It is a typical day on the sprawling grounds of Denver Health and Hospital. Doctors and nurses dressed in the uniform of the day—sky blue scrubs—walk to their next appointment. Countless others, there to drop someone off or see a doctor, share the same passageway. It’s unorganized choreography that takes place all day long. Just another normal day at Denver’s busiest hospital.
Everyone is going someplace, to a building labeled ‘A’ or ‘B’ or some other letter of the alphabet. Or, maybe, just headed home.
Navigating the sidewalks, you take a serpentine route, walking around the ‘burrito man,’ dodging the heart surgeon or the nurse, the worried family or the Uber driver who’s just stepped out of the car to stretch. As you do, you hear a cacophony of accents and languages. It’s Monday, but it could be any day at Denver Health.
The hospital has gone through an evolution of names since it began more than 160 years ago. In previous incarnations, it was City Hospital, later the Poor House, County Hospital, Arapahoe County Hospital, Denver General and in 1997 to present, Denver Health and Hospital. But its basic mission has remained constant, “to provide access to the highest quality health care.”
Its emergency department remains an American gold standard. But it has other specialties that rival any health facility in the country.
Its open doors also mean treating one in four Denver residents each year. Half of the babies born each year in Denver are ‘Denver Health babies.’ All told, 300,000-plus people are in-patient or out-patients at the hospital each year with a growing number of being non-native born.
“I’d say it’s 60-40,” a friendly Denver Health concierge answers when asked the percentage of those asking for help or directions are Spanish speakers.’ Today’s concierge is well equipped. He also speaks Spanish. The hospital is its own Tower of Babel. Languages proliferate.
Despite recent fiscal challenges, the facility has shown amazing resiliency and imagination. While it posted a $35 million loss in 2022 it bounced back the next year reporting a $17 million profit. It finished 2024 $10 million in the red. And while the numbers are steep, in the healthcare world, they’re neither foreign nor unique. They’re part of doing business.
But, said CEO and former Colorado Lieutenant Governor Donna Lynne, “Our budget is holding steady this year.” That, of course, is thanks to passage of ballot measure 2Q that voters approved last November.
The measure, a .34 percent sales tax hike, is estimated to raise approximately $70 million per year. Following the vote, District 3 City Council member Jamie Torres and primary co-sponsor of 2Q applauded voters. “You have ensured Denver Health can continue to provide crucial health services” she told The Denver Post.
Despite the hospital’s red ink challenges, Lynne said it has so far escaped layoffs. But even with passage of 2Q, it cannot relax nor take anything off the table. “We are hoping to avoid staff reductions.” So far, so good.
But money to fund one of Colorado’s and the West’s finest hospitals, even in good times, is no easy task. And because Denver Health serves a Medicare/Medicaid—about 70 percent—and indigent population, it will always be challenged.
“In 2024, Denver Health had $155 million in uncompensated care costs,” Lynne said. Also, added Lynne, “because of H.R.1’s (Trump’s ‘Big Beautiful Bill) Medicaid eligibility changes, we fully anticipate that number to grow exponentially in the years to come. In that regard, Denver Health is not unlike scores of similar regional hospitals.
“Nearly two thirds of our funding come from the federal government,” Lynne said. In 2024, the hospital took in “$474 million in Medicaid reimbursement.” Lynne and the hospital will have to wait on the legislation’s impact. But it will have ramifications, both fiscal and in pure health care delivery. The ‘how big’ and ‘when’ variables of this equation remain a mystery. But they’re coming and the hospital is bracing for it.
“If people go without health insurance,” Lynne said, “it’s likely they will delay care and choose to receive it in an emergency room where the cost of care is much higher…as the state’s major safety-net hospital, we will see the greatest number of patients coming to us for care because they simply cannot afford it.” Also, for facilities like Denver Health, no one visiting the ER is turned away.
Because rural hospitals also receive a large portion of their operating costs from Medicare and Medicaid, they will face the same challenges. Some, it has been predicted, may have to close. If that happens, hospitals like Denver Health may be taxed with an even higher patient load as the migration for care will surely bring them.
Just how the President’s center piece legislation, H.R. 1, ultimately impacts hospitals, both rural and metropolitan facilities like Denver Health, will not be known for months. But the template, with changes in Medicaid eligibility requirements, including a provision calling for all able-bodied male adults over age 18 seeking health care must work. It’s part of the deal.
Still, knowing that tough times may be coming, Lynne said, the mission at Denver Health will not change. There may be fewer dollars to cover treatments, but healthcare will not be compromised.
