UHF's Chad Shearer Testifies Before City Council on Public Hospital Challenges, Progress

Chad Shearer testifying before the City Council Committee on Hospitals, live-streamed on February 28.

“It is always important to remember, however, that the public hospital system in New York City provides a unique public good that benefits all citizens and hospitals, and can't always be measured in services provided, or dollars and cents.”

With those words Chad Shearer, UHF's vice president for policy and director of the Medicaid Institute, concluded his Feb. 28 testimony before the New York City Council's Committee on Hospitals, laying out the importance of the city's health care safety net and what can be done to ensure it sustains its vital role.

The hospital committee hearing was held to examine the progress made since City Hall issued One New York: Health Care for Our Neighborhoods, a comprehensive report outlining the City's plan to restructure models of care and expand access to high-quality health care in high-needs communities, while financially stabilizing NYC Health + Hospitals (H+H). At the time the report was issued in 2016, the city's public hospitals were projected to reach a budget shortfall of $1.8 billion by fiscal year 2020.

In his testimony Mr. Shearer noted that, although more than one million previously uninsured people in New York State now have coverage under the federal Affordable Care Act (ACA), one of the reasons that the city's public hospitals are still suffering is because Medicaid reimbursements do not cover the full cost of care. UHF analyzed the payer mix at H+H facilities and found that a much higher percentage of hospital discharges were covered by Medicaid than at other hospitals across the city. Medicaid accounted for 57.9 percent of H+H payments in Manhattan, for example, versus 24.6 percent for private Manhattan hospitals.

Despite financial pressures, the city's public hospitals perform as well as other health care systems in the city and state on inpatient quality measures, Mr. Shearer said. And H+H institutions are moving ahead with efforts to shift more care into the community through primary care practices. H+H is also addressing social determinants of health, such as housing and food insecurity, and is currently pilot testing social determinant screening tools in three hospital-based clinics.

“There are many positive signs that H+H is on the right path, but substantial challenges remain,” Mr. Shearer concluded. He encouraged the City Council to remain data-driven in its assessment of both the progress made and the challenges ahead, while always keeping in mind the system's value and critical importance.

A video of the hearing can be found here, and Mr. Shearer's testimony can be downloaded below.

March 2, 2018
Focus Area
Clinical-Community PartnershipsQuality and EfficiencyCoverage and Access
Medicaid Institute