July 25, 2018
Hilda Martin

Shrinking Bed Counts – How Hospitals are Evolving

In general, health systems are choosing to build hospitals with lower bed counts. Technology, demand and reimbursement changes are all pressures that shift the focus to patient experience, advancing technology, and wellness and preventative medicine. This translates into more outpatient services, private rooms and fewer beds. Take a look at the evolving size of acute care hospitals in the chart below. The average number of beds in hospitals built in the 50’s, 60’s and 70’s was up to 200 beds. These averages were maintained despite the rapid increase in small, rural hospital construction during these decades – largely a result of the Hill-Burton Act which provided subsidies for the construction of government and nonprofit local hospitals. In contrast to those large mid century averages, the hospitals being built in recent years have been at or under 100 beds. Things are certainly changing.

Average Beds By Year Chart

A growing part of this change is a new healthcare delivery strategy – the micro-hospital. A micro-hospital (also known as a “community” or “neighborhood” hospital) can come in many forms but generally includes an emergency department, imaging, lab and up to 20 inpatient beds.  They are open 24 hours a day, 7 days a week and 90% of cases can typically be accommodated without the need to transfer to a larger hospital facility. Some include more space for other types of care and focus on surgery, women’s health and other specialty care. The strategy is to give greater access to an under served community that maybe doesn’t have the volume or the space to support a full-blown hospital campus. This can help expand market share and has the added effect of reserving the main campus beds for higher acuity patients and more complex cases. Another reason the main campus may need less beds. Oh – and one more benefit – they are reimbursed at the hospital rate for outpatient services, unlike a new off campus hospital outpatient development. 22 of these projects broke ground in 2017 and another 22 have either started or will break ground later this year. Many more are in planning.

Micro Hospital Chart

Most of the micro-hospital developments tracked by Revista are in under served areas near major metros and are backed by strong healthcare systems. Some systems are diving in head first and developing several at a time including St Luke’s in Kansas City, Integris in Oklahoma City & Allegheny Health Network in Pittsburgh. These health systems are using micro-hospitals in a multi-pronged approach to deliver care closer to the consumer and expand their markets. In a time when things are changing so rapidly, you are seeing many systems and providers thinking outside the box and being flexible in their approach to care delivery. This means they can deploy the right services when and where it’s needed.  Thinking of using this strategy? Check out Revista to assess needs in YOUR market!