State Turns to Northwell for Brooklyn Solutions

Politico
April 20, 2016
Northwell Receives $500K State Grant for Central Brooklyn Study

Northwell Health will receive a $500,000 grant from the Cuomo administration for a feasibility study on options for health care in central and northeastern Brooklyn, part of a broader plan to reshape health care in one of the most economically challenging regions of the state.
The money will come from the Vital Access Provider program.
Northwell has for some time shown an interest in Brooklyn, unsuccessfully bidding to take over Long Island College Hospital in 2014 and partnering with Maimonides Medical Center in 2015.
The health system, with an expansionist bent, has long thought to have been eyeing central Brooklyn, though it has been wary of public pronouncements or long-term commitments that could bog it down in the same kind of political headaches that came to characterize the battle surrounding LICH.
Crain's first reported the possibility of a feasibility study last month.
The Cuomo administration has sought to fix the broken health care delivery system in Brooklyn, which has left several hospitals reliant on state dollars for survival.
Brookdale Medical Center received around $100 million last year. Interfaith Medical Center, which recently emerged from bankruptcy, received a $25 million subsidy from the Vital Access Provider Assurance Program, which ran April through August, while Wyckoff and Kingsbrook Jewish Medical Center each received $15 million from that program.
In January of 2015, Gov. Andrew Cuomo proposed $700 million to improve health care in Brooklyn by rebuilding Brookdale Hospital, though what would replace it was never articulated and the money was never appropriated.
The study, according to the state, will look at the potential of management partnerships among those four hospitals as well as University Hospital.
The concern is that any plan to reduce the number of beds would meet resistance from local communities and stir up union angst.
This feasibility study, which is expected to take three to four months, keeps Northwell clear of those possible problems because the health system is not committing to any action, just presenting a possible path forward.
But the state appears to favor some kind of collaboration among the standalone struggling hospitals, pointing out in a press release that many other hospitals in Brooklyn have partnered with larger systems to adapt to changing economic models for delivering care.
"While other hospitals in Brooklyn have forged partnerships with other health care systems, the five hospitals in central and northeastern Brooklyn have not and consequently lack resources to adapt in this new health care environment," the release said. "One finding that the State expects to see in the feasibility study is the need for a significant increase in the network of ambulatory care services in these communities. An increase in ambulatory care will help reduce unnecessary reliance on ED services and inpatient hospital utilization."

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Crain’s New York Business
April 20, 2016
Northwell Health Takes Steps to Bail Out Ailing Brooklyn Hospitals

New York state brokered a deal for the hospital system to analyze how to restructure the borough's health care delivery
The New York State Department of Health announced today that Northwell Health was awarded a grant to prepare a feasibility and sustainability study that could pave the way for the hospital system to manage a network formed by Brooklyn’s financially challenged hospitals.
As Crain’s reported last month, the Cuomo administration has spent months in discussions with big hospital networks that had the resources to manage those troubled facilities and boost primary and outpatient care in Brooklyn. But none were willing to sacrifice their own bottom lines by helping the failing hospitals, until Northwell Health finally agreed to this feasibility study.
The system, formerly known as the North Shore-LIJ Health System, will examine potential management or partnership arrangements with one or more of these institutions: Brookdale University Hospital and Medical Center, Kingsbrook Jewish Medical Center, Interfaith Medical Center, Wyckoff Heights Medical Center and University Hospital Brooklyn.
The study, whose parameters are online here, is expected to be submitted over the next three to four months, according to the announcement. Once completed, the state will use the findings to develop and issue a request for applications from those hospitals and other health care providers in the borough to undertake capital projects. Funding is from $700 million set aside in the state budget for overhauling Brooklyn’s health care delivery system. The money was set aside a year ago but never awarded, delayed by the state’s effort to get a big health system to commit to Brooklyn. Northwell already has a partnership agreement with Maimonides Medical Center.
There is immense financial pressure on the Cuomo administration to fix Brooklyn’s long-ailing hospitals. In past years, the state has bailed out facilities to prevent them from closing. In announcing the study, the state disclosed that in 2017 fiscal year, Brookdale, Interfaith, Kingsbrook and Wyckoff will need nearly $300 million in direct state funding for operations so that they remain open.
Without “significant restructuring efforts targeted at reducing costs and increasing revenue,” the state said that estimated funding will grow to $380 million by its 2021 fiscal year—and that is without the state’s subsidy to University Hospital, part of SUNY Downstate.
The wording of the study didn’t explicitly state that at least one of the hospitals will close. But that is the expectation, as more health care shifts to outpatient settings and preventative care. One possibility is to consolidate inpatient care at a new facility that would be built on Brookdale’s campus.
The study hints at that possibility. The analysis will examine how much state operating support is needed for "specific capital investments that would be required … to consolidate programs and facilities, rebuild needed facilities as well as to build an ambulatory care network, if necessary."
“Brookdale, as a major health care provider in East Brooklyn, supports the state’s decision to have Northwell Health conduct a feasibility study,” said Mark Toney, Brookdale’s president and chief executive. “We look forward to working with local leaders, residents, physicians, staff and unions on this opportunity for better access to better medical care in Brooklyn.”

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New York State Department of Health
April 20, 2016
NYS Department of Health Announces Launch of Study to Assess and Improve Quality of Health Care in Brooklyn
 

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