In the early days of the pandemic Munson Healthcare administrators were in a flurry of panic.
They launched a telehealth program in a matter of weeks. Dependable supply chains dried up overnight as supplies were diverted to hospitals in coronavirus hot spots. The remaining available personal protective equipment cost 10 to 20 times the normal rate.
Munson’s President of Ambulatory Services and Value Based Care Laura Glenn described it as a game of whack a mole.
“You would be working on a problem. You’d get that one resolved and then another one would pop up,” she says.
Fast forward to June, three months into the pandemic and Munson isn’t treating any patients for COVID-19.
But they’ve missed a lot of business when the system’s surgeries, including joint replacements and cosmetic surgeries, were suddenly cancelled. That and a drop in outpatient visits cost Munson millions of dollars in lost revenue over two months.
Even so, hospital officials are still saying they’re not going back to business as usual.
Governor Gretchen Whitmer cleared hospitals to perform elective procedures again on May 21. But Munson representatives say they are carefully choosing which procedures to book when, while making sure it doesn’t impact other patient care.
For example, Glenn says some procedures, like open heart surgeries, require an extended stay in an ICU bed. Glenn says they’re mindful when booking procedures to account for other possible needs.
“We still have to ensure that we are prepared in the event there is another spike in COVID cases in the community,” she says.
During the period the governor closed some hospital services, Munson lost 50-60 percent of its typical patient load. Since then, inpatient and outpatient visits have improved, Glenn says. But she notes it will be a while, how long she doesn’t know, before patient visits return to normal.
In the meantime, Munson officials monitor positive cases in the region and keep track of their equipment, bedspace and available testing, factoring each data point into the equation of how to operate the hospitals.
To the south, Spectrum Health hospitals in Ludington and Big Rapids welcomed patients back quickly.
The Chief Medical Officer for Spectrum West Michigan Region Josh Kooistra says his hospitals are over capacity, trying to fit in procedures that were delayed like colonoscopies.
As of the second week in June, there were 50 to 60 Spectrum patients who tested positive for COVID-19. Kooistra says he’s confident in the hospitals’ projections that they won’t see a spike in COVID-19 patients.
“With those models, and with our ability to safely procure PPE and know that we had enough PPE to protect our staff and ensure safe care, we’ve made the decision to open up more of the electives,” Kooistra says.
Kooistra says like other Michigan hospitals, Spectrum’s been hurt by the pandemic. But he says the hospital was in good financial standing before the pandemic.
“We are fortunate that we received some funding from the CARES Act but that won’t be enough to make up some of the losses we’ve experienced,” Kooistra says.
So far, the federal government has given $326 million in coronavirus relief to Michigan’s rural hospitals.
The Michigan Hospital Association’s Senior Vice President of Public Affairs and Communications Ruthanne Sudderth says Munson and some other hospitals have had to cut pay and furlough employees to survive.
“I think that going forward those kinds of things will remain on the table until we know when this pandemic will truly come to an end,” Sudderth says.
She says the way forward for northern Michigan hospitals is for patients to catch up with the care they likely delayed — joint replacements, child vaccinations and emergency care.
“We need to get them in the doors and getting their preventative services,” Sudderth says.
For hospitals, it’s an imperfect solution, as visits could be disrupted again if a predicted second wave of the virus hits in the fall.