REPORT TO THE BOARD OF DIRECTORS – October 2016

Enrollment in MetroPlus’s Essential Plan has grown by 50 percent over the past seven months, now surpassing 63,000 enrollees.

Created through the federal Affordable Care Act, the Essential Plan is new to the insurance market this year. While it features the same essential benefits offered by other plans available through New York State of Health, the State’s insurance marketplace, it costs much less than the other plans and is available only to adults who meet specific income criteria. For example, an individual cannot earn more than $23,540 a year. In addition, those who qualify for Medicaid are not eligible.

The growing number of enrollees indicate that uninsured New Yorkers are embracing MetroPlus’s Essential Plan as an opportunity to enroll in great health insurance at affordable prices. NYC Health + Hospitals has been the longtime provider for many of the new enrollees, so we offer continuity of care for them. In addition, enrollment is possible throughout the year, and it costs only $20 a month, or nothing for some. It’s an affordable option that presents easier access to all the services provided by NYC Health + Hospitals in all five boroughs, as well as to our other providers.

Another recent success for MetroPlus involves ratification of a new contract agreement favoring MetroPlus as the health plan option for 2,700 day care employees and members of District Council 1707 and the Day Care Council of New York. This is the first union agreement that offers MetroPlus as the sole plan of choice for members and their families living in New York City. Workers will now have access to comprehensive health benefits, including prescription coverage, mental health services, and maternity care, as well as free wellness visits, for as little as $15 per month.

Leading up to the open enrollment periods for Medicare and Marketplace, NYC Health + Hospitals and the Centers for Medicare & Medicaid Services (CMS) have teamed up for the sixth consecutive year to offer free seminars to help residents understand the health plan options available to them. Health insurance specialists from CMS provided updates on Medicare (Parts A, B, C and D) and Medicaid programs, information about health care reform, the Affordable Care Act (ACA), and how to select and purchase affordable insurance on New York State of Health, the state’s official online marketplace to provide health insurance under the ACA.

Seminars were held at five NYC Health + Hospitals locations across New York City. Hundreds of caregivers, patients, community providers, NYC Health + Hospitals staff nearing the age of 65 and individuals who work with seniors, were encouraged to attend.

NYC Health + Hospitals marked National Depression Screening Day on October 6 with screenings and treatment referrals at 14 patient care locations. Confidential screenings are conducted by mental health professionals in individual, private consultations, and are designed to identify symptoms of depression and mood disorders. Patients requiring assistance will be referred to the appropriate levels of treatment within each location.

NYC Health + Hospitals has integrated universal depression screenings for adults in primary care, has successfully led efforts in the city to screen all pregnant women and new mothers for maternal depression, and has focused efforts to promote health care services to young people at YouthHealth neighborhood centers.

NYC Health + Hospitals is a major provider of behavioral and mental health services in New York City with a team of expert and compassionate health care providers who focus on prevention, provide mental health care with the same urgency as any other health condition, and work toward recovery and a better quality of life for all patients. The health system has integrated universal depression screening for adults in primary care to reach even more New Yorkers who may be suffering from mental illness. Specialized services, including depression help, for youth ages 12-21 are also available at YouthHealth neighborhood centers in all five boroughs.

On October 13, NYC Health + Hospitals announced that through a combination of funding in the NYC budget and a partnership with Merck & Co., the City will triple the number of incarcerated patients in the next two years who receive medication that can cure hepatitis C.

NYC Health + Hospitals is committed to the health and well-being of all New Yorkers. And is proud to be able to expand life-saving hepatitis C treatment to some of the most vulnerable patients in our City and ensure that people moving into and out of the corrections system can receive a full course of treatment and services.

New York City operates one of only two jail systems in the nation that initiates treatment for patients during incarceration. In April, the City announced that over the next five years it will expand the provision of a drug regimen that cures hepatitis C with $2.5 million in funding in Fiscal Year 2017, ramping up to $5 million in the following years. To increase the impact of this funding, NYC Health + Hospitals partnered with Merck & Co. to obtain its hepatitis C drug ZEPATIER at a discounted price and will use this therapy exclusively unless it is not advisable for an individual patient or not medically appropriate. The combination of new funding, which brings the program’s budget to $4.4 million, and the discounted drug price will enable the City to treat and cure over 100 patients in Fiscal Year 2017.

For the first time NYC Health + Hospitals is posting banners on lamp posts throughout the city to promote its unified health care network of hospitals, community-based health centers and long-term care nursing facilities under one logo. Highlighting NYC Health + Hospitals’ “Live Your Healthiest Life” wellness slogan in 13 languages, the banners will be seen in 68 neighborhoods that surround the health system’s patient care sites.

The banner campaign, which promotes service areas like mental health, youth health and LGBTQ health, also markets MetroPlus, the health plan of choice for more than 500,000 New Yorkers.

“The banners are a public invitation and a visual representation of our integrated health care delivery system. They also send a strong message about what we value: community wellness, quality care, cultural diversity and access to affordable health insurance coverage,” said NYC Health + Hospitals President and CEO Dr. Ram Raju.

To enhance the patient experience for new mothers, in September, NYC Health + Hospitals/ Woodhull launched a new mother’s support group to combat postpartum depression. There are two therapy groups led by a mental health provider who is an expert in postpartum mental health, and co-facilitated by a psychology intern. Two weekly groups just began – one in English and one in Spanish – with a community health worker as part of the team to help bridge cultural gaps. The sessions are called “Mother’s Support Groups” in order to attract more participants and reduce stigma. The groups will be open to all pregnant and new moms and a formal diagnosis of depression is not required to participate. The program was made possible through a $20,000 grant from The Fund for NYC Health + Hospitals.

To enhance the patient experience and lower the Length of Stay at Woodhull, a Social Worker Work Station was created adjacent to primary Medicine Units (8-100 and 8-200) where social workers can work on patient discharges in the same area as the patients. The workstation was the result of a multidisciplinary process to improve efficiencies and increase accountability.

Last month, the Joint Commission conducted its final triennial survey for 2016, at NYC Health + Hospitals / Elmhurst. Elmhurst will receive full Joint Commission accreditation for the next three years. This was a challenging survey for Elmhurst, given that the facility had only months before implemented Epic, the electronic medical record system. The Joint Commission survey team leader, having surveyed other NYC Health + Hospitals facilities on QuadraMed, and her team, were eager to observe the functionality of the system and staff’s response. The team leader stated NYC Health + Hospitals and Elmhurst have done a great job with the Epic implementation, and are way ahead of other organizations who have had Epic for a longer period of time”. Surveyors commented that staff were awesome, and that physicians participated and were engaged throughout the survey”. There were recommendations for improvement, some of which were corrected during the survey while others are already being addressed. There were recommendations for improvement, some of which were corrected during the survey while others are already being addressed.

Congratulations to Israel Rocha, CEO, Jasmin Moshirpur, MD, Chief Medical Officer, Joann Gull, RN, Chief Nurse Executive, Joseph Halbach, MD, Deputy Medical Director and Sharon Behar, Sr. AED Quality Management/Regulatory Services, and Elmhurst staff, for a successful survey outcome. Thanks also to Board Member Helen Arteaga-Landaverde, for participating and representing the NYC Health + Hospitals Board at the Leadership Session of the survey.

Congratulations to the class of 2016 – Elmhurst, Gouverneur, Harlem, Jacobi, McKinney, and Metropolitan for continuing to provide outstanding quality patient care to our patients. In 2017, a new survey cycle will begin, with Bellevue, Carter, Coler, NCB, Queens and Woodhull up for survey.

OneCity Health continues with our transformation efforts in care management, primary care and behavioral health integration, and chronic disease improvement. We are also proud to announce that we achieved 100 percent of our eligible achievement values for the first quarter of DSRIP Year 2 (April 1, 2016 – June 30, 2016).

• To support the building of a high quality primary care network, we are supporting Patient Centered Medical Home (PCMH) certification for over 80 community primary care partners; the first of two cohorts of primary care organizations are working with technical assistance to achieve PCMH requirements. Our NYC Health + Hospitals facilities will achieve certification via in-house efforts, as was successfully done in the past.
• Five NYC Health + Hospitals sites and five community partner behavioral health and primary care sites have been selected as pilots for intensive support in implementing co-located services for primary care and behavioral health and will begin site-level diagnostics and implementation planning.
• At two NYC Health + Hospitals facilities, transition management teams continue to provide 30 days of supportive care management for patients at high risk of readmission. Since piloting, the teams have supported 248 patients with 29 readmissions within the group.
• OneCity Health, in conjunction with three other Performing Provider Systems, Community Care of Brooklyn, Bronx Health Access and Bronx Partners for Healthy Communities, launched the 100 Schools Project in September to address mental health disorders in adolescents, beginning with 10 schools across Brooklyn and the Bronx. The PPSs are funding and overseeing the project, while the Jewish Board of Family and Children’s Services is coordinating the initiative and will teach schools how to connect students who have emotional, behavioral and substance-abuse challenges with top-tier local mental health providers while enabling the students to remain in school.

OneCity Health was selected to present at a Greater New York Hospital Association symposium in November to discuss how we’ve successfully partnered with community-based organizations in outreach and engagement of uninsured New Yorkers to connect them with insurance and primary care. NYC Health + Hospitals and 35 community-based organizations are collaborating in the effort.

For two years or more, we have been doing the difficult initial foundation work necessary to become more patient-centric, more competitive, and more sustainable by the year 2020.

We know that one of the most critical components of transformation will be our success at building an integrated IT system.

But when we talk about IT and its central place in our plans, we are usually talking about our effort to build a state-of-the-art Electronic Medical Record.

But just as important is building an integrated system to unify “back office” functions in a coordinated and effective way. That’s why we have embarked on Enterprise Resource Planning, a combined effort of our Supply Chain, Finance, IT, Operations, and Medical & Professional Affairs departments, all of whom are partnering to phase-out our legacy business applications and replace them with an integrated tool.

Answering big, strategic questions requires that we see the whole picture. ERP will allow us to do just that, by bringing various data together in a digestible, accessible, actionable way. Ultimately, it will give our leadership a powerful device for making decisions with a unified source of real time data.

This project will accelerate our transformation by empowering us to offer more seamless care on multiple levels. It will help to drive more community-based care, more wellness, and more linkage of payment to better outcomes for our patients.

Please join me in thanking Elizabeth Guzman, ERP project lead for Finance Jun Amora, project lead for Supply Chain and Janet Karageozian project lead for IT Services, for the great work they’ve done so far, and will continue to do, on this important initiative.

Last week we marked a truly phenomenal milestone—the 280th anniversary of the founding of NYC Health + Hospitals/ Bellevue.

And it made me think about how NYC Health + Hospitals / Bellevue and the concept of public health are inseparable.

We’ve never had one in this country without the other.

It’s a legacy that’s really unmatched in the annals of medicine, or in the history of our country.

Actually Bellevue is older than this country. It traces its origins to the City’s first almshouse, which was a two-story brick building completed in 1736 on the site of what is now City Hall.

Let’s watch a quick video tribute to that incredible past, and to Bellevue’s future as our flagship premier medical, teaching, and research institution.

Joining us here today as representatives of Bellevue’s staff, past and present, are: Bill Hicks, Chief Executive Officer of Bellevue and two additional honored guests: Barbara Duckett who has been at Bellevue for an amazing 57 years as a staff member and volunteer and Elvis Durazzo, Director of Planning, who is doing great work involving DRSIP implementation. Please join me in honoring these talented members of Bellevue’s current staff, and the thousands of committed caregivers who came before them.