materials fall into a large bin near the edge of the Children's Hospital construction site on Parsons Avenue.
Children's is spending $840 million to renovate and expand its campus - including the construction of a 12-story, 750,000 square-foot inpatient tower.
It won't be long before construction sites like Children's become semi-permanent fixtures at hospitals around the city.
Ohio State University Medical Center recently announced a $1 billion expansion. OSU will build a new James Cancer Hospital and a critical care building. Mount Carmel plans to build a new cardiovascular center that would allow for open heart surgeries at Saint Ann's Hospital in Westerville. And Ohio Health has told city officials it plans an expansion to Riverside Hospital which could include a cancer hospital.
Combined the central Ohio hospital projects could cost as much as $2.4 billion.
So, it begs the question, at a time when the country and lawmakers are trying to reign in health care costs, is all this hospital construction really necessary?
"We sure think it is."
Doctor Steven Gabbe is OSU Medical Center's CEO. Gabbe said OSU has to build a new hospital. He said the current James Cancer Hospital is 20 years old and the critical care facilities also are aging. Gabbe said the hospital is near capacity most of the time and critical care patients have been turned away because of a lack of room.
"It's really a challenge for us to meet the needs of the patients and their families and of the referring physicians," Gabbe said. OSU's story is not unique. Children's Hospital's Senior Vice President for planning Patty McClimon said its current buildings are almost 50 years old.
"Those buildings do not support the technology, the air quality and the types of systems that a modern patient care building would support," McClimon said.
And Mount Carmel Saint Ann's CEO Janet Meeks said area doctors and EMS workers have said for years the Westerville hospital needs to expand its cardiovascular capabilities.
"Inpatient discharges at St. Ann's have grown by 25 percent which is a huge increase in our volume," she said.
The projects will boost employment. Executives predict the expansions will produce more than 17,000 new jobs.
But someone has to pay the $2.5 billion construction bills and critics fear the costs will show up in patient bills and health insurance premiums.
Cathy Levine directs Ohio's Universal Health Care Action Network. It's a consumer health advocacy group. Levine said she's troubled by the projects
"There's a growing body of research that shows the more you build, the more health care treatments you do. That areas that have two hospitals provide more procedures to patients than areas with one hospital because they've got to pay for the buildings," Levine said.
And critics worry about duplication of services. Columbus already has two heart hospitals - Saint Ann's unit would be a third facility catering to cardiovascular care. OSU's James Cancer Hospital is nationally renowned. If Ohio Health chooses to expand its cancer facilities it would compete with the James for patients and doctors.
"We do know that if you spread specialty care over a larger number of facilities the quality of care at each facility is going to go down," Levine said. Kelly Devers is a senior fellow at the Urban Institute in Washington, an economic research firm. Devers said many hospitals feel they have to expand because aging baby boomers - and to keep up with market competition.
"For fear that they will be seen as out-of-date or perhaps not offering the kinds of technological options and amenities...sort of comfortable patient rooms," Devers said.
Comfort is a big part of the building plans. Some of the expansions will feature large green spaces and gardens. OSU's new hospital will have all private rooms with windows, many overlooking the so-called grand concourse and what it touts as an aesthetically pleasing landscape. And its new critical care unit will offer apartment-like rooms. Children's will also feature a park, garden and larger patient rooms to be more comfortable for family members who stay overnight.
Both OSU's Gabbe and Children's McClimon say such features are proven to speed up patients' recovery. McClimon said having the green spaces will reduce the length of stay and in theory reduce costs for patients.
"The co-pay would be based on how long the patient stays, and if the patient stays for a shorter period of time the co-pay would go down," McClimon said.
Both hospital executives also say the new facilities will be more energy efficient - further reducing costs.
As for the keeping up with the Doctor Joneses argument...OSU's Gabbe said they are not trying to one up each other.
"It's not competing with hospitals in the communities. It's meeting the needs of patients and their families. It's being one of the highest quality and safety hospitals and some of that comes with new facilities," Gabbe said.
Kelly Devers said it's difficult to predict a community's heath care needs 10 to 20 years in the future.
"Guess what, a lot of planners get it wrong because it's tough to do. It's like reading a crystal ball. And if you guess wrong you pay a heavy price," she said.
But Central hospital executives are confident they have got it right.
In part two of the series, WOSU looks at the changes in state law that made hospital expansion easier. And WOSU profiles an area of Columbus still under served despite all the new construction.