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One big Philly hospital is seeing a lot more coronavirus patients than its rival

Thomas Jefferson University Hospital had twice as many average daily coronavirus inpatients as the Hospital of the University of Pennsylvania last week, according to new state data, a difference that could have significant financial ramifications for the two largest health-care providers in the Philadelphia region.

Both hospitals are facing hundreds of millions of dollars in lost revenue as a result of the pandemic. The disclosure came in Pennsylvania Department of Health data released Wednesday that showed 51 hospitals in Pennsylvania, including 31 in the southeastern part of the state, were allocated vials of remdesivir, a drug that may help some patients recover more quickly from the coronavirus. The drugs were allocated this week based on patient counts from May 4 to 10.

Pennsylvania hospitals received 1,200 vials of the drug from the federal government on Tuesday. The drug, which the Food and Drug Administration recently approved for emergency use, was expected to arrive at the hospitals this week, the Health Department said. Jefferson’s flagship hospital in Center City is slated to receive 72 vials.

“It is important to note that there is limited information on the safety and effectiveness of using remdesivir to treat people in the hospital with COVID-19,” Secretary of Health Rachel Levine said.

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New Jersey has received 8,560 doses of remdesivir so far, that state’s Department of Health said, but it has not provided a breakdown by hospital. “All hospitals that are treating COVID patients are expected to get some supply,” a spokesperson said.

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Pennsylvania made its allocations based not just on the number of COVID-19 patients a hospital had during the seven-day period, but also taking into account the number of patients on ventilators at different hospitals.

Jefferson had 143 COVID-19 patients during the period, 22% more than Temple University Hospital at the time. It had 27 patients on ventilators, second only to Einstein Medical Center Philadelphia, which had 32. As a system, Jefferson’s Pennsylvania hospitals had 426 COVID-19 patients, or 28% of the total reported for Southeastern Pennsylvania. Those Jefferson hospitals have a total of 2,089 staffed beds, according to the latest state tally.

By contrast, the University of Pennsylvania’s four hospitals in Southeastern Pennsylvania — with 1,763 staffed beds — had 195 COVID-19 patients early this month, including 52 on ventilators.

Jonathan L. Gleason, Jefferson’s chief quality officer, said in an email that the organization, like most health systems, has had limited access to remdesivir.

“We appreciate the state’s efforts to expand supply to Pennsylvania hospitals, and we support increased production of remdesivir in part because of the need for additional scientific evidence on the best uses for it,” he said.

The Hospital of the University of Pennsylvania and Penn Presbyterian Medical Center each had just under 100 COVID-19 cases at the hospital’s peak, beginning during the week of April 20, a health system spokesperson said. More than 1,800 COVID-19 patients have been treated at Penn Medicine hospitals so far, the spokesperson said.

PJ Brennan, Penn’s chief medical officer, said decisions about which current patients will get the limited supply of the drug will be made based on factors such as the severity of the illness and the need for supplemental oxygen. “Penn has three remdesivir clinical trials in its portfolio being conducted at HUP and Penn Presbyterian Medical Center,” he said.

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The coronavirus pandemic has hurt hospitals and other health-care providers financially in at least two ways. They’ve lost huge chunks of revenue because of the suspension of all nonurgent care, which is the more profitable part of their business. Plus, they’ve had added costs for COVID patients, such as personal protective equipment, coupled with low payments for patients.

Hospitals and public health officials prepared for a surge of COVID-19 patients by emptying hospitals to the extent possible. Thanks to prevention measures, the feared surge didn’t happen, at least not in this initial wave of the outbreak. Philadelphia has more than 4,000 acute-care hospital beds. On Wednesday, 741 of them were occupied by COVID-19 patients, down from a peak of 1,013 on April 24.

Last month, Jefferson estimated the financial impact of COVID-19 at up to $120 million a month, without specifying whether that figure represents revenue loss or decline in operating income. At the same time, Penn estimated that it would incur a $450 million loss in operating income in the year ending June 30.

Both systems said estimates were before taking relief funds into account.

Penn received $101 million in payments from the U.S. Health and Human Services Provider Relief Fund, which was based on Medicare billings last year, and $53 million from a $12 billion allotment for 395 hospitals nationwide that had treated at least 100 coronavirus patients through April 10.

Jefferson received $101 million from the high-impact fund, but the amounts it received under the program based on Medicare billings has not yet been published.

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