Patients Can't Wait; N.Y. Needs Health Reform Now

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

Will Improve Access, Quality and Affordability in Health Care

ALBANY, N.Y. (March 18, 2008) – Health care clinicians, consumer representatives and health care advocates joined State Health Commissioner Richard F. Daines, M.D., to stress the importance of including health reform in the state budget. The 2008-09 Executive Budget includes proposals that shift Medicaid funds from hospital inpatient rates to critical outpatient services, including primary and preventive care, and reallocate graduate medical funds to support a new Doctors Across New York initiative to bring doctors to medically underserved rural and urban communities.

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. The overarching goal of the proposed health care reforms is to transform a low-performing health care system that is increasingly unaffordable and inaccessible into a high-quality system focused on improving patients' health. The Governor's budget ties improved quality and safety to each reform.

New York already has the nation's highest per-patient Medicaid spending; that spending should support and advance health care priorities. Commissioner Daines noted that only through Medicaid reimbursement reform can additional dollars be allocated to raise 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 this budget proposes," Dr. Daines 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."

Doctors Across New York will bring physicians into medically needy areas throughout the state. The Executive Budget proposes investing $15.6 million of the $362 million dollar Professional Education Pool into the new Doctors Across New York program, which 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. Next year, in order to fully support this program, the Executive Budget increases the reallocation to $50.6 million.

"As State budget negotiations begin in earnest, we must remember that patients cannot wait any longer for these vital reforms – they need them now," Dr. Daines said.

Kate Breslin, Policy Director of the Community Health Care Association of New York State, appearing on behalf of the Primary Care Coalition, said, "If we're going to reform health care in New York State, we have to make primary care a priority. The way to have healthier New Yorkers is to make sure there is access to high quality, affordable primary care in all settings, from a community health center to a private doctor's office."

Barbra Minch, President and CEO of the William F. Ryan Community Health Center in Manhattan, said, "We know first hand that community based care is what our patients need and want. And, we know primary and preventive care is cost effective. For the first time, we have a proposed State budget that puts money where it will do the most good for patients -- in ambulatory care in the community."

Dr. "Jun" Jose David, President-Elect of the New York State Academy of Family Physicians, said: "The Academy applauds the Executive Budget for its proposed reforms to health care reimbursement and to address the growing shortage of primary care providers by creating a Peace Corps for physicians who work in underserved areas of the state, Doctors Across New York. The time is now for New York to address the crucial access issues in our health care system by enacting the Executive Budget proposals to reform health care reimbursement to a more patient-centered system and to direct State resources to help recruit an adequate number of primary care providers to meet the growing needs of our citizens."

Dr. Kallanna Manjunath, Vice President of medical services and staff pediatrician at Whitney M. Young Jr. Health Services in Albany, said, "I am the Chief Medical Officer at Whitney Young Health Center in Albany and we face tremendous difficulties in trying to recruit and retain young physicians to work in our center. With average medical school debt being upwards of $200,000, graduating physicians have little choice but to accept jobs in areas and fields where they can make enough money to pay off their debt and still provide for themselves and their families. The Doctors Across New York program proposed in the Executive Budget would greatly assist us in our efforts to attract more physicians to help meet the health care needs of the patients we serve. Also the proposed health care reimbursement reforms would better support the State's primary care infrastructure and ensure patient access to comprehensive and preventative medical care."

Dr. Mary Rappazzo, who practices in Albany and is a Governor Elect of the American College of Physicians, said, "Physicians in private practice provide a valuable training experience for residents, while encouraging them to enter the primary care field. Residents need to see the connection between a doctor and her patient, the establishment of a bond beyond one visit, and the satisfaction of working with a patient and their family across the care continuum."

Lara Kassel, advocacy coordinator for Medicaid Matters NY, a coalition of 150 advocacy groups representing consumers, said: "Medicaid Matters looks forward to working with Governor Paterson, Commissioner Daines and the Legislature to ensure that the reforms proposed in the budget are realized. We will insist that the consumer voice be heard loud and clear in hammering out the best possible changes to our health care system. The time for reform is now, and New Yorkers cannot and will not wait any longer for a system that works for everyone."

Dr. Henry Schaeffer, President of the American Academy of Pediatrics District II in New York, said, "This budget has the potential to significantly improve access to and quality of health care for more than 2 million children across our state."

Also attending today's event are Executive Director Ronda Kotelchuck and Vice Chair Thomas J. Murphy of the Primary Care Development Corporation in New York City, Associate Director Mary J. Sienkiewicz of the New York State Area Health Education Center System (AHEC) in Buffalo, Executive Director Kathryn Reed of the Catskill-Hudson AHEC, and Program Director Jill Wells of the Hudson-Mohawk AHEC.