Patient Care Advocates Join Health Commissioner to Support Governor's Health Care Reforms

Will Improve Access, Quality and Affordability in Health Care

ROCHESTER, N.Y. (March 6, 2008) – Rochester-area clinicians and health care advocates joined State Health Commissioner Richard F. Daines, M.D., today at the Westside Health Services 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.

"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."

For example, his budget will strengthen last year's investment of $3 million in childhood lead poisoning prevention with an additional $2.5 million to expand prevention and testing efforts in high-risk residential areas – including parts of Monroe County.

"Preventing the myriad of public health problems seen in various health care settings will pay huge dividends. While we have significantly reduced the level of childhood lead poisoning in Monroe County, still hundreds of children are exposed each year. Monroe County's new Nurse Family Partnership has proven very popular and holds great promise to improve the health of first-time mothers and their newborns and to drive down medical costs," said Dr. Andrew Doniger, Monroe County Public Health Director.

The Nurse-Family Partnership initiative is a results-oriented prevention investment that will use nurse home visits to improve the health and well-being of first-time pregnant women and their children who are at risk for poor outcomes.

In addition, the Governor's budget will increase Medicaid reimbursement for physician fees on average by almost 50 percent above existing levels. So a basic new patient visit that currently pays physicians $31 will pay $55 in year one, and $74 in year two – which more accurately reflects the doctors' true costs. Providers practicing in underserved areas and maintaining weekend and evening hours will receive even higher fees.

The budget addresses access to care in other ways, including allowing clinical social workers to provide mental health counseling services to children, adolescents and pregnant women.

In a major reform, the Governor's budget begins the process of making greater investments in primary care by shifting some funding from inpatient care – where historically New York has overpaid for services – to primary care – where it has underpaid. As the largest single purchaser 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.

Commissioner 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. "We would phase in reform over four years, to allow hospitals to realign their business plans. As a former hospital president, I know that this is a challenge, but it's one that every institution can meet."

Chris Wilkins, CEO of Westside Health Services, said, "Governor Spitzer's budget proposal affirms that the community health movement's time has come. Led by the Governor, Dr. Daines and the Governor's health team, we all stand ready with an unwavering commitment to put 'People First.' The proposal weaves a sensible tapestry of reimbursement, workforce incentive and prevention services targeted build critical community infrastructure. Westside Health is grateful to the Governor for his faithfulness in setting this priority."

Jonathan Klein, M.D., M.P.H., president of the local chapter of the American Academy of Pediatrics and a pediatrician at the University of Rochester Medical Center, said, "The New York State American Academy of Pediatrics strongly supports the Governor's budget in areas that improve the health of children and adolescents. The proposed expansion of the Child Health Plus program to children in families with incomes up to 400 percent of the poverty level will bring 400,000 additional children into SCHIP, and this will improve their access to preventive care, reduce unmet health care needs, and significantly reduce disparities in care."

Susanna Peer, R.N., B.S.N., M.P.H., division manager of the Monroe County Department of Public Health Child and Family Services, said, "We are very pleased and appreciative that the Nurse-Family Partnership Program of Monroe County has been included in the Governor's 2008-2009 Executive budget. This funding will allow us to continue to provide and expand services to high-risk, low income, first time mothers and their infants. The funding will provide a solid foundation that will enable us to reach the Nurse-Family Partnership's goals of improving pregnancy outcomes, improving child health and development, and improving economic self-sufficiency of the family."

Trilby de Jung, senior attorney on health at the Empire Justice Center, and steering committee member of Medicaid Matters NY, said, "The Governor's budget will help low-income people who desperately need access to more primary and preventive care in their communities. The budget provides incentives for doctors to serve communities in need and finally tackles New York's outdated reimbursement methodology, which is much too heavily weighted toward institutional settings rather than community clinics like Westside. We have seen budget after budget fail to take the bold steps that are necessary to reform our system, calling for studies and providing for transition funding for the institutions year after year instead. Medicaid consumers can't afford to wait any longer. Empire Justice Center also supports the budget's steps toward a lead poisoning prevention program in which cities like Rochester would look for lead-paint hazards in buildings BEFORE any children are poisoned."

Lenora Colaruotolo of the New York chapter of the National Association of Social Workers said, "NASW-NY State Chapter is pleased to see the Governor's commitment to provide Medicaid reimbursement for licensed clinical social workers who are providing services to children, adolescents, and pregnant women. These are some of the most vulnerable populations we serve, and to ensure their access to social work services is crucial to childhood and adolescent development and the well-being of expectant mothers."