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NNY hospitals awaiting Medicaid waiver approval

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A federal government Medicaid waiver could help some hospitals throughout New York avoid closure, but time is starting to run out, according to the governor’s budget message.

Throughout the past 18 months while the state has awaited approval of the $10 billion Medicaid waiver from the U.S. Department of Health and Human Services, three hospitals in Brooklyn are barely hanging on while awaiting federal intervention, according to state Health Commissioner Nirav Shah.

The longer the state goes without that approval, local health officials have said, the longer north country hospitals are also in jeopardy.

According to Kaiser Health News, the Brooklyn-based Interfaith Medical Center has been bankrupt since December 2012, and was expected to close in the fall of 2013. In December, the Health Department gave the hospital a reprieve to remain open through the spring, according to the Brooklyn Daily Eagle.

To alleviate that situation, the state needs the Medicaid waiver approval. According to the state Department of Health, that approval would “effectively bend the cost curve for the state’s overall health care system.”

Receiving the waiver, which would put $10 billion in state coffers for health care assistance, was a key element of Gov. Andrew M. Cuomo’s budget message Tuesday.

Many hospitals here continue to struggle financially, but River Hospital Chief Executive Officer Ben Moore III said that could all change if the Medicaid waiver is approved.

Mr. Moore said funding attached to the waiver would mesh well with a local, six-hospital effort to reduce unnecessary repeat Medicaid readmissions and improve patient outcomes. He serves as spokesman of the group, which includes River Hospital, Alexandria Bay; Samaritan Medical Center, Watertown; Carthage Area Hospital; Lewis County General Hospital, Lowville; Clifton-Fine Hospital, Star Lake, and Claxton-Hepburn Medical Center, Ogdensburg.

“I assume, of course, a lot will go down to Brooklyn, and we’re hoping to get some up here for the north country, especially as we look forward trying to establish this collaboration,” Mr. Moore said. “As we change patient care models, to more outpatient and less inpatient, hopefully in following years there will be some funding for redesign and renovation of facilities to be more efficient. That’d make a lot of sense to me.”

The Medicaid waiver issue was one topic of discussion presented by Jason Helgerson, deputy commissioner, office of health insurance programs, during the Dec. 17 meeting of the North Country Health Systems Redesign Commission. The commission, which met Tuesday and will meet today at the Best Western Carriage House Inn, was formed by the state Department of Health to create an effective, integrated health care delivery system for preventive, medical, behavioral and long-term care services to north country communities.

The 18-member commission, which includes four residents from Jefferson, Lewis and St. Lawrence counties, also will make specific recommendations that providers and communities can implement to improve access and develop recommendations for distribution of reinvestment grants. The commission’s efforts follow progress being made through the six-hospital effort. Mr. Moore said work of the two need funding for implementation.

That’s where the Medicaid waiver would come in handy, he said.

Meanwhile, in his remarks Tuesday, Dr. Shah said the same type of waiver was approved within six months for California, and five months for Texas. He said the unnecessary delay “is endangering New York’s entire health care system.”

Gov. Cuomo urged the federal government to act now.

The Healthcare Association of New York State, an advocacy group for health organizations in the state, issued a statement Tuesday from President Dennis Whalen that commended the governor for mentioning the waiver in his 2014-15 budget message.

“Many hospitals and health care systems are financially fragile and lack the resources needed as they embrace reform and improve delivery of care for our patients,” Mr. Whalen said in the prepared statement.

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