11-04-2025
Commentary: Hospital closures and buyouts are on the rise. Pa. must act to prevent disaster.
The Crozer-Chester Nurses Association and local lawmakers picket outside Crozer-Chester Medical Center in Upland, Pa., last May, to protest actions by the hospital's owner, the for-profit chain Prospect Medical Holdings. Private equity firms have been buying up hospitals in recent years; cutbacks and closures sometimes follow. (Courtesy of the Pennsylvania Association of Staff Nurses and Professionals)
Hospital closures, buyouts, and service closures continue to rise in Pennsylvania, part of a troubling statewide trend.
As the latest examples, Crozer-Chester Medical Center in Delaware County is in real danger of closing entirely, despite efforts by many stakeholders to keep it open, and UPMC Cole in Potter County recently closed its Labor and Delivery department.
These closures have serious consequences for communities.
Crozer-Chester is a critical safety net facility in a densely populated and low-income area of Delaware County. Its closure would have dire implications for local access to emergency services, trauma care, psychiatric care, maternity care, neonatal care, and more. Hospitals in the surrounding area would face increased demand that they would struggle to meet. Wait times would grow, and ultimately, local residents would be unable to access lifesaving care when they need it most.
Likewise, UPMC Cole's shuttering of maternity care services will mean pregnant women in a rural part of Pennsylvania will travel longer distances to receive appropriate care, potentially putting their lives in danger.
These disastrous scenarios are not unique.
In the past 20 years, the rate of hospital closures and shuttering of core services in Pennsylvania has been rising at an alarming rate. Across the state, 32 hospitals have closed completely, and another 25 have shuttered core services like emergency care or maternity care since 2004.
Some communities have lost their only hospital; some no longer have a reliable local emergency room. In rural Pennsylvania, an entire seven-county area now lacks any hospital-based maternity care.
Hospital closures rarely come out of nowhere. An analysis conducted by PHAN last year found that 90% of hospital closures are preceded by a merger or acquisition that eventually leads to financial distress.
This is how Crozer-Chester found itself in danger of closing. Prospect Medical Holdings, a California-based private equity firm, purchased Crozer Health in 2016, overextended itself financially over time while paying generous dividends to its investors, and eventually filed for bankruptcy this January, leaving a catastrophe in its wake.
Private equity firms aren't the only culprit.
Non-profit hospital system UPMC has grown over time by acquiring smaller health systems and individual hospitals. In 2017, they acquired Sunbury Community Hospital and Lock Haven Hospital, telling the local communities that, 'bringing these hospitals into our family allows us to reinvest in both facilities to improve access, enhance care and grow existing services.'
Contrary to what they said, Susquehanna Sunbury was closed in 2020, and Lock Haven's inpatient services were terminated in 2023. This week, they closed UPMC Cole's Labor and Delivery department.
Concerningly, hospital mergers and acquisitions, which often lead to closures over time, are booming across Pennsylvania with 148 transactions taking place since 2004 and more slated to come. When hospital mergers and acquisitions are proposed, promises are almost always made that the transaction will actually make access to healthcare in the local area better, not worse.
But those promises are typically not kept. Some mergers and acquisitions turn out to be neutral, or even positive, for the local community, but some end in disaster.
That's why it's critically important that communities have more transparency and oversight when hospital mergers and acquisitions are proposed. Fortunately, a solution has been proposed in Harrisburg that would establish much-needed public review and oversight for hospital mergers and acquisitions.
A bill passed on a bipartisan basis in the Pennsylvania House and in Committee in the Pennsylvania Senate last session would empower the state Attorney General to gather the facts about all significant proposed hospital mergers and acquisitions, hear from community members about their concerns, evaluate the impact on communities, patients, and access to care, and take legal action to protect communities from the serious negative impacts of hospital consolidation when needed.
The legislation would also empower the state Attorney General's Office to track the promises made during an acquisition and take legal action when those promises are not kept. Just after its acquisition of Crozer Health, a spokesperson promised that Prospect would 'increase the ability of Crozer-Keystone facilities to modernize, attract more patients and expand services' and 'maintain critical service lines and expand service offerings in the community to help ensure growth and sustainability.'
This statement is typical of the promises made during a merger or acquisition– and far from the truth. In addition to the potential closure of Crozer-Chester, Prospect also closed Delaware County Memorial and Springfield Hospitals in 2023.
Pennsylvania can prevent harmful scenarios like the ones Crozer-Chester Medical Center and UPMC Cole are facing. The General Assembly must bring this legislation to the floor before more communities are put at risk of losing access to lifesaving care.
Antoinette Kraus is the founding Executive Director of the Pennsylvania Health Access Network (PHAN), where she works to expand and protect access to high-quality, equitable, affordable healthcare for all Pennsylvanians.
