State Health Commissioner Outlines Plan to Attack Racial, Ethnic Health-Care Disparities

ALBANY, NY - June 15, 2007 - A combination of universal access to health insurance and the use of quality-based reimbursement powered by health information technology will dramatically reduce health-care disparities in New York, state Health Commissioner Richard F. Daines, M.D., said today.

Commissioner Daines outlined his vision for reducing health disparities today at the Sixth Annual Urban Health Conference sponsored by Generations+/Northern Manhattan Health Network and the New York City Health and Hospitals Corporation.

Dr. Daines used the South Bronx as an example of an area suffering health-care disparities – an area he knows well. Earlier in his career, Dr. Daines worked for 19 years in the South Bronx, mostly at St. Barnabas Hospital. He is a certified hospital translator in Spanish.

The state Department of Health (DOH) is implementing Governor Eliot Spitzer's initiative to restructure the health-care system and reform public financing for health care, including making health insurance available to all New Yorkers. As a first step, Dr. Daines said, the Child Health Plus insurance program will be expanded to families with incomes up to 400 percent of the federal poverty level – or $80,000 annually for a family of four. "With this increase, every family in New York State should be able to access health insurance for their children." Dr. Daines said. He outlined additional steps that will lead to the development of a plan for full universal access to health insurance in the spring of 2008.

Dr. Daines is leading the state's effort to restructure the health-care system to make it patient-centered, emphasizing primary and preventive care to help keep New Yorkers healthy and prevent serious complications from chronic diseases. In reforming the state's $47 billion Medicaid reimbursement system, Dr. Daines said New York will move "from a system that rewards volume of services and favors inpatient care to a system that rewards quality, improved outcomes, and encourages the delivery of preventive care."

The reimbursement system would be tied to nationally recommended quality indicators that would be provided through a health information technology system that would also give health-care providers complete electronic access to patient medical histories, clinical data, and quality decision-making support tools at all points of service. "A patient's complete medical history, including medication history, would be accessible whether the patient was at one location for drug treatment, another for mental health services, at a hospital emergency room, or at an outpatient clinic receiving primary care services," said Dr. Daines.

"Integrating quality measures into Medicaid reimbursement offers tremendous potential to address and eliminate serious health disparities caused by a lack of emphasis on prevention and lack of access to the most-effective health interventions," Dr. Daines added.

"To target community initiatives to eliminate health disparities, we must know the people, their environment and their health problems," Dr. Daines said. He outlined some statistics on the health of South Bronx residents:

  • The leading causes of death are heart disease, cancer, AIDS, accidents and injuries, diabetes, pneumonia, drug-related events, and stroke.
  • The leading causes of hospitalization for children are asthma, injuries and lead poisoning – all preventable.
  • The rate of lower-extremity amputations, a serious complication of diabetes – is double the state average.
  • Residents of the South Bronx are much more likely than residents in the rest of the state to experience serious health complications.

"We are spending $3.2 billion in Medicaid funding on 510,000 Medicaid enrollees in that section of the Bronx – more than 60 percent of the population," Dr. Daines said. "We don't need more funding; we need to use the existing funding more wisely and effectively."

Dr. Daines' speech is attached.