BY JON CRONIN
On a federal, state and city level, the landscape of the medical field is changing drastically, experts said.
During the past 15 years in Queens, several hospitals have closed and outpatient care facilities have popped up to replace them. In the years to come, the city and private healthcare industry will have to deal with an aging population of baby boomers who will become the largest group of senior citizens our economic and healthcare system has ever seen.
Many among the borough’s diverse population rely on insurance from President Barack Obama’s Affordable Care Act (ACA), which President Donald Trump’s administration has attempted multiple times to eradicate.
Currently, the healthcare policy known as Obamacare appears to be remaining in place—but if it goes away, 3.7 million New Yorkers will be without health insurance.
Even with the ACA still in place, Queens faces numerous challenges in taking care of its residents—an increasingly diverse population; questions of how to bring the latest medical technology, medicines and procedures to benefit the greatest number of patients; figuring out how to design and locate modern medical facilities; and the degree to which healthcare facilities commit to policies regarding preventive medicine and wellness care.
The city’s Independent Budget Office (IBO) released a study in July stating that hospitalization in the city’s public and private hospitals has been falling for some time. The agency reported that long-term hospital stays fell from 1.3 million to 1.1 million between 2009 and 2014, but that trend was consistent with the rest of the nation, which the IBO attributed to the growth of outpatient clinics across the nation. This is a statistic that resonates in Queens, especially in the Rockaways, which saw Peninsula Hospital close in 2012 after it couldn’t fill its beds.
Although Peninsula Hospital couldn’t fill its long-term–care wing, its emergency room remained busy and other facilities—such as St. John’s Episcopal Hospital and the Addabbo Health Center—have been forced to pick up where the shuttered hospital left off. The Addabbo Health Center was granted a $17 million addition by its board in 2016 that would serve all six of the center’s sites. Dr. Marjorie Hill, CEO of the Addabbo Health Center, said that it will serve as a training center.
Hill said that the center averaged 218,000 visits in 2015. She believes that by the end of the first year of the project, it will average 267,000 visits. While awaiting the extension, its clinics provided Saturday and Sunday hours, but the center’s waiting rooms remain full.
This year, Israel Rocha—the CEO of NYC Health + Hospitals/Elmhurst, which is a part of the city’s public health system—announced a $30 million expansion to the hospital in June. The hospital is one of the busiest in the nation, and its trauma center serves all of western Queens. The project would add another floor to the hospital’s emergency department; increase the number of treatment bays from 48 to 80; and add nursing support areas, five additional isolation rooms and centralized radiology services.
Atiya Butler, a spokeswoman for the hospital, said that the project is also intended to lower the hospital’s ER wait times.
“Our ER wait times are in line with other New York City public hospitals, with the average wait time being around 75 minutes,” she said.
Butler noted that there should be a groundbreaking for the expansion by late December. Rocha said that when the expansion to its emergency room is completed, Elmhurst Hospital will have a better unit to care for stroke and traumatic-brain-injury patients.
In regard to the ACA, Rocha said, “The most critical is the Disproportionate Share Hospital fund,” which ensures that hospitals have a safety net to cover those without insurance.
Rocha said that this fund is scheduled to be reduced, and notes that it is used “very specifically in areas where there is a high concentration of uninsured.”
“It’s a big concern for us in Queens,” Rocha said.
Regarding senior care and the baby boomer population, Rocha said that the ACA provides good access to preventative care services and noted that “a lot of those are geared toward that aging population.”
He said that part of the ACA is aimed “to keep people healthy as long as possible and be able to manage their costs.”
As Elmhurst Hospital is part of the NYC Health + Hospitals network, Rocha said that it is focusing on expansions across all forms of healthcare, including primary care, night clinics and urgent care.
State Sen. Joe Addabbo Jr. (D-Howard Beach) said that he recently spoke to the head of an outpatient care facility who is hoping that insurance companies will allow their customers to go to a broader spectrum of facilities. Addabbo noted that his constituents frequently relay to him their fear of the repeal of the ACA.
“I hear about it every time I visit a senior center,” he said, noting that if the state were to pick up the slack of federal dollars going toward the ACA, other state programs would be cut. “I have to reassure them [that] whatever changes there are on the federal level, the state will pick up the slack. That’s why we’re so concerned. We created a marketplace a few years ago. Now, we may have to re-create the wheel.”
Addabbo noted that when the state Senate created the budget in April, it added “some cushion” in anticipation of federal cuts to the ACA. He added that the state Senate might have to take further action since the Republican-controlled House of Representatives and U.S. Senate are trying to add ACA cuts to the proposed GOP tax plan.
“We may have to be called back to a special session before January,” he said. “But it doesn’t look like it.”