 At suburban Detroit's Henry Ford West Bloomfield Hospital, patients will indulge in gourmet room service, stroll walking trails and take cooking classes. A former Ritz-Carlton executive is running the show.
The description seems more day spa than sick bay. But hospitals are finding it pays to pump up the perks as they compete for patients who want a bit extra — and have private health insurance. Proponents add that these amenities promote healing and stress relief.
Others see a chasm deepening between hospitals pushing into leafy suburbs to grab market share and those serving poorer patient populations. Quentin Young, a longtime Chicago doctor and national coordinator of the nonprofit Physicians for a National Health Program, calls it the "edifice complex."
Because private health insurance offers better reimbursement than government payers like Medicaid or Medicare, the perks are partly meant to lure in more profitable patients, according to those who study health care trends.
The clinical care at the Henry Ford Health System's new hospital, set to open in March, will be no different from what it offers at its older, flagship hospital in downtown Detroit, according to the not-for-profit hospital chain's chief executive, Nancy Schlichting.
However, the design and other services are meant to stand out.  The $360 million hospital's atrium resembles a northern Michigan Main Street complete with storefronts that will offer health and wellness products geared toward women, who hold most of the purchasing power in health care, hospital Chief Executive Gerard van Grinsven said.
"Women are not satisfied anymore in getting traditional medical care," said van Grinsven, who came to Henry Ford from the Ritz-Carlton hotel chain with no hospital experience. "They want activities and programs to help them in their physical and mental well-being."
Hospital leaders say many of the amenities they stuff into modern designs happen because today's patient wants more than just top-line care, a palatable meal and a clean bedpan. Take Internet service, for example, which has become common in patient rooms.
"I have an 85-year-old aunt in Indiana who I don't think wants to be away from her computer very often because that's how she keeps in touch with her family all around the country," said Rick Wade, senior vice president of the American Hospital Association.  He also noted that fewer people stay in hospitals these days, thanks to the growth of outpatient care. Those who fill beds generally receive "pretty intense treatment."
"The revolution now is to find any way possible to reduce the stress, reduce the tension, reduce the anxiety," he said.
Many hospitals tout single rooms, made more common by federal regulations protecting privacy. Many also offer valet parking.
Community Hospital North in Indianapolis took a couple of extra steps for its $170 million expansion.
It added a patient concierge who can run errands or fetch groceries. Community North, which borders fast-growing Indianapolis suburbs, also sprinkled about $400,000 in art throughout its hospital.
Hospital leaders say these extra touches all have a purpose. The artwork — paid for by donors — and the concierge offer stress relief.
"We don't do things just to look pretty. We have a purpose behind it," said Mark Hayden, senior facilities project manager for the hospital's parent, Community Health Network.
The new $829 million Ronald Reagan UCLA Medical Center in Los Angeles features the latest in clinical technology and, thanks again to donors, extra touches like granite countertops.
Hospitals aren't adding perks just to ease stress. Competition also plays a role.
"If a patient has a free choice to go to this hospital or that hospital, they're going to choose the one that has the better amenities," said Dr. James Atkinson, chief of pediatric surgery at the Ronald Reagan center. "That is a factor."
This leads to medical arms races, according to Debra Draper, an associate director of the Center for Studying Health System Change, which monitors health care construction in a dozen U.S. cities.
"They're really trying to secure their future margins, and the way to do that is to have happy doctors, happy patients and to be able to differentiate yourself on the basis of what you have to offer," she said.
At the same time, many state laws that used to regulate the amount of hospital construction by requiring hospitals to demonstrate there's an unmet need for hospital beds have been weakened or successfully challenged in court.
The changes have made it easier for hospitals to push into markets filled with potential patients covered by private insurance. That helps them generate enough money to cover expenses, handle charity cases and invest in technology. The Henry Ford system, for instance, uses its suburban locations to help support its Detroit hospital, which serves many more Medicaid and uninsured patients. That hospital also is undergoing a $310 million expansion.
But perks are still not the same at hospitals that serve the poorest patients.
Private insurance covers only about 6 percent of the patients at Wishard Memorial Hospital, the public safety net hospital near downtown Indianapolis. Patient amenities there are relatively low key. They include clergy services, translators and volunteers who walk dogs to rooms for pet therapy.
Chief Executive Matt Gutwein thinks there may be some flat-screen TVs at Wishard, donated for the hospital's burn unit. But the CEO of the municipal corporation that owns Wishard doesn't begrudge hospitals that spend more lavishly on amenities.
He says they have no choice. The U.S. health care system pressures most hospitals to draw commercially insured patients to offset lower reimbursement from government payers or no payment from the uninsured.
"It's this complete and total crazy quilt of financing," said Gutwein, whose safety net hospital receives some public money to help with its burden.
Young, the Chicago doctor, favors national health insurance. He says the present system "follows the money," and distortions between the haves and have nots in it are growing larger.
"I don't think the present unpleasantness in the markets (is) going to make it any better," he said.
Capital projects rich in amenities can help pay for themselves. Rick Gundling, a vice president with the Healthcare Financial Management Association, said nicer amenities help attract doctors, who then bring more patients to a hospital.
Plus the cost of amenities pales compared with a hospital's two largest expenses: personnel and equipment, said the American Hospital Association's Wade.
"It's a very small investment for a very large return in terms of patient satisfaction," he said. |