Greater New York Hospital Association responds to Crain report that hospital consolidation impacts communities of color
Also in 2013, Mount Sinai Hospital established a footprint in several new communities (including underserved ones) by acquiring St. Luke’s-Roosevelt Hospital, Beth Israel Medical Center, and New York Eye and Ear Infirmary. In 2016, NYU Langone Health acquired Lutheran Medical Center in Brooklyn. The Journal of the American Medical Association recently published a study describing significant quality improvements on the Brooklyn campus due to the NYU-Lutheran merger. Montefiore Health System acquired hospitals in Mount Vernon and New Rochelle that serve communities of color to keep them from closing.
Second, there has been a significant shift from inpatient hospitalizations to outpatient outpatient care. As this trend gained momentum, some financially troubled hospitals closed or consolidated because health planning agencies determined that their low occupancy rates, underutilization and poor condition financial constraints prevented them from providing high quality care.
Ambulatory outpatient services have filled this void. The full-service emergency department and medical complex in Lenox Hill Greenwich Village, which Northwell Health established on the site of the former St. Vincent’s Hospital in Manhattan, provides essential healthcare services while transferring the small number of patients requiring inpatient services.
Montefiore opened a similar facility at its Hutchinson campus in the Bronx. One Brooklyn Health, created by the merger of three safety-net hospitals, is converting the campus of Kingsbrook Jewish Medical Center into a medical village with outpatient services. Quite simply, the closing of inpatient services at New York hospitals over the past decade has not eliminated health care services at these sites.
Third, you can consolidate yourself out of business. Every health care system is aware of what happened to St. Vincent’s Catholic Medical Centers, a system that collapsed under massive debt, primarily due to the weight of the acquisition of five financially troubled Catholic hospitals serving large indigent communities in Brooklyn and Queens. Healthcare systems must carefully weigh the financial risk to the mainframe before coming to the aid of struggling independent hospitals.
Yet many academic medical centers provide assistance to safety net hospitals without taking financial risk through clinical affiliations such as Mount Sinai’s with Richmond University Medical Center and Northwell’s with Maimonides Medical Center and Wyckoff Heights Medical Center.
Fourth, the indispensable role of government in maintaining the viability of independent hospitals must be strengthened. A major driver of hospital closings is that Medicaid is woefully underpaying New York hospitals. New York’s Medicaid program covers less than 65% of hospital costs.
These Medicaid rates affect everyone – the five largest private health systems in the New York area are collectively responsible for more than 45% of Medicaid hospital discharges in the downstate region and 38% in New York. These systems are deeply committed to serving vulnerable communities of color and reducing health disparities, but for independent hospitals with a safety net to survive, the government must dramatically increase its support for them.
We strongly support Governor Kathy Hochul’s proposals in this year’s state budget to provide nearly $2 billion in operating support for safety net hospitals, as well as a record health care investment of $1.6 billion.
But more is needed to ensure the lasting stability of these hospitals. That’s why the Greater New York Hospital Association, in conjunction with Service Employees International Union Local 1199, is advocating for increased funding for Medicaid in the state budget and for additional funding from the federal government. .
Kenneth E. Raske is president of the Greater New York Hospital Association.