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The group is made up of more than 50 CEOs and executives of the region’s health-care, business, academic and insurance sectors. Its goal is to bring stakeholders from those sectors together to map out a new model for providing health-care services that focuses on collaboration and even consolidation, said William Mooney Jr., president of the WCA.
“I don’t think there’s any question you’re going to see changes in the delivery system here,” Mooney said. “You have a model right now in the hospital business where you have huge revenue cuts, then you have expenses going up. So I think that consolidation will play a role here.”
Mooney would not specify what consolidation could look like but said the group would look to integrate services among hospitals, physicians and long-term care.
The federal Affordable Care Act is a driving force behind the WCA’s concerns. Most hospitals are struggling now but will be hit hard when the new health care law goes into effect next year, said Dr. Simeon Schwartz, founder and CEO of WestMed, a multi-specialty group practice in Westchester.
“We have to respond to the changes in the market place,” Schwartz said. “Not just in Westchester but worldwide there has been a shift of healthcare services from being hospital-centric to ambulatory care. That poses new challenges on the Westchester hospital system.”
The "Healthcare Insights" study found that hospital use is down during the last 15 years. It found that:
- In-patient hospital bed use dropped 15 percent;
- The average length of in-patient stay dropped 13 percent;
- In-patient services for maternity and pediatric care dropped as a result of an aging population;
- In-patient and ambulatory surgeries dropped;
- In-patient medicine services increased 32 percent;
- Hospital referrals to home care and long-term nursing facilities doubled; and
- Medicare surpassed commercial insurance as a primary method of payment.
“We can clearly see that our aging population is affecting the healthcare market,” said Bill Harrington, chairman of the WCA. “This will have long-term implications for our healthcare providers."
When the Affordable Care Act goes into effect next year, it will expand Medicaid coverage to millions of low-income Americans. The Healthcare Consortium hopes to find efficiencies and develop a new model to get out ahead of what Harrington said could be described as a "potential tsunami" for employers, employees, retirees, hospitals, doctors, nurses and everyone in the community.
“It is the driving issue that every business should be focused on,” he said. “Most that are paying attention don’t know what to do.”
No plans have been set and could take years to move forward with because any action the WCA wants to take has to be approved by the state, said Angela Skretta, vice president of the Northern Metropolitan Hospital Association.
"This is a very very complicated process," said Skretta, who added this could be a five- to 10-year plan. "And the data that has been presented is significant because it does impact how healthcare is actually delivered."
Similar plans are being discussed across the country, but the WCA Healthcare Consortium is unique because it has the business community involved, Skretta said.
The health-care sector employs 30,000 people and generates $10 billion to the local economy.
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