Market share is a concept that all hospital executives understand very well. The long-term consequences of Sandy on some of the prestigious New York hospitals like NYU Longone are now becoming painfully clear (see: NYU Langone has reopened, but can it regain market share?). Here's an excerpt from a recent article about this topic:
As of mid-January, most of NYU is up and running again, including the labor and delivery unit. But the question still looms whether NYU [Longone] will lose some of the patients and even doctors who sought refuge at NYU’s biggest competitors after the storm. If that happens, the storm could end up having a long term impact on NYU's valuable share of the fiercely competitive health care market in New York City. Most of the 500 NYU doctors who left for other hospitals have since returned....But more than a dozen have applied for permanent privileges at competitors Mount Sinai Hospital and Beth Israel, according to those hospitals, and there are probably more at other institutions. It’s not clear how many of those doctors would also keep their privileges at NYU. [An NYU executive] says he's not concerned about the shift, and he isn't surprised by claims that other hospitals tried to recruit some of the NYU doctors working there after the storm.... NYU's loss was in some ways its competitors' gain. Hospitals like Lenox Hill, Mount Sinai and Beth Israel all saw spikes in their monthly birth rates during November and December, when NYU was closed. NYU doctors were still able to bill insurers directly for their services, and some competitors - including Beth Israel - helped offset the salaries of doctors employed by NYU. But "doctor bills make up about 10-12 percent of the fee" for a test or procedure done at a hospital...."The rest of it went to those other hospitals....[The] president of Beth Israel, says while they did not make any efforts to poach NYU doctors, Beth Israel did benefit from new doctors and patients being exposed to the hospital. He predicts that Beth Israel "will have a higher occupancy rate going forward. I think some patients and physicians will see the opportunity here and have enjoyed their experience and may seek new relationships. ....[A] total of five New York institutions closed for at least some time after the storm. But they managed. The important question now isn’t whether hospitals return to pre-Sandy conditions, but whether they should...."When two very large hospitals -- Bellevue with 900 beds and NYU which also has close to 900 beds -- were suddenly taken out of service, we did have some backlogs and wait times at other places, but the system was able to absorb most of that capacity [according to an expert on New York bed capacity]."
My guess is that NYU Longone will claw back most of the patients it lost to other institutions and many of its physicians will return. However, Sandy, as an "experiment of nature," seems to have shown that New York is overbedded. The consequences on patient care of losing about 1800 beds for a protracted period of time was not as serous as one would have predicted. In other words, the hospitals that remained in business were able to pick up the slack. I am sure that more information will be forthcoming about how other hospitals accommodated to the loss of the Bellevue and NYU beds. Of course, Belelvue is a special case. Here are some details about it that you may not know:
Bellevue Hospital is the oldest continuously operating hospital in America. We trace our roots back to 1736 when a six-bed infirmary opened on the second floor of the New York City Almshouse. This was four years before the birth of George Washington and forty years before the signing of the Declaration of Independence.Since its humble beginnings as a haven for the indigent, Bellevue has become a major academic medical institution of international renown. Over the centuries, we served as an incubator for major innovations in public health, medical science and medical education. Often referred to as a national treasure, Bellevue defines the very best traditions of public medicine as a public service vital to the well being of our civil society.