Aging population, newly insured contribute to York Hospital's busiest year


With thousands of Yorkers freshly insured under the Affordable Care Act and an aging population, WellSpan's York Hospital is fielding its largest number of emergency room patients.

Officials at the hospital view the increase as a kind of a "new normal," and WellSpan is hoping to get ahead of the curve by developing plans to see more patients in an efficient manner, said hospital president Keith Noll. In the last fiscal year, York Hospital fielded 80,864 patient visits to its emergency room, surpassing its previous high of 78,504.

Noll said the hospital started seeing the bulk of the increase in January, when insurance coverage went into effect from the Affordable Care Act. That led more residents to get coverage and seek services, he said.

Along with those who are taking advantage of their new insurance, York County's population is increasing, and the population is aging and getting a lot sicker than in years past, he said.

"It was probably our busiest year on record," he said. "I don't think it's any one thing that caused the increase, but a multitude of factors."

Other factors: Insurance companies also have created "narrow networks" that limit the number of doctors and hospitals a person could use to help control medical costs, and that change might have funneled more residents to York Hospital, he said.

"We are one of the biggest providers in the area; not many hospitals can handle the types of patients we do," Noll said.

Noll also noted that the length of stay among patients has increased over the years, by about a half a day.

"You may not think that is a lot, but when you have 570 beds within the hospital and multiply that 365 days a year, it adds up," he said.

The hospital also is experiencing an upswing in the number of transfers from other hospitals, Noll said.

In the last few years, York Hospital went from averaging 15 transfers a month to getting sometimes as many as 200 a month.

Planning ahead: To keep up with hospital demand, Noll said they are looking at a series of long-term and short-term approaches.

The hospital plans to hire 150 additional employees and work aggressively with community partners, home-care agencies and nursing homes to discharge patients to the correct level of care more rapidly, he said.

In addition, WellSpan staff members are planning to update the facility's master plan to see where additional beds could be added.

Officials also are investing about $48 million in upgrades to the emergency department to ensure better access and efficiency. That work is already under way.

Growing trend: Other medical facilities around the country also have experienced higher patient volumes in emergency rooms.

According to a poll released in May from the American College of Emergency Physicians, three-quarters of emergency doctors said visits were increasing.

One year ago, less than half reported increases, according to the organization's findings.

More than one-quarter — 28 percent — of respondents saw increases since the requirement to have health insurance took effect.

Dr. Michael Gerardi, president of the ACEP, said even with new insurance, many residents still don't have access to timely medical care.

"America has severe primary-care physician shortages, and many physicians will not accept Medicaid patients because Medicaid pays so inadequately," Dr. Gerardi said. "Just because people have health insurance does not mean they have access to timely medical care."

Less waiting: Patients can help cut down on wait times, connecting with a primary care physician when they're feeling ill, Noll said.

People might not always need to go to the emergency room, he said.

Noll said family members who are picking up a patient from the hospital should come around the estimated discharge time.

"We can give you an estimate ahead of time when a loved one will be sent home," he said. "Between 10 a.m. and 4 p.m., things start to get a little tight."

But even with the patient increase, Noll said the hospital continues fielding patients.

"You never want to turn away someone in need," he said. "We will continue to help those who need our services."

— Reach Sara Blumberg at