- Demographic shifts. There is considerable dispute over just what the area’s population and its components will be which will determine the usage of the facility as the majority of its clients are predicted to be there on some kind of federal-government run insurance or reimbursement. Using even more conservative estimates, with room to grow would prove more cost-effective.
- DSH redefinition. The
payments program was changed a year ago which means fewer revenues can be drawn by a charity hospital, meaning a reduction in the number of beds may be in order. Disproportionate Share Hospital
- National policy. One way or the other, national health policy seems driven to get the government out of direct reimbursement of health expenses, either by forcing higher costs onto the private sector and consumers or by empowering consumers with more choice and less government interference to improve efficiency. Either way, this means less business for a charity hospital.
- Other state priorities. Competition for state one-time dollars only has been increasing, with road needs drifting upwards into the $14 billion range, unfunded accrued liabilities in pensions now approaching $17 billion, and an unknown in cost but greater demand placed upon coastal restoration. Downsizing the present facility planned could save an extra couple of hundred million dollars to be used for these purposes that might prove more cost effective than for the facility.