In a fight over health care territory and patients, a regional hospital association and the Westchester County Medical Society have joined forces in opposing plans by Memorial Sloan-Kettering Cancer Center to open a regional cancer treatment center in a vacant office building in Harrison.
An executive at Memorial Sloan-Kettering”™s Regional Care Network in Manhattan said the private center, a national leader in cancer treatment and research, does not aim to draw away patients from existing Westchester medical practices to the Harrison facility. Rather, it wants to treat its current patients at an accessible location closer to their homes in Westchester, the lower Hudson Valley and Fairfield County, Conn., he said, and prepare to meet an anticipated growing need for cancer care in the future.
Officials at the Northern Metropolitan Hospital Association (NorMet) and the county medical society take a different view of Memorial Sloan-Kettering”™s plans in Westchester, where the Manhattan hospital for about 15 years has operated a cancer outpatient center at Phelps Memorial Hospital in Sleepy Hollow. In separate letters, they recently notified state Health Commissioner Nirav R. Shah of their groups”™ strong opposition to the $130 million project, which they claim is not needed.
Sloan-Kettering has filed a certificate of need application for approval of its Harrison project by the state Health Department”™s Public Health and Health Planning Council. No hearing on the proposal has yet been scheduled.
Sloan-Kettering plans to redevelop and expand vacant office space at 500 Westchester Ave. in Harrison for an approximately 114,000-square-foot treatment center. The Manhattan hospital two years ago paid $9.2 million to acquire the former Verizon facility. The approximately 8-acre property adjoins Fordham University”™s Westchester campus at 400 Westchester Ave. and is easily accessible from interstate highways 287 and 684.
The town of Harrison Planning Board in July began its review of site plans for the project. That process is expected to be completed late this year. Hospital officials have said they expect construction to begin next spring and the facility to open in the first quarter of 2015.
The treatment center would create 140 jobs, said Victor Ribaudo, executive director of the Memorial Sloan-Kettering Regional Care Network. The network includes the Sleepy Hollow center at Phelps Memorial, three centers in Long Island and one in New Jersey.
“We think it brings a lot of positives to the community, both to Harrison the town and to Westchester County,” Ribaudo said. “It”™s turning an abandoned eyesore into a very attractive asset for the community.” For Memorial Sloan-Kettering, “It”™s an opportunity for us to collaborate with businesses and medical professionals” in Westchester in providing its cancer-care services.
“What they”™re adding is redundant service,” said Alfred Tinger, chief of radiation oncology at the Northern Westchester Hospital Cancer Treatment and Wellness Center in Mount Kisco and a past president of the Westchester County Medical Society. “True, it”™s good quality, but it”™s not bad quality that we have in Westchester now. We have excellent quality.”
“Our position is it”™s superfluous, redundant and wasteful of public resources” that Memorial Sloan-Kettering receives in the form of federal grants for cancer research, Tinger said.
Kevin W. Dahill, president and CEO of NorMet, which represents 30 hospitals in the seven-county Hudson Valley region, in his letter to Shah, the state health commissioner, said the proposed Harrison facility would create excess capacity for oncology service in Westchester and “jeopardize the fragile economic health of existing health care providers, particularly those that currently serve a larger than average Medicaid population.”
Supporting the NorMet CEO”™s claims, Westchester County Medical Society Executive Director Brian O. Foy in his letter to Shah noted that Memorial Sloan-Kettering primarily serves commercially insured patients and limited numbers of Medicare patients. Medicaid and uninsured or underinsured patients on public health plans make up only about 5 percent of its payer mix, he said.
If Memorial Sloan-Kettering attracts the same type of payer mix to its Harrison facility, it will draw away commercially insured patients from existing Westchester oncology practices, Foy claimed. Those practices, already operating on “very thin” margins, would be economically imperiled by increases in the proportions of Medicaid and other patients with lower-reimbursing government health plans that they treat.
Existing health-care providers in the county “depend on the good-paying insurers to make up the shortfall when they take on poor patients who are on public assistance,” Tinger said. “There is a barrier to receiving care in the Memorial (Sloan-Kettering) system if you”™re not adequately insured.”
As Memorial Sloan-Kettering expands its market share in Westchester, “Certainly there will be losers in the game,” Tinger said. “Hospitals will close. The patients who are most needy ultimately will lose if there are not the facilities” to serve them.
At Memorial Sloan-Kettering, Ribaudo said the Manhattan hospital has been unable to get a contract with Medicaid-managed care plans to serve those low-income patients, “though we would very much like to do that.” He said Sloan-Kettering has one employee working full-time to enroll patients in Medicaid. In 2010, about 300 Medicaid patients were enrolled and admitted to the hospital, he said.
Memorial Sloan-Kettering will waive fees for uninsured patients with household incomes of up to five times the federal poverty level, Ribaudo said.
About 71 percent of the hospital”™s patients from Westchester County still travel to Manhattan for treatment, Ribaudo said. The Harrison site was chosen for its accessibility for Sloan-Kettering patients in Westchester, the Hudson Valley and Connecticut, he said.
With the Harrison proposal, “It”™s trying to provide better care to patients who are going to be coming to Sloan-Kettering anyway,” said Ribaudo. “Our intention is to treat the current patients who would come to Manhattan closer to home.”
The state health commissioner also has heard from Westchester-based supporters of the Memorial Sloan-Kettering project. They include the Westchester-Hudson Valley Chapter of the Leukemia and Lymphoma Society, Gilda”™s Club Westchester, Cancer Support Team, the Collaborative for Palliative Care and Westchester Jewish Community Services.
Breaking with NorMet in its opposition to the project, Phelps Memorial Hospital President and CEO Keith F. Safian told the commissioner that his hospital and Memorial Sloan-Kettering have mutually benefited from the cancer outpatient center in Sleepy Hollow. Medicaid patients from Phelps and the medically underserved “have complete access to MSKCC”™s excellent care,” he said.
“Without a doubt, expanding MSKCC”™s services in Westchester would be well received by patients and their families and help address the growing incidence of cancer with high quality care,” Safian wrote.
Foy said the project”™s opponents are gathering more data to support their claim that another cancer-care provider is not needed in Westchester. The Harrison proposal comes as Hudson Valley Hospital Center in Cortlandt Manor nears completion this year of a new comprehensive cancer care center and Lawrence Hospital Center plans to begin construction of a cancer center in Bronxville in early 2012.
“I”™m hearing from a lot of other doctors who believe this is a good fight,” Foy said. “A lot of physicians other than oncologists are supportive of this effort.”
This sounds like local hospitals trying to protect their turf without concern for patients’ well being.
I agree with Millie. Why does it always come down to money? Cancer has become a business. This opposition to Sloan Kettering is just GREEDY.People should be able to choose where they want to be treated and who they want to be treated by. It is hard to travel to NYC for treatment where you are ill.
The care MSKCC is able to provide surpasses all of the local Westchester hospital’s capabilities. These doctors are more concerned with their own pockets than the health of the citizens of Westchester County.