Wellstar Atlanta Medical Center (AMC) and more than a dozen of its affiliated clinics closed their doors at the end of 2022, citing financial difficulties. Located in a community where 31% of residents live in poverty and 42% are Black, this hospital met a critical need in an area that has historically suffered from disinvestment and limited access to care. A year since the facility shuttered its doors, local hospitals are beginning to see the impact of AMC’s absence.
What happened to AMC?
Atlanta Medical Center, a 466-bed acute care hospital in the heart of Atlanta, was ranked #2 in the state on patient inclusivity in the Lown Institute Hospitals Index, in part due to their demographically and economically diverse patient population. Wellstar administrators stated that the primary reasons behind AMC’s closure was poor financial performance, pointing to inflation and attempts to recoup from investments in uncompensated care and capital improvement projects, as well as other financial losses. However, the system as a whole did fine financially that year, with more than $150 million in net income, in addition to $186 million in CARES Act funding.
Wellstar’s decision to close AMC provoked strong objections from local policymakers. In March 2023, the NAACP and local policymakers filed two federal complaints against Wellstar: one to the Department of Health and Human Services’ Office of Civil Rights alleging discrimination and one to the IRS asking for an investigation of the system’s nonprofit status. They argued that Wellstar closing their Atlanta campuses violated the Civil Rights Act for discriminating against poorer communities of color, and violated their community benefit requirements by reducing access to care.
According to a statement from Wellstar spokesperson Matthew O’Connor, “Wellstar undertook significant efforts to improve AMC and avoid the closure despite significant financial and operational challenges and a lack of public assistance.” He disputed accusations that Wellstar was removing resources from communities of color. “We believe everyone should have equitable access to healthcare, regardless of their ability to pay,” he said.
The state of healthcare in Atlanta
When AMC closed in late 2022, Grady Hospital responded, “this decision by Wellstar to abandon the community will further strain our operations, particularly our emergency room, as more patients will present with medical needs.” Unfortunately, their prediction appears to be bearing out.
According to NBC News, the impact of AMC’s departure on remaining Atlanta hospitals like Emory University Hospital Midtown and Grady Memorial Hospital has been profound. Emory’s ER patient volume rose by 20% in the past year, driven by both AMC’s closure and increasing population of the Atlanta metro area. Georgia’s capacity monitoring dashboard often lists both Emory and Grady as “severely” or “dangerously” overcrowded.
“These problems need to be fixed. We are less safe as a community without a robust public health infrastructure.”
Dr. Anwar Osborne (Grady Memorial Hospital), NBC News
With AMC closed, community members and leaders fear that certain populations will fall through the cracks when it comes to receiving care. Dr. Michelle Cooke, a former Wellstar family medicine doctor who now works in private practice, explained her concerns to NBC News. “Unfortunately, I think we’re going to see a huge rise in morbidity and mortality, just because a year of people not getting their blood pressure checked, a year of not getting appropriate cancer screenings, like mammograms, pap smears—so much of that builds up that we’re going to see terrible effects in the next five to 10 years,” Cooke said.
This outcome would be heartbreaking, but not surprising. Existing research has revealed that in both rural and urban areas, hospital closures have led to reduced access to or interruptions in primary care, as well as drops in emergency and specialty care utilization rates.
The consequences of AMC’s closure has prompted local policymakers to think more seriously about regulations around hospital closures. “Hospitals can only be built with a certificate of need, but it takes nothing for them to pull out of a community,” said City Council member Marci Collier Overstreet to NBC News. Ideally, she said, they would “need to have a certificate of departure, as well.”
This would be in line with other state policies–for example, New York requires an independent assessment before hospitals can close maternity wards; Connecticut also requires state approval for hospitals to close birthing centers; and Oregon’s Health Care Market Oversight program evaluates the potential impact of mergers and closures before they happen.
Providers and community advocates are sounding the alarm—Atlanta hospitals need more resources to serve the growing community need before the situation gets worse.