NYC Health + Hospitals looks to turn around declining outpatient operations
- NYC Health + Hospitals is implementing a multi-pronged strategy to reverse the trend of declining outpatient visits among its vast ambulatory care business. A troubling issue is the high volume of no-show patients scheduled for outpatient visits (30% to 40%).
- The public health system, which cares for more than 1 million New Yorkers each year, is expected to have a deficit of $1.8 billion by fiscal year 2020, and this strategy is part of a larger attempt to make a financial turnaround. The changes are designed to meet goals previously drafted by New York City Mayor Bill de Blasio, including increased primary care access for residents in underserved areas.
- The plan announced Wednesday follows facility upgrades and other investments that are all part of de Blasio's improvement goals for the system.
The mayor has warned that the looming financial crisis at NYC Health + Hospitals is at a breaking point, a dangerous situation for a system that is a safety-net provider for the city's uninsured and underserved.
The beleaguered system, which operates 11 hospitals and employs more than 42,000, has already eliminated layers of management and 476 positions amid the financial pressure. It reported a $776 million loss through the first half of 2017. The deficit is projected to balloon to $1.8 billion by fiscal year 2018, according to de Blasio's earlier report.
The five-part strategy laid out on Wednesday aims to:
- Fix continuity of care by using a new scheduling system that can easily connect patients with their primary care physician.
- Reduce no-show rates with a new scheduling system that helps patients reschedule appointments.
- Expand eConsult to reduce long waits for specialists. The program allows primary care physicians to consult with specialists through messaging to speed up the process to treat the patient.
- Improve clinic management so doctors and nurses can practice at the top of their licenses. Administrative functions will be delegated to other staff so doctors and nurses can spend more time with patients.
- Increase revenue by improving billing and coding. Training will occur so reimbursement isn't rejected because a service isn't coded properly or entirely.
Despite the goal to increase primary care across the city, the system reports that new patients visiting a primary care physician declined from 446,000 in fiscal year 2016 to 417,000 in fiscal year 2018. The new initiative hopes to stem that trend.