Skip to main content
Sister Publication Links
  • ESG: THE NEW IMPERATIVE
Subscribe
  • Sign Up Free
  • Login
  • Subscribe
  • News
    • Current News
    • COVID-19
    • Providers
    • Insurance
    • Government
    • Finance
    • Technology
    • Safety & Quality
    • Transformation
    • People
    • Regional News
    • Digital Edition (Web Version)
    • Patients
    • Operations
    • Care Delivery
    • Payment
    • Midwest
    • Northeast
    • South
    • West
  • Digital Health
  • Insights
    • ACA 10 Years After
    • Best Practices
    • Special Reports
    • Innovations
  • Opinion
    • Bold Moves
    • Breaking Bias
    • Commentaries
    • Letters
    • Vital Signs Blog
    • From the Editor
  • Events & Awards
    • Awards
    • Conferences
    • Galas
    • Virtual Briefings
    • Webinars
    • Nominate/Eligibility
    • 100 Most Influential People
    • 50 Most Influential Clinical Executives
    • Best Places to Work in Healthcare
    • Excellence in Governance
    • Health Care Hall of Fame
    • Healthcare Marketing Impact Awards
    • Top 25 Emerging Leaders
    • Top 25 Innovators
    • Diversity in Healthcare
      • - Luminaries
      • - Top 25 Diversity Leaders
      • - Leaders to Watch
    • Women in Healthcare
      • - Luminaries
      • - Top 25 Women Leaders
      • - Women to Watch
    • Digital Health Transformation Summit
    • ESG: The Implementation Imperative Summit
    • Leadership Symposium
    • Social Determinants of Health Symposium
    • Women Leaders in Healthcare Conference
    • Best Places to Work Awards Gala
    • Health Care Hall of Fame Gala
    • Top 25 Diversity Leaders Gala
    • Top 25 Women Leaders Gala
    • - Hospital of the Future
    • - Value Based Care
    • - Supply Chain
    • - Hospital at Home
    • - Workplace of the Future
    • - Digital Health
    • - Future of Staffing
    • - Hospital of the Future (Fall)
  • Multimedia
    • Podcast - Beyond the Byline
    • Sponsored Podcast - Healthcare Insider
    • Video Series - The Check Up
    • Sponsored Video Series - One on One
  • Data Center
    • Data Center Home
    • Hospital Financials
    • Staffing & Compensation
    • Quality & Safety
    • Mergers & Acquisitions
    • Data Archive
    • Resource Guide: By the Numbers
    • Surveys
    • Data Points
  • MORE +
    • Contact Us
    • Advertise
    • Media Kit
    • Newsletters
    • Jobs
    • People on the Move
    • Reprints & Licensing
MENU
Breadcrumb
  1. Home
  2. Opinion
December 15, 2018 12:00 AM

Commentary: It's time for a 21st century Hill-Burton plan, not to build hospitals but to re-invent healthcare

Susan Dentzer
  • Tweet
  • Share
  • Share
  • Email
  • More
    Reprints Print

    Susan Dentzer is president and CEO of the Network for Excellence in Health Innovation, Washington, D.C., and the editor and lead author of Health Care Without Walls: A Roadmap for Reinventing Health Care.

    When World War II ended in 1945, and the U.S. turned its attention to the homefront, healthcare was high on the nation's agenda. Gripping stories appeared in newspapers of returning service members suffering from a lack of access to care.

    At the time, many hospitals across the country were “too small and ill-equipped” to accommodate even a peacetime nation's healthcare needs, as Rosemary Stevens recounted in her definitive history, In Sickness and in Wealth. One U.S. senator of that era, Lister Hill of Alabama, a Democrat, lamented that “scientific healthcare (would not be) readily available to all our people.”

    So Hill teamed up with a Senate colleague, Harold Burton of Ohio, a Republican. In 1946, they secured enactment of a law that, over the next 20 years, helped to finance creation of nearly 5,000 hospitals and clinics across the country.

    Seventy-two years later, it's time for a 21st Century Hill-Burton—not to build more hospitals, but to turn many of today's institutions inside out.

    Today's America looks far different from that of the postwar period. Payment reforms and practice changes have moved much acute and surgical care out of inpatient to outpatient settings. In rural areas, many hospitals built with Hill-Burton funds now have scant numbers of inpatients. Most sick Americans are coping with multiple conditions, landing in the hospital mainly when those are out of control.

    Meanwhile, scientific and technological aspects of healthcare are being transformed through the genomic and digital revolutions. And the nation has arguably a greater need than ever to address the primary drivers of health status—the social and economic determinants, such as income and education, that exist far afield from healthcare.

    For all of these reasons, a 21st century Hill-Burton program should now repurpose and restructure many of the nation's hospitals to push more care than ever outside their walls.

    U.S. hospitals today experience different realities: Some are building new facilities to add inpatient beds or replace an aging plant, while others face financial pressures and closure. The latter group, especially, needs support to transition from the world of filling beds and dependency on reimbursement for high-priced procedures. The goal should be healthcare without walls, or providing care for people in their homes, workplaces and other community settings, through enhanced primary and preventive care, mental health and substance abuse treatment, virtual visits and more.

    Healthcare leaders know that the world is changing, and that they should refocus and become a force for health creation and preservation in their communities. But they need incentives to make the change.

    They need support from payers and regulators to adopt hospital-at-home programs, which produce excellent patient outcomes at lower costs. They need support from policymakers and their communities to replace inpatient beds with observation units, from which patients needing hospitalization could be transferred to larger institutions.

    Many hospitals need funding to make investments in videoconferencing and telehealth equipment, so that local patients can have remote consultations with specialists elsewhere. They also need a federal commitment to ensure universal broadband and cellular service, much the way the nation once extended electricity and telephone service nationwide.

    And all hospitals need support, including from schools of health professions, to retrain workers for new roles. Much of the workforce that now staffs ailing hospitals could be retrained as community health workers or paramedics, working in tandem with other community-based organizations to address patients' other vital needs: housing, food and transportation.

    A package of federal and state support to finance these interventions, along with a reinvigorated national will, would surely produce better care, better access and lower costs for 21st century America. Here's hoping the next Hill and Burton will step forward in Congress to launch us down this path.

    Interested in submitting a Guest Expert op-ed? Send drafts to Assistant Managing Editor David May at [email protected].

    Letter
    to the
    Editor

    Send us a letter

    Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.

    Recommended for You
    Copy of 011821-regionals-ascension_sign_WEB_i.jpg
    Ascension names Conrado president; Impicciche remaining CEO
    PHE ending
    What the end of the federal COVID-19 emergency means for healthcare
    Most Popular
    1
    More healthcare organizations at risk of credit default, Moody's says
    2
    Centene fills out senior executive team with new president, COO
    3
    SCAN, CareOregon plan to merge into the HealthRight Group
    4
    Blue Cross Blue Shield of Michigan unveils big push that lets physicians take on risk, reap rewards
    5
    Bright Health weighs reverse stock split as delisting looms
    Sponsored Content
    Get Newsletters

    Sign up for enewsletters and alerts to receive breaking news and in-depth coverage of healthcare events and trends, as they happen, right to your inbox.

    Subscribe Today
    MH Magazine Cover

    MH magazine offers content that sheds light on healthcare leaders’ complex choices and touch points—from strategy, governance, leadership development and finance to operations, clinical care, and marketing.

    Subscribe
    Connect with Us
    • LinkedIn
    • Twitter
    • Facebook
    • RSS

    Our Mission

    Modern Healthcare empowers industry leaders to succeed by providing unbiased reporting of the news, insights, analysis and data.

    Contact Us

    (877) 812-1581

    Email us

     

    Resources
    • Contact Us
    • Advertise with Us
    • Ad Choices Ad Choices
    • Sitemap
    Editorial Dept
    • Submission Guidelines
    • Code of Ethics
    • Awards
    • About Us
    Legal
    • Terms and Conditions
    • Privacy Policy
    • Privacy Request
    Modern Healthcare
    Copyright © 1996-2023. Crain Communications, Inc. All Rights Reserved.
    • News
      • Current News
      • COVID-19
      • Providers
      • Insurance
      • Government
      • Finance
      • Technology
      • Safety & Quality
      • Transformation
        • Patients
        • Operations
        • Care Delivery
        • Payment
      • People
      • Regional News
        • Midwest
        • Northeast
        • South
        • West
      • Digital Edition (Web Version)
    • Digital Health
    • Insights
      • ACA 10 Years After
      • Best Practices
      • Special Reports
      • Innovations
    • Opinion
      • Bold Moves
      • Breaking Bias
      • Commentaries
      • Letters
      • Vital Signs Blog
      • From the Editor
    • Events & Awards
      • Awards
        • Nominate/Eligibility
        • 100 Most Influential People
        • 50 Most Influential Clinical Executives
        • Best Places to Work in Healthcare
        • Excellence in Governance
        • Health Care Hall of Fame
        • Healthcare Marketing Impact Awards
        • Top 25 Emerging Leaders
        • Top 25 Innovators
        • Diversity in Healthcare
          • - Luminaries
          • - Top 25 Diversity Leaders
          • - Leaders to Watch
        • Women in Healthcare
          • - Luminaries
          • - Top 25 Women Leaders
          • - Women to Watch
      • Conferences
        • Digital Health Transformation Summit
        • ESG: The Implementation Imperative Summit
        • Leadership Symposium
        • Social Determinants of Health Symposium
        • Women Leaders in Healthcare Conference
      • Galas
        • Best Places to Work Awards Gala
        • Health Care Hall of Fame Gala
        • Top 25 Diversity Leaders Gala
        • Top 25 Women Leaders Gala
      • Virtual Briefings
        • - Hospital of the Future
        • - Value Based Care
        • - Supply Chain
        • - Hospital at Home
        • - Workplace of the Future
        • - Digital Health
        • - Future of Staffing
        • - Hospital of the Future (Fall)
      • Webinars
    • Multimedia
      • Podcast - Beyond the Byline
      • Sponsored Podcast - Healthcare Insider
      • Video Series - The Check Up
      • Sponsored Video Series - One on One
    • Data Center
      • Data Center Home
      • Hospital Financials
      • Staffing & Compensation
      • Quality & Safety
      • Mergers & Acquisitions
      • Data Archive
      • Resource Guide: By the Numbers
      • Surveys
      • Data Points
    • MORE +
      • Contact Us
      • Advertise
      • Media Kit
      • Newsletters
      • Jobs
      • People on the Move
      • Reprints & Licensing