Aiming to plan a new health care delivery model informed by hard data and tailored to the needs and demographics of the county, leaders in business, academia and the health care industry have joined in a consortium launched by the Westchester County Association.
The WCA Healthcare Consortium already has enlisted more than 50 CEOs and senior executives of hospitals, the county”™s largest physician groups, home care agencies, nursing homes, assisted facilities, insurers, trade associations, academic institutions and businesses such as Simone Development Cos., a developer formerly based in New Rochelle whose commercial real estate projects include medical office buildings.
Their work will be neither easy nor quickly done, consortium leaders said at an April 10 press conference to announce the effort to unite in the service of what Dr. Simeon Schwartz, president of Westmed Medical Group, called their common mission: “to improve the health of the county.”
“To achieve that mission, which is hardly trivial, we have to respond to changes in the marketplace,” he said.
Schwartz, whose physician-owned multispecialty practice group has grown to be a strong competitor with area hospitals in providing a wide range of health care services, suggested that response should include hospital closings or consolidations.
There are 10 acute care hospitals in the county serving approximately 1 million patients, he said. “That”˜s not an effective model,” he said. Planning is needed “to chart new paths for health care in Westchester.”
“Having a common focus and discussion on concerns and issues engaging health care today is essential for effective county planning,” he said.
White Plains Hospital President and CEO Jon B. Schandler, who has had a 35-year career in health care, predicted, “We”™re going to see more changes in the next three to five years than I”™ve seen in the last 30 years.”
With hospitals adapting to provisions of the federal Affordable Care Act and state reforms of the costly Medicaid program, “There”™s no doubt we”™re being challenged to take care of more members of our community with fewer resources,” he said.
Beyond federal and state legislative and regulatory reforms, “There”™s a local solution” to developing new health care delivery models, Schandler said. “That”™s probably the unique effort going on here that we all feel very enthusiastic about.”
Angela Skretta, vice president of the Northern Metropolitan Hospital Association and Suburban Hospital Alliance in Newburgh, said the consortium in its health care planning could recommend changes that hospitals would implement in five to 10 years. She said the group would look at “what makes sense from a business perspective and how things are going across the entire county ”“ where the needs are.”
Skretta cautioned that changes to health care delivery that affect hospitals, including consolidations and closings and added or eliminated services, will not ultimately be decided at the county level. The state will determine “which hospitals will do what,” she said. “This is a very, very complicated process.”
WCA Chairman William P. Harrington said the consortium is “the next step” in the WCA”™s 7-year-old Blue Ribbon Task Force initiative to reform the health care insurance industry to reduce the burden of rising costs on businesses and employees.
Health care “is the driving issue that every business should be focused on if they”™re paying attention,” said Harrington, managing partner at Bleakley Platt & Schmidt L.L.P. in White Plains. And the health care industry “is by far the largest economic engine in the region,” he said, employing more than 30,000 workers in Westchester and pumping more than $10 billion into the economy.
Harrington said the consortium likely would take more than one year to prepare its report and recommendations. “We don”™t know anywhere else in the state, let alone in the country, where this model is being replicated,” he said.
Planning will be based on data compiled by an academic subcommittee of the consortium that includes health care experts from Fordham University in Westchester, Iona College, Mercy College and Pace University. That data is “critical to development of a sustainable, efficient health care model,” Harrington said.
Paul Savage, program director of health care management at Iona College”™s Hagan School of Business, reported on preliminary data on hospitals compiled from the state Department of Health to help the consortium “visualize the magnitude of demand.” The data provide the following picture of the county”™s changing health care landscape over a 15-year period from 1997 to 2012:
Ӣ Fewer than 11 percent of Westchester residents travel to Manhattan for hospital care.
Ӣ Inpatient hospital bed use dropped by 15 percent.
Ӣ Hospital patient discharges were down 6 percent.
Ӣ Average length of a patientӪs hospital stay declined 13 percent.
Ӣ Inpatient services for maternity and pediatric care declined as the countyӪs population has aged.
Ӣ Inpatient and ambulatory surgeries declined.
Ӣ Medicine services for hospital patients increased 32 percent.
Ӣ Referrals of discharged patients to home care and skilled nursing facilities doubled.
Ӣ Medicare has surpassed commercial insurance as a primary payer of inpatient services.
Ӣ With an aging population, the number of hospital patients with Medicare rose 15 percent.
As President/CEO of Concept: CARE, Inc. a licensed home health care corporation, I am interested in knowing whether home care is being viewed as a critical component of the WCA Healthcare Consortium. As clinical interventions may be rationed in our “affordable” future, home care will be a prominent player in keeping our community healthy.