On Sept. 17, Stroudwater Associates Inc., a healthcare consulting firm, released a report commissioned by the Massachusetts Department of Public Health (DPH) Office of Rural Health concluding that it may not be feasible to meet the inpatient healthcare needs of Berkshire County Northern District residents.
The DPH commissioned the report following the closing of the bankrupt North Adams Regional Hospital (NARH) last March. According to the report, stakeholders most frequently expressed a need for primary care and emergency services in the region, while obstetric services are the most common need for hospitalization. The report suggests that the inability to provide technology and specialists to the region, even if inpatient services were restored, may mean that consolidating services at the Berkshire Medical Center (BMC) in Pittsfield would afford North District residents better care. BMC purchased the former NARH and opened an emergency facility in the same location so that residents would not have to travel to Pittsfield for urgent care, but Stroudwater found that it would cost millions to replicate the inpatient services BMC offers in Pittsfield in North Adams.
“The report doesn’t focus separately on care for college students … Williams worked with Berkshire Medical Center, Southwestern Vermont Medical Center, Village Ambulance Service and others to put in place systems that, with 911, get our students in a timely manner to the emergency and non-emergency services they need,” Vice President for Public Affairs James Kolesar said.
Stroudwater found that other members of the community advocated strongly for re-establishing inpatient care, claiming that low socioeconomic status and poor transportation systems might limit residents’ access to hospitals located outside of the Northern District, such as BMC. Advocates also told Stroudwater that the Northern District has sufficient healthcare problems, including substance abuse, mental health issues and obesity, to merit a local hospital.
According to the report published by Stroudwater, “The region is worse off than the state and national average for a number of health status indicators. Asthma, most cancers and heart disease incidences are all higher than the state average, and high percentages of the population are overweight, have a disability and report poor general health. Combined, these factors create a vulnerable population for healthcare services.”
The report found the need for 20 inpatient beds for Northern District residents, but did not specify that those beds needed to be within the district.
With many residents relying on public sources of financing for healthcare, it may not be possible for BMC to provide these services in North Adams unless it receives a federal Critical Access Hospital designation, which increases federal reimbursements for rural hospitals that are necessary to maintain access for Medicare beneficiaries.
Stroudwater identified the need for at least six full-time doctors in the Northern District. This need could be met by Community Health Programs, a Federally Qualified Health Center in Berkshire County which received a $200,000 grant through the Affordable Care Act this year to expand its primary care services in the region.
“Among the report’s interesting conclusions is the possible role to be played, in addition to that of Berkshire Health Systems, by Community Health Programs, a federally qualified health center operating in central and south county that is considering an expansion north,” Kolesar said. “Though their doors are open to all, their main focus is serving people with otherwise limited access to health care.”
The report did suggest that expanding outpatient care in North Adams, including emergency services, may be cost effective.
“If more services are returned to North Adams, as the study proposes, that would make for shorter rides for some students,” Kolesar said. But, “The closing of the hospital was a painful way to accelerate the planning process, but the evolution of health care was already happening nationally, regionally and locally.”