Paul Francis Discusses Healthcare Policy and Uncertainty with Members at HANYS Issues Forum

Paul Francis addresses participants at HANYS Issues Forum.

HANYS President Bea Grause offers welcoming remarks at the Issues Forum.

Issues Forum participants heard from Paul Francis on healthcare reform and the Cuomo Administration’s healthcare initiatives.

Assembly Member John McDonald III (D-Albany) speaking with Glenda Kelman, Vice Chair of the Board for Glens Falls Hospital (middle), and Dianne Shugrue, President and CEO of Glens Falls Hospital.

HANYS President Bea Grause greets Assembly Member John McDonald III (D-Albany). Looking on is Robin Frank, HANYS Vice President, Governmental Affairs and Continuing Care.

Paul Francis, Governor Cuomo’s Deputy Secretary for Health and Human Services, spoke at HANYS inaugural Issues Forum on Tuesday morning, providing insight into the Cuomo Administration’s healthcare policies and the possible Affordable Care Act (ACA) repeal, and responding to questions from HANYS members and reporters. HANYS was pleased to welcome chief executives, trustees, and other senior leaders from member organizations.

Introduced by HANYS President Bea Grause, Mr. Francis began by addressing the Trump Administration’s promise to repeal and replace ACA, noting that while some aspects of “repeal and replace” are very likely to happen—like reduced federal support for Medicaid and other currently insured populations—other proposals are less certain to gain traction, such as changing Medicare into a premium support model.   Mr. Francis remarked that healthcare is 18% of the nation’s economy, so any dramatic changes could have serious unintended consequences that go beyond healthcare.  When asked about the fate of New York’s Essential Health Plan, Mr. Francis said New York would wait to see what the federal government does, but he added that enrollment exceeded expectations, an indication that the Essential Health Plan fulfills a real need and its repeal could also create real fiscal gaps for the state.

While ACA uncertainty continues, New York continues to move forward, he said, with programs that are changing how healthcare is delivered and reducing costs.  With 6.3 million Medicaid recipients, “Medicaid has truly become a mainstream health plan in New York,” he remarked. Importantly, per capita spending for each Medicaid recipient is lower today than it was in 2002, he said.

Mr. Francis acknowledged the financial difficulties facing many hospitals and health systems in New York, with low operating margins and declining admissions.  He discussed the various capital programs that have provided $2.7 billion in transformational funding and additional “bridge” funding to help providers reach sustainability. He said the main driver of excess costs now is pharmaceuticals, and while the state is taking steps to address it, this is a national issue that requires federal policy changes to significantly reduce costs.

When asked if the Delivery System Reform Incentive Payment (DSRIP) Program would be extended beyond five years, Mr. Francis said a “DSRIP 2.0” is a possibility but noted that from its inception DSRIP has been a transitional “catalyst, a roadmap for other payment streams” to move away from fee-for-service and toward value-based, patient-centered care.  Today, two-thirds of New York’s Medicaid payments are on a fee-for-service basis; but he said New York hospitals and other providers are on track to reach the state’s goal of 90% value-based payment by 2020.

Mr. Francis also emphasized the Cuomo Administration’s efforts to address the social determinants of health, including the state investments in supportive housing and continued efforts toward integrating behavioral health and primary care.

In addition to healthcare reporters and HANYS member healthcare providers, several elected leaders participated in HANYS Issues Forum, including Assembly Members John McDonald (D-Albany) and Patricia Fahy (D-Albany), and representatives from the offices of Senator George Amedore (R-Kingston) and Senator-elect and current Assembly Member James Tedisco (R-Clifton Park).