In a competition between Alaska's two largest hospitals for state approval to add emergency room beds, neither got exactly what it wanted.
Providence Alaska Medical Center received permission from the Department of Health and Social Services to add eight emergency treatment rooms, six fewer than it requested.
Alaska Regional Hospital's proposal to add satellite medical facilities in Eagle River and South Anchorage was denied on the grounds it would drive up health care costs unnecessarily and provide inefficient treatment in high-trauma cases.
In a letter to the hospitals explaining her decision, DHSS Commissioner Valerie Davidson said Providence's proposal "better aligns with Alaska's health care system" and "will provide a more cost and service efficient setting for care" than Alaska Regional's.
Like many states, Alaska limits the capacity of emergency rooms because any unused beds would still cost hospitals money. An overabundance of unoccupied beds would likely drive up costs to patients and insurers.
The two hospitals were vying for the right to build the latest batch of emergency beds allowed by the state. Until the year 2022, no more than 13 can be added anywhere in Anchorage.
Although Davidson saw more merit in Providence's plan, she chose not to allot all the beds to the state's largest hospital, because she did not think the municipality should rely so heavily on a single hospital for emergency services.
Providence officials were generally supportive of the decision.
"It's fair to say that overall we're quite pleased," said Providence Chief Executive Dr. Richard Mandsager. "Obviously we would have been a little happier if the whole application had been approved, but we're much more pleased than not."
Providence's budget for the expansion is $12.8 million. The hospital could not disclose which architecture and construction companies would be involved as no contracts have been signed, said spokesman Mikal Canfield.
Julie Taylor, chief executive of Alaska Regional Hospital, said officials there are very disappointed by the state's decision.
"We still believe our approach is sound, and that providing necessary emergency services close to home serves our communities best," Taylor said in an emailed statement.
Neither hospital would say whether they would appeal the state's decision.