How does the recently enacted New York State budget affect New York Hospital Queens?
This new budget is expected to have a significant impact on the delivery of health care services in New York. It includes major cuts to a broad range of vital programs in health and education. And, the cuts may not be over. The budget includes a statewide cap on Medicaid spending. If that cap is exceeded, the Department of Health can implement further cuts.
So far, this budget translates to a reduction of $4 million for New York Hospital Queens for fiscal year 2011-2012. Included in this reduction is the elimination of the 2011 trend factor and a 2 percent reduction on Medicaid fee-for-service payments effective April 1, 2011. Hoping for the best, but prepared for reductions in 2011 state health care spending, our hospital’s budget included allowances for state spending changes. Our predictions were on par with the actual reductions.
Other proposals passed in the state budget regarding health care include:
· Implementation of nursing home rebasing and the finalization of a methodology for statewide pricing
· Home care payment changes
· Mandatory enrollment of residents into managed care programs
With regard to medical malpractice reform, the budget contains a provision to establish a medical indemnity fund to pay for future health related costs of neurologically-impaired infants. The fund would apply to all cases involving neurologically-impaired infants that have not concluded by April 1, thus covering all cases currently in the litigation pipeline. The previously proposed cap on non-economic damages of $250,000 was not included in the final budget.
There were some positive gains in the way of overall quality of care improvement for New Yorkers. The budget included provisions for palliative care, pay-for-performance initiatives and expanding the “patient centered medical home” and new models of integrated care, such as Accountable Care Organizations.
This budget process was unique in that health care providers, labor, government and other Medicaid stakeholders were brought together to form Governor Cuomo's Medicaid Redesign Team (MRT). The State Senate and Assembly passed most of the MRT proposals for the state fiscal year 2011-2012 budget. We remain hopeful that the Redesign Team keeps moving toward full systemic reform.
Thank you to those of you who participated in advocacy efforts with us. Only by working together can we ensure that our voices will be heard by those who will make systemic change a reality.
Stephen S. Mills, F.A.C.H.E