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Transformation Q&A

Questions & Answers

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A: NYC Health + Hospitals is engaging in a comprehensive plan to transform into a high-performing, competitive, and sustainable community-based system. Our need to transform is predicated on two imperatives:

  • The need to better serve our patients and communities by enhancing access to ambulatory care, addressing social determinants of health, and right-sizing our clinical services to provide 21st  century health care for all New Yorkers, regardless of their ability to pay;
  • A major financial challenge brought on by rising costs to operate our system, operational inefficiencies, funding reforms, and the deterioration in federal supplemental payments that help cover some of the shortfall associated with being the City’s single largest provider of care to Medicaid and uninsured patients.

A: Transforming a large, complex health care system is a massive undertaking. That’s why we have embarked in a five-year plan to make strategic changes. We’ve been building the groundwork and have been focused hard on two fronts:

  • Meeting our financial targets – In fiscal year 2017, we had an ambitious goal to close a $1.16 billion gap, and we ended the year with a $603 million cash balance—which we achieved through enhanced revenue streams and short- and long-term cost efficiencies. The health system is on track to close the current fiscal year 2018 projected gap of $1.14 billion by continuing to focus on organizational efficiencies and actions in our control.
  • Redesigning, planning, and implementing the transformational changes that will improve care for NYC communities – That includes helping to enroll as many people as possible in health insurance, adding special programs to coordinate health care services, strengthening primary care, helping to screen people for their social needs, and connecting them to services that can help them.

A: Different communities may see different changes depending on the local health care needs.  In some communities, there may be new ambulatory care services or health centers. In others, there may be redesigned services with more convenient hours. Some will see the help of care coordinators to navigate the health care system and connect people with services – like food pantries with fresh produce – that can help keep people healthy.  Some communities may see new outpatient mental health or substance abuse programs so that people who need help can get it close to where they live.  Many communities have already seen outreach for insurance enrollment and education.  Some hospital campuses may get affordable housing built on unused parcels, or new post-acute care programs, and some will see a reduction in inpatient beds if occupancy rates continue to decline.  Everywhere, the goal will be to provide high quality services that best meet communities and patient needs in an efficient and sustainable way.