The country’s largest public-hospital system is about to tackle one of health care’s biggest challenges: getting patients out of emergency rooms and into the offices of primary-care doctors.
What has been touted by New York City Mayor Bill de Blasio as “literally universal” health care guaranteed to all New Yorkers is more technically an expanded primary-care system for the most needy.
Called NYC Care, it is planned to have the typical perks familiar to people who have insurance: a membership card, 24/7 on-call service, easier access to specialists and ready appointments with the same primary-care physician.
Mitchell Katz, the chief executive and president of the city’s $8 billion NYC Health + Hospitals system, calls NYC Care “a population health drive.”
“We are going to make New York City healthier by focusing on primary care,” he said.
The program—which isn’t insurance—will cost about $100 million a year and begin Aug. 1 in the Bronx, with other boroughs to follow. It is expected to serve roughly 300,000 people who are ineligible for insurance, including undocumented and poor people.
New Yorkers, regardless of ability to pay, have long been universally able to receive emergency and preventive care at one of the 11 hospitals and numerous clinics that are part of the city’s sprawling hospital system.
But how patients receive that care, how long they wait for it and whether that care is continuous is questionable. Rolling out a program that people want to use and changing negative perceptions about the quality of care through the city’s safety-net system are significant challenges, say experts.
Another hurdle is whether the new program can live up to the idea of universal health care, said Bill Hammond, a health-care analyst at the Empire Center, a conservative-leaning New York think tank. New Yorkers already had universal access, he said; the problem is how it is used. Health officials are rightly “trying to fix the delivery system,” said Mr. Hammond; meanwhile, the mayor, “made it sound like they’re fixing the coverage system.”
Weaning people from use of the emergency department remains a substantial issue.
It is extraordinarily difficult to change patient patterns of behavior, said Michael Sparer, chair of the Department of Health Policy and Management at the Mailman School of Public Health at Columbia University. “It’s kind of a cliché, but it is true: the hard thing is to make what you might consider the right choice, the easy choice” for patients, he said.
…
Read the rest at wsj.com.
© 2019 Wall Street Journal
You may also like
Editorial: Cuomo’s problematic Medicaid maneuvers
“It’s everything that’s wrong with Albany in one ugly deal,” Bill Hammond, a health policy expert at the fiscally conservative Empire Center, told The Times. Read More
More New Yorkers covered by health insurance: report
An analysis by Bill Hammond of The Empire Center for Public Policy said the continued drop bolsters the case against the Albany Legislature passing a new law imposing a state government-run health insurance, which Democratic candidates for president are pushing for on a national level. Read More
What Cuomo’s executive order on vaping will and won’t do
“If you have these really young kids and teens getting hooked, then that’s not good," said Bill Hammond, director of health policy at the Empire Center for Public Policy. "But the first step would be to do some research, have a public hearing, get the best expert evidence that you have. Instead of reacting to headlines, find out what’s really going on and proceed with proposed regulations.” Read More
Medicaid bungle cost state $102 million over 4 years
“A little series of mistakes in a program this big can add up to a lot of money in a hurry,” Hammond told The Post. “A quarter of a million dollars is a lot of money. It’s important that the auditors are looking at this and are pointing to things that could be fixed.” Read More
Watchdog Group Questions New York’s Delayed Medicaid Payment
The Empire Center’s Bill Hammond says Governor Andrew Cuomo’s budget office quietly postponed a $1.7 billion dollar Medicaid payment in late March by three business days and made the payment instead in early April. That’s significant because the state’s fiscal year ended March 31 and a new one began April 1. If the payment were made in March, the state would have been over a statutory cap that limits growth of Medicaid spending to 3% last year. Read More
Universal Health Care For New Yorkers? Not Exactly
De Blasio’s claim was “very misleading,” said Bill Hammond, the health policy director at the Empire Center for Public Policy, a nonpartisan, New York-focused think tank. Voters might think he is referring to universal insurance or even a single-payer system, he said, neither of which is true. Read More
Why New York’s hospitals do terrible in federal rankings
In 2016, the Empire Center for Public Policy, a right-leaning think tank, found that New York had the lowest average score of any state, a paltry 2.26. Only the District of Columbia and certain U.S. territories were lower. Read More
Panel at LIA meeting knocks state single-payer health care bill
"Ninety-three hospitals would lose more than 10 percent of revenue," said Bill Hammond, director of health policy at the Empire Center for Public Policy, a fiscally conservative Albany think tank. Read More