CarePoint Health is seeking more than $130 million in state funding and pursuing a unique strategic partnership to shore up its finances and continue to provide critical care services at its three safety-net hospitals, which have seen a combined 50,000 underinsured or uninsured patients since the pandemic.
Uncompensated care demands, escalating homelessness, workforce challenges and rising healthcare costs have put the health system on a shaky financial footing, reporting a $34.4 million loss for the nine months ended Sept. 30, 2023, down from a $7.5 million loss in the prior-year period.
Two of CarePoint's hospitals, Hoboken University Medical Center and Christ Hospital in Jersey City, N.J., are nonprofits while Bayonne Medical Center operates as a for-profit entity.
Last year, CarePoint saw a significant spike in charity care and uninsured patients, with more than 50% of its patients now underinsured or uninsured. Almost 95,000 patients visit one of CarePoint's emergency departments each year, but since the pandemic, about 57,000 of those patients came under charity care or self-pay, according to data CarePoint shared with Becker's.
"The national median for charity care is 1.4%, and we're seeing more than 10%. That makes things very difficult," CarePoint President and CEO Achintya Moulick, MD, told Becker's. "That is allocated from previous calculations and does not account for the inflationary prices of care. Inflation has affected pharmaceuticals, labor, payer and vendor contracts, and the supply chain. The cost of care has increased exponentially."
Here's a breakdown of the payer mixes at CarePoint's Hoboken, Christ and Bayonne hospitals over the last three years, according to data CarePoint shared with Becker's:
Christ Hospital
| 2021 | 2022 | 2023 | |
| Medicare | 9.8% | 7.1% | 6.7% |
| Medicaid | 11.2% | 10% | 9.8% |
| Managed care | 34.7% | 37.5% | 37.8% |
| Other commercial | 18.5% | 18% | 19.1% |
| Charity care | 15.6% | 17.8% | 18.6% |
| Self-pay | 10.1% | 9.5% | 8.1% |
Hoboken University Medical Center
| 2021 | 2022 | 2023 | |
| Medicare | 9.4% | 6.4% | 5.9% |
| Medicaid | 9.2% | 9.9% | 9.8% |
| Managed care | 32.5% | 34.9% | 34.1% |
| Other commercial | 20.7% | 20.2% | 19.7% |
| Charity care | 19.2% | 20.3% | 24% |
| Self-pay | 9.1% | 8.3% | 6.5% |
Bayonne Medical Center
| 2021 | 2022 | 2023 | |
| Medicare | 24.2% | 19.9% | 18.2% |
| Medicaid | 1.4% | 1.7% | 1.7% |
| Managed care | 34% | 37.5% | 41.3% |
| Other commercial | 29.2% | 29.6% | 30.1% |
| Charity care | 1.5% | 1.5% | 2% |
| Self-pay | 9.6% | 9.8% | 6.6% |
CarePoint leaders argue that the system needs at least $100 million in state appropriations and a $30 million Governors Grant to continue optimal pace operations.
"Safety-nets also need a safety-net," Dr. Moulick said. "It cannot be our burden to bear alone. It should be a collective burden due to the societal problems we are dealing with. We've seen almost 12,000 homeless people in our emergency rooms since the pandemic."
CarePoint has also seen a spike in the number of undocumented people that visit its facilities. Its costs for dialysis services for undocumented people has reached more than $5 million a year, which also falls under uncompensated care.
"We urge our state leadership to recognize the urgent need that exists at our hospitals and allocate appropriate funding from the state budget and any available discretionary funds towards CarePoint's community health initiatives," Dr. Moulick said.
In mid-January, with an eye on growth and long-term financial sustainability, CarePoint and Hudson Regional Hospital in Secaucus, N.J., signed a letter of intent to combine under a new management company, Hudson Health System.
Hudson Regional, a for-profit facility, would combine with CarePoint's three hospitals under a new operating company that would continue to be in-network with all major payers. The transaction is expected to strengthen CarePoint's financial position and improve patient care and outcomes across the hospitals.
"Bayonne will continue as a for-profit facility, as well as Hudson Regional," Dr. Moulick said. "There will be a strong firewall between the two facilities in terms of finances, and we are working through the rest of the proposed agreement."
The proposed strategic partnership would lay the foundation for the expansion of new and existing service lines and spur more collaboration between CarePoint and Hudson Regional. As a four-hospital system with for-profit and nonprofit hospitals operating in different payer mixes, there would also be opportunities to negotiate better contracts with insurers and vendors as well as greater economies of scale overall.
"We are hoping that the state looks at it as a positive move. There's a lot of consolidation happening in healthcare. It will be good to have a new, vibrant health system that can provide great value to the community and expand facilities and services," Dr. Moulick said. "Hudson Regional is a successful, profitable hospital, and although they have a different payer mix than CarePoint, they have some efficiencies that we can leverage and they can tap into our physician pool. There could be some great synergies as a combined entity."