How Hospitals Are Reacting To The ACA

20 Healthcaregovsite

Staff Writer

Now that registration is open and the Affordable Care Act is ramping up for 2014 and beyond, the effects of the landmark reform will begin to be felt in a broader capacity. Many of Queens’ hospitals are getting ready for the impact by changing the way they take care of patients.

Some hospitals in the Borough have made plans for the upcoming changes, slowly moving away from reactionary healthcare. Rather than waiting until someone is sick enough to need a hospital bed, locations like New York Hospital Queens, Jamaica Hospital and Flushing Hospital want to use preventative care to keep patients healthy all year around.

According to Stephen Mills, President and CEO of New York Hospital Queens, all hospitals across the country have collectively faced billions of dollars less in Medicare, Medicaid and commercial services. Observation rooms are being pushed to make sure patients in hospital beds absolutely have to be there.

“The goal is to get rid of beds, because they’re not needed,” Mills said. “The other incentive is to take care of populations of people in the community. Primary care and specialty care out there in the community is where we’re going.”

As part of its move in that direction, NYHQ is setting up primary care and office centers throughout the Borough, in neighborhoods such as Astoria, Maspeth, Whitestone and Clearview, with more to come. These centers are open in evenings and on Saturdays, in order to accommodate the needs of their patients better.

New technology and medicine has allowed hospitals to perform simple surgeries and other procedures over the course of a day, limiting the need for long hospital stays.

“We are not utilizing in the hospital as many beds as we had,” Mills said. “We are moving to a smaller in-patient service and we are focusing on the out-patient.”

Mills added that the switch to a focus on primary care will help take the stress off of emergency rooms, since patients will have other venues to utilize. While a few hospitals in Queens have closed over the past several years, he said the impact to patients who have severe medical problems is minimal.

“Five or six hospitals in Queens have closed in the last few years. Has anyone not gotten a hospital bed when they really needed one as a result of that? The answer is no,” he said. “The real demand has been to our emergency rooms, not for emergency care as much as primary care. That’s why growth has been in the primary care arena. The more we can do in the community, the better off the system will be.”

NYHQ is not the only hospital making these moves. Both Jamaica Hospital and Flushing Hospital are moving to keep their patients healthier, with specialized care that handles their needs efficiently.

Flushing Hospital recently opened a new ambulatory care unit with 32 examination rooms, meant to increase its out-patient services rather than focusing only on helping sick in-patients.

“This is about health maintenance, prevention. This is the innovative model of the future. This is what healthcare needs to look like,” Dr. Robert Crupi, the hospital’s chairman of ambulatory care, said at the opening ceremony.

Jamaica Hospital is focusing its resources on accessibility, having signed on to about 90 percent of the plans available under the ACA healthcare exchange. It is working to partner with the remaining 10 percent as well.

“We continue to be a low-cost provider. We continue to be a high-quality provider,” David Evangelista, director of managed care at Jamaica Hospital, said. “In Queens County, we’re certainly going to be the leader.

The hospital is also putting resources towards education, not just for its own staff, but for private physicians and community residents as well.

“Most people in the community don’t truly know what to expect from the exchange. We’ve done presentations of education with everyone in our organization,” Evangelista said. “We are now going into the community, educating private physicians, letting them know what the exchange is. We’re going to community events and doing education to the public.”

While these Queens hospitals have been preparing for the massive healthcare reform, the results of the legislation are far from certain. Hospital administrators are supportive of the law, saying that it will help some of the 400,000 Queens residents who do not have insurance.

“What will be the impact of the health exchanges? I don’t know,” Mills said. “The way it’s headed now is genuinely a good thing. NYHQ has been supportive of the law itself.”

Evangelista said that the ACA will force hospitals to further rethink how they do business, moving focus away from the individual and towards managing a population.

“The focus is going to be on keeping people healthy. It’s going to force providers to manage patients outside of the hospital,” he said. “Because of the reduced reimbursement, it’s going to force providers to transform how they think and focus on quality, not volume.”

Reach Joe Marvilli at (718) 357-7400, Ext. 125,, or @Joey788.