Two major hospital systems in Delaware have gotten into an arms race to acquire land and expand services in Sussex County, and the trend is likely to continue as retirees continue to flock to rural areas.
“Demographics is fate in this case,” said Wayne Smith, president and CEO of the Delaware Healthcare Association. “At one time, Sussex County was the fastest growing place for retirees to move to in the nation. This is what drives health care needs. If this were Boulder, Colorado, where many people live in their twenties and thirties, it would be a very different landscape. “
For years, Beebe Healthcare and Bayhealth both bought land in the state’s southernmost county for major expansions that were recently realized. Dover-based Bayhealth sold its Milford Memorial Hospital and invested $ 314 million to build a six-story hospital on Route 1 that opened in 2019. Since then, Bayhealth has partnered with Nemours / AI duPont Hospital for Children to open up pediatric care and invested an additional $ 19 million in bed expansion and the addition of a cesarean suite on the Sussex campus.
At the same time, Beebe strengthened its presence in lower Sussex County with the opening of the South Coastal Health Campus near Millville in April 2020, followed by a comprehensive $ 48 million cancer center. Beebe is currently building his $ 124 million surgical hospital on Route 24 near Lewes.
But over time, both Bayhealth and Beebe have tried to push their unspoken limits in Kent and Sussex counties. Bayhealth successfully received $ 35 million preliminary approval for a hybrid emergency room and offices outside of Milton from the Delaware Health Resources Board, the regulator overseeing the expansion of health resources in the state. In the meantime, Beebe is applying for approval for its own hybrid emergency department on Route 113 between Georgetown and Millsboro, which will target the edge of Bayhealth’s planned service area for its own hybrid facility.
“Sussex County is growing exponentially. The area around the location of our new ambulance center along Hudson Road and Route 9 is growing particularly rapidly. ” Terry Murphy, President and CEO of Bayhealth said.
Both Bayhealth and Beebe executives point to a steadily growing population in Sussex County as more services are needed. The Delaware Population Consortium predicts that Sussex County’s population will be around 139,000 by 2030, about 25% more than five years ago. Areas like Milton, Millville, and Haberson, on the edge of the county’s well-known beaches, promise a population boom as people want to be just a short drive from the ocean but not close enough to be disturbed by beach traffic.
However, Ed Ratledge, director of the Center for Applied Demographics and Survey Research at the University of Delaware, said the numbers any hospital director keeps track of are age demographics. Sussex County’s 65 year old and older population is projected to reach 87,000 by 2030 – a 65% increase from 2015.
“It’s a very old county and you are seeing more of an older group moving for summer homes and facing health issues that need to be addressed when they occur rather than delaying them until they get home,” said Ratledge. “There are around 3,500 retirees who move here every year and sell houses because it is so attractive with low income and property taxes and is adapted to pensions. But there is also a year-round population of younger residents who have low-wage jobs. “
While the older population is seeing the need for health services, more and more hospital executives are choosing more outpatient offices because they are cheaper than building a new hospital, support preventive care and keep costs down. Dr. David Tam, President and CEO of Beebe Healthcare, said Beebe’s hospital stays on Lewes campus increased 22.3% between fiscal years 2014 and 2017, “unprecedented in its recent history.”
“Medical technology and nursing protocols enable patients to receive safe, innovative care with shorter inpatient stays. The same healthcare innovations are allowing some surgeries that traditionally required hospitalization to be performed on an outpatient basis, ”Tam told the Delaware Business Times.
Beebe’s Special Surgical Hospital was designed with that in mind, he added. Since this facility will focus solely on planned operations, demand in the emergency room will be lower.
As Sussex County attracts more retirees, support for health services such as hospice and home nursing can also be expected to increase. Beth Copeland, executive director of Griswold Home Care in Sussex and Kent Counties, the county’s largest non-clinical support provider with 190 caregivers and 200 clients, said competition in her home care field has been fierce.
“It has grown tremendously in the last few years, and I really believe that the reason we have benefited from it for so long is word of mouth. We are constantly recruiting and finding qualified staff seems to be the biggest barrier right now, ”said Copeland.
Sussex County’s other immediate need will be first aid. The Delaware Department of Health and Social Services reported that approximately 15% to 20% of doctors in Sussex County plan to retire or be unavailable by 2024. Copeland said many of her clients are concerned when a doctor’s office closes or moves to a concierge service that charges $ 1,800 per visit.
“It’s big news when that happens and it’s difficult when they find a new doctor and sometimes have to wait about eight months to see someone and there’s no follow-up,” she said. “Many people fall through the cracks.”
As a stop-gap measure, MP David Bentz (D-Milford / Harrington) has tabled a bill to create a repayment program for healthcare providers that will allow new first responders to receive USD 50,000 per year for a maximum of four years if they serve underserved areas and accept Medicare and Medicaid.
In the meantime, Bayhealth is preparing to launch a residency program in July to bring the best medical residents to Sussex County for three years. Bayhealth’s Family Residency program will add eight new physicians each year with a capacity of 24 residents, and Bayhealth’s Internal Medicine Residency program will add 13 new resident physicians to the area each year with a ceiling of 39 Residents.
Taken together, the total capacity of the Bayhealth residency programs will add more than 50,000 patient care visits for the community each year.
“The hope is that they will thrive and become part of our communities and ultimately choose to practice medicine in southern Delaware.” Murphy said. “We have an opportunity to show these aspiring doctors, through the wealth of our communities and the hospitality of our cities, that Sussex is a wonderful county to live and work in.”