Dr. Niran Al-Agba

Musings on a Micro-Hospital for the City of Bremerton

The idea of micro-hospitals is gaining traction because costs of construction are far lower than that of more traditional hospital facilities –costing anywhere between $7-$30 million, depending on the range of services available, according to Advisory Board statistics. Micro-hospitals can meet 90% of the community healthcare needs. They seem to flourish best in markets with critical service gaps. Ideally, micro-hospitals are located within 20 miles of a full-service hospital, facilitating the transfer of patients to larger facilities if higher-acuity needs arise. Hospital stays anticipated to be longer than 48 hours are sent to higher-acuity facilities.

Niran Al-Agba2020-05-14T04:04:04+00:00September 22, 2017|Categories: Patient, Policy|Tags: ACA, Affordable Care, CHI, Consolidation, Corporatization, Dignity, Franciscan, Hospitals, Microhospital, Surprise Billing|

A Two-Hospital Solution in the Event of a Mass Casualty Incident (MCI)

In June 2016, Kitsap County emergency personnel participated in Cascadia Rising, a large-scale earthquake drill. At the time, three local hospitals planned to coordinate management of injured casualties: Navy Hospital, which would treat the “walking wounded” (least injured), or Harrison Silverdale and Harrison Bremerton, which would clear their emergency departments to receive the flood of injured patients. While those plans have changed, the grave risk to our community in the event of an earthquake should not be ignored.

Niran Al-Agba2020-05-14T03:58:17+00:00September 5, 2017|Categories: Patient, Policy|Tags: ACA, Affordable Care, Cascade Rising, CHI, Consolidation, Dignity, Franciscan, Hospitals, Mass Casualty Incident, Patient Physician Relationship|

Washington State Regulators Gave CHI a Monopoly. It is Time to Take it Back.

How did we get here? America has struggled to balance access to hospital services with utilization, quality and price for the past 50 years. In the mid-1960’s, certificate of need laws were established to limit the supply of hospital beds and equipment, prevent overutilization of services, control costs and improve quality.

Niran Al-Agba2020-05-14T03:57:15+00:00August 22, 2017|Categories: Patient, Policy|Tags: Certificate of Need, CHI, CON laws, Consolidation, Corporatization, Franciscan, Hospitals, Rural Care, Washington State|

A Hospital With No Beds Cannot Stand

The evidence is now clear CON laws not only increase costs, but also restrict access for the underserved, especially in rural areas. Hospital bed access is expressed in the number of beds/1,000 population; on average, there are 3.62 beds/1,000 people in the United States. Recent studies by Strattman and Russ found states with CON laws have 1.31 fewer beds/1,000 overall. Kaiser Foundation found Washington and Oregon have the lowest bed ratios in the nation, at 1.7 beds/1,000, with Kitsap County having a woefully inadequate ration of 1.30 beds/1,000. In short, the evidence supports the fact that CON regulations worsen access for rural residents.

Niran Al-Agba2020-05-14T03:56:26+00:00August 15, 2017|Categories: Patient, Policy|Tags: Certificate of Need, CHI, CON laws, Corporatization, Franciscan, Health Policy, Hospitals, Rural Care, Washington State|

Phoebe-Putney Hospital vs. Lee County, Georgia: A Tale of Consolidation and a Little County That Could

Lee County is on their way to achieving something extraordinary; challenging the dominance of a hospital monopoly. On July 21, 2017, the CON application for Lee County was deemed complete by the Georgia Department of Community Health. A decision is anticipated by Nov. 15. If granted, the county plans to break ground on the new structure in early 2018. The CEO of Lee County Medical Center, Mr. G. Edward Alexander, stated “Our goal is to ensure that decisions for the hospital are made locally by people who live and work in Lee County.”

Niran Al-Agba2020-05-14T03:55:32+00:00August 8, 2017|Categories: Patient, Policy|Tags: ACA, Certificate of Need, CHI, CON laws, Consolidation, Corporatization, Franciscan, Health Policy, Phoebe Putney Hospital, Rural Care|

To CHI and Back: A Journey of 85 Hospital Beds in Kitsap County, Washington

One Vision. One Voice. Our Choice.

Niran Al-Agba2020-05-14T03:53:04+00:00July 24, 2017|Categories: Patient, Policy|Tags: ACA, Affordable Care, CHI, Consolidation, Corporatization, Franciscan, Hospital, Rural Care|

An Open Letter to the Future Mayor of Bremerton

The single most critical issue facing your tenure will be improving access to healthcare for the population of Bremerton. On May 1, 2017, the state Department of Health granted Catholic Health Initiatives (CHI) a long awaited Certificate of Need to transfer all of the available hospital beds outside of the city and complete a $600 million dollar hospital expansion project in Silverdale, at the expense of healthcare access.

Niran Al-Agba2020-05-14T03:51:59+00:00July 18, 2017|Categories: Patient, Policy|Tags: ACA, Affordable Care, CHI, Consolidation, Franciscan, Health Policy, Patient Advocacy|

Is the KentuckyOne Health Experience a Road Map for Kitsap County?

The Pacific Northwest hospital group may be considered the “golden child” for now, but what happens if profit margins decline and further cutting costs is not feasible? The Jewish Hospital merger experience should serve as a cautionary tale for Kitsap County. Will our beloved community hospital be sold off five years from now or can we escape the same fate by devising a viable alternative for healthcare in our community?

Niran Al-Agba2020-05-26T01:29:47+00:00June 13, 2017|Categories: Patient, Policy|Tags: ACA, Affordable Care, CHI, Consolidation, Corporatization, Franciscan, Hospitals, Obamacare, Physician Autonomy, Surprise Billing, Transparency|