Advocates of Primary Health Care Join Health Commissioner to Support Governor's Health Care Reforms

Will Improve Access, Quality and Affordability in Health Care

GLENS FALLS, N.Y. (Feb. 29, 2008) – North Country clinicians and health care advocates joined State Health Commissioner Richard F. Daines, M.D., today at the Hudson Headwaters clinic here to support Governor Spitzer's 2008-09 budget proposals that shift Medicaid funds from inpatient services to strengthen support for primary and preventive care.

Governor Spitzer's Doctors Across New York initiative will bring physicians into medically needy areas. A rebalancing of the Medicaid payment system will support greater access to high-quality primary care and outpatient services.

"Changes in Medicaid reimbursement will provide incentives for increased emphasis on primary and preventive care to improve health outcomes," Commissioner Daines said. "The overarching goal of the Governor's proposed health care reforms is to transform a low-performing health care system that is increasingly unaffordable and inaccessible into a high-quality system that is focused on improving patients' health."

Doctors Across New York

To help address physician shortages in certain geographic areas, the Governor's budget proposes investing $15.6 million of the $362 million Graduate Medical Education (GME) Professional Education Pool into a new Doctors Across New York program. The initiative will provide new physicians with up to $150,000 in medical school loan repayment tied to a five-year commitment to practice in medically underserved rural and urban communities. It also provides start-up funds for new physicians practicing in shortage areas.

Despite overall growth in the supply of physicians in New York between 2002 and 2006, many upstate regions saw no change in the number of physicians and some regions saw a decline. For example, the North Country lost 5 percent of its primary care physicians over that time period. In recent years, every sector of New York's health care system has been challenged to recruit and retain staff, especially in rural and certain urban areas where the shortage of physicians is particularly acute.

Primary care reimbursement

As the largest single payer of health care in the state, New York's $47 billion Medicaid program must lead the way in restructuring and re-balancing health care reimbursement to provide needed incentives for primary and preventive care and better management of chronic diseases.

New York already has the nation's highest total and per-patient Medicaid spending and must link spending to health care priorities. By updating the reimbursement formula to more accurately reflect current health care costs, New York can leverage those reforms to influence the way every provider and payer serves every patient in the state.

A realignment of Medicaid investments will create fiscal incentives to increase access to quality preventive and ambulatory care, while reducing over-reliance on inpatient and emergency department care.

Dr. Daines noted that only through Medicaid reimbursement reform can additional dollars be allocated to enhanced primary care rates in hospital and community clinics and private doctors' offices. "Historically, New York's Medicaid program has overpaid for inpatient care. We need the entire spectrum of reimbursement reform to change, freeing up funds for reinvestment in community care. New York doesn't need to spend more on health care. It needs to spend smarter, and that's what the Governor has proposed," he said.

Support for reform

John Rugge, M.D., CEO of Hudson Headwaters Health Network said, "Governor Spitzer has clearly been hearing from the people of the North Country that our health care system is in critical condition. Now we're seeing a serious effort to ensure that essential health care services remain available for all our communities, even the most rural. What's at stake today is how we rebuild the foundation of the health care system - primary care and related supporting services. We can't expect to fix health care by raising taxes or taking funds from other areas. Yet we can carefully redistribute state health care funding to ensure the availability of primary care – the most effective and least expensive health care strategy. That's what the Governor's health budget does, and it's a necessary first step in rebuilding the health care system in New York State."

Robin Pierce, Director of the Smith House Health Care Center in Essex County said, "The Smith House Health Care Center has been without a physician for more than a year and we continue to struggle in our search for a family doctor to serve our clinic's more than 3,100 patients. The candidates we have interviewed have conveyed a desire to have their student loans paid in full. This was more than our small health center could manage without the support of Federal and State loan reduction and other incentive programs that currently are limited in the amount available. The Governor's proposed shift of graduate medical education dollars to support Doctors Across New York will go a long way into helping our Health Care Center, and others like us, recruit the physicians we need.

Jose "Jun" David, M.D., President-Elect of the New York State Academy of Family Physicians said, "Governor Spitzer's proposed Executive Budget moves our failing health care system toward a patient-centered and primary care focused system. It addresses the growing shortage of primary care providers by creating Doctors Across New York for physicians who work in underserved areas. The shift in emphasis to primary and preventive care will improve the health and lives of all New Yorkers."

Lara Kassel of the consumer group Medicaid Matters New York said, "Doctors Across New York is a reflection of a new attitude in state government – that government has both the responsibility to address people's needs and problems, and the ability to respond effectively. MMNY members across the state will be working with the Spitzer administration to assure that health care dollars are reallocated to the primary and preventive care that people need in their communities."

Among the supporters at today's event were Senator Elizabeth O'C. Little; Assemblywoman Teresa A. Sayward; Howard Nelson, Director of the Hudson Headwaters Health Foundation; Lottie Johnson of Area Health Education Centers; Vicky Wheaton of the Adirondack Health Network, Cathy Lamay, Director of the Greater Adirondack Perinatal Network; Dennis Weaver., M.D., CEO and President of Transformation Health Care; Kate Breslin, Director of Policy, Community Health Care Association of New York State; Jim North, Director of the Health Center on Broad Street; Carol Smith, Office Manager of the Health Center on Broad Street; Sister Charla Cummins of Catholic Charities; Larrie Gouge, Executive Director, Prospect Child and Family Center, Cerebral Palsy Associations of New York State; and Laura Davis of the Conference of Local Mental Hygiene Directors.