Why does the hospital enter the real estate business?
Michael Dudi remembers some of his things in Columbus, Ohio in the 1990s:
“gunshots, helicopters, theft, smashing windows, theft, robbery, assault and murder.”
In addition to crime, about 50% of children in the region live in poverty-stricken areas, the Southern Orchard.
In the mid-20th century, an interstate highway was built between the communities, separating most of the black residents of the neighborhood residents from the employment opportunities in downtown Columbus.
But things started to change in 2008. The National Children’s Hospital in the Southern Orchard began investing in homes in the neighborhood.
Dudi, a 62-year-old fraud investigator, said: “Most are in such a bad state.” “But they came in, they worked in these houses, they didn’t take them off.”
The hospital’s initiative is known as the Healthy Community Health Family (HNHF). HNHF worked with cities and community groups such as United Way and the local Methodist Church to renovate vacant homes, build new affordable homes, and write checks to homeowners to fund the renovation of their homes.
The article concludes that the project’s activities appeared in August in the journal Pediatrics.
But why does the hospital enter the housing business?
There is ample evidence that there is a link between living in poverty and health. This is what the doctors of Nationwide Children’s have seen with their own eyes.
Dr. Kelly Kelleher, Director of the Pediatric Practice Innovation Center at the National Children’s Hospital, said: “As a doctor, it is very frustrating to see patients from these high-risk communities again and again.” “The house is collapsing, pipeline problems, mold, mice attack Violence. You see 25 children every day, and two-thirds of them may be in a desperate situation.”
Kelleher said the impact on children is beyond the toxic living conditions of mold and lead. The stress of living in violence and trauma, apartheid and unstable living conditions has led researchers to call it the “neighborhood effect”.
“Children are affected by neighbors,” Kelleher said. “The children are trapped in their apartment, there is a lot of violence outside, they are watching TV. They eat too much. They have asthma.”
Kelleher said that by providing safe and stable housing for children and reducing diseases in nearby areas, the hospital hopes to help prevent many health problems caused by harmful physical and socio-economic environments.
Basically, Kelleher pointed out in a paediatric article that they regard “neighbors as patients.”
Columbus is not the only community-based approach to health care.
“This is a national trend,” said Jason Coburn, professor of urban and regional planning at the University of California, Berkeley. “This happened in cities across the country.”
Cockburn pointed out similar projects in Seattle, Boston, Atlanta and New York.
The hospital is working with a lawyer to treat the legal needs of patients
Why affordable housing may become difficult to find
But Dr. Megan Sandel, who helped guide the housing program at the Boston Medical Center and advised HNHF, said the Columbus model was somewhat special.
She said the Boston Medical Center supports housing programs, but they are owned and operated by other community organizations.
In Columbus, a hospital-led partnership built 58 affordable housing, renovated 71 homes, built 15 new homes, and provided 149 housing improvement grants between 2008 and 2018. Through additional funding, it also built a 58-unit housing development project, office space.
Sandel said that due to changes in the Medicaid reimbursement, the hospital may invest in community projects such as housing.
Sandel said that the traditional service-based charging model, that is, each hospital will reimburse medical expenses. Instead, states began to give WHO a “money to manage someone in the population”.
The National Children’s Hospital is optimistic that it can improve the health of children living there by helping to provide higher quality housing in the communities they serve.
National Children’s Hospital
This motivates them to invest in preventive health care. One way to invest in preventive care is to provide patients with a healthy place to live.
Nationwide Children’s Hospital has a responsible medical facility (ACO) that serves 300,000 Ohio Children in the Medicaid program.
Each patient is reimbursed for a responsible medical institution according to their plan, rather than for each service they provide. Tim Robinson, chief financial officer of the National Children’s Hospital, said everyone is benefiting from this arrangement.
“We are very optimistic that it is a win-win situation,” Robinson said. “This is a more efficient and better alignment mode.”
According to Robinson, these arrangements can improve the health of patients and the profitability of hospitals and insurance companies, while reducing state Medicaid spending. He cited a 2015 paper that showed that each patient’s expenditure increased by 85% when patients participated in ACO rather than the traditional pay-as-you-go model.
Kelleher presented another reason for the hospital’s recent interest in housing.
“Hospitals now need to be part of the “Affordable Care Act” to conduct community health needs assessments and try to respond to them,” said Kelleher, referring to the language of health law, requiring non-profit hospitals to identify and resolve them. The root cause of health problems in the community of services.
According to Pediatrics, Columbus’s HNHF project cost more than $22 million in southern orchards.
The share of children’s nationals in this investment is $6.6 million. However, Kelleher and Sandel believe that if the number of hospital visits from members of the Southern Orchard community is reduced, the investment will recover the cost.
“If we can show these improvements in [health] and the reduction in utilization, it will be an economic benefit,” Kelleher said.
He pointed out several indicators that have been moving in a positive direction.
Keller said: “The number of murders in our neighbours has dropped dramatically.” “This used to be a very big problem. The high school graduation rate is also rising.”
“We are also studying the number of emergency room visits, the number of hospital stays, and the types of specific problems that children have in hospitals,” Kelleher added, but he said that these indicators may take longer to show signs of improvement.
Doody, a resident of the Southern Orchard, said he has seen positive changes in the vicinity.
“In the past, people didn’t walk. They would drive three blocks to somewhere because they were afraid of being robbed,” Doody said. “Now I see couples, family, and dogs walking down the street until 11pm.”
“In the past ten or twenty years, it has often become more suitable for families,” adds Doody.
Interactive red line zoom in the history of discrimination in the United States
However, he is worried that the project may lead to the introduction of some high-end residents..
Kelleher acknowledged concerns about gentrification, but he said that because the hospital controls most of the housing, they can also work with the community to limit price increases. For example, many of the units owned by HNHF are cost-controlled and are only available to low-income tenants, Kelleher said.
“Our goal is a sustainable community of mixed incomes,” says Kelleher. “We are monitoring the proportion of Medicaid family planning, which is representative of low-income families living in our census tract. So far, they have not shown a real recession.”
Colburn is optimistic about the success of the project, but points out that it is trying to reverse several generations of economic disparity, in part because of the red line of racism, mainly because African American communities generally deny home loans and other financial services. Corburn said the results should not appear overnight.
“Over 80 years of housing and other services divestment will not reverse the situation due to eight years of affordable housing, job creation and other community welfare work,” he said.