{"id":3038,"date":"2024-05-27T07:41:28","date_gmt":"2024-05-27T11:41:28","guid":{"rendered":"https:\/\/www.nypirg.org\/capitolperspective\/?p=3038"},"modified":"2024-05-27T07:41:28","modified_gmt":"2024-05-27T11:41:28","slug":"how-safe-is-new-yorks-hospital-care","status":"publish","type":"post","link":"https:\/\/www.nypirg.org\/capitolperspective\/how-safe-is-new-yorks-hospital-care\/","title":{"rendered":"How Safe Is New York\u2019s Hospital Care?"},"content":{"rendered":"\n<p>In the first year of Governor Andrew Cuomo\u2019s tenure in 2011, he successfully established a Medicaid Task Force whose job was to figure out ways to curtail the program\u2019s increasing costs.&nbsp; The idea was to bring together Medicaid \u201cstakeholders\u201d and design programs to limit Medicaid spending.&nbsp; That effort became known as the <a href=\"https:\/\/www.health.ny.gov\/health_care\/medicaid\/regulations\/global_cap\/\">Medicaid Global Spending Cap<\/a> program and was a component of the then-governor\u2019s plans to keep the overall state budget at no more than a <a href=\"https:\/\/www.politifact.com\/factchecks\/2016\/dec\/02\/andrew-cuomo\/cuomo-spending-increases\/\">2 percent<\/a> annual increase.<\/p>\n\n\n\n<p>One of the major components of the Medicaid Global Cap was a new program to limit the financial exposure of hospitals where a baby was born with catastrophic neurological damage due to medical malpractice.&nbsp; The <a href=\"https:\/\/www.health.ny.gov\/regulations\/medical_indemnity_fund\/#:~:text=The%20MIF%20was%20designed%20to,malpractice%20during%20a%20delivery%20admission.\">Medical Indemnity Fund<\/a> offset the medical malpractice by shifting those payments from the hospitals\u2019 insurance to the taxpayer.&nbsp; Under the program, the future medical costs of treating a neurologically-impaired baby would be <a href=\"https:\/\/www.health.ny.gov\/regulations\/medical_indemnity_fund\/faqs.htm\">covered by the state<\/a>.&nbsp; In that way, the financial exposure of hospitals was limited and, at least theoretically, the lifetime medical needs of the injured baby would be covered \u2013 the money would never run out.<\/p>\n\n\n\n<p>Unfortunately, it didn\u2019t work out that way.&nbsp; Earlier this Spring, the program <a href=\"https:\/\/www.health.ny.gov\/regulations\/medical_indemnity_fund\/reports\/2023\/docs\/q1_acturial_analysis.pdf\">ran out of money<\/a>.&nbsp; The Department of Health <a href=\"https:\/\/www.health.ny.gov\/regulations\/medical_indemnity_fund\/index.htm\">announced<\/a> that it had run out of money and could <em>not<\/em> take new enrollees.&nbsp; In this year\u2019s budget, no new money was allocated so the families in the process of enrolling were now unsure if they would have the coverage needed for their neurologically impaired children.&nbsp; This is devastating news for those families and threatens the precarious health of their children.<\/p>\n\n\n\n<p>This past weekend, <em>The New York Times<\/em> <a href=\"https:\/\/www.nytimes.com\/2024\/05\/24\/nyregion\/medical-indemnity-fund-malpractice.html\">reported<\/a> that the state would add revenues in order to keep the program running for at least another year.&nbsp; However, the Hochul Administration commented about the mushrooming costs that could put the program\u2019s survival in jeopardy.<\/p>\n\n\n\n<p>The overall financial health of the program only is sustainable if the state is doing all it can to <em>reduce<\/em> the number of injuries \u2013 thus keeping costs down as well as reducing the number of families caring for seriously injured children.&nbsp; And in fact, New York <a href=\"https:\/\/www.nytimes.com\/2024\/05\/24\/nyregion\/medical-indemnity-fund-malpractice.html\">pledged<\/a> to do just that by instituting new safety protocols, such as increased staffing and training, to reduce the number of birth injuries.&nbsp; Again according to the <a href=\"https:\/\/www.nytimes.com\/2024\/05\/24\/nyregion\/medical-indemnity-fund-malpractice.html\"><em>Times<\/em><\/a>, no such reduction in cases has occurred: \u201cWhere actuaries predicted that roughly one in 10,000 children would be eligible for the fund as a result of a brain or spinal cord injury in 2011, by 2014 they were expecting nearly three times that number.\u201d<\/p>\n\n\n\n<p>In retrospect, that outcome is not surprising.&nbsp; When it comes to patient safety, New York\u2019s track record is not good.<\/p>\n\n\n\n<p>The U.S. Department of Health and Human Services annually publishes <a href=\"https:\/\/www.medicare.gov\/care-compare\/\"><em>Medicare.gov\/Compare<\/em><\/a>, which reports the quality of the nation\u2019s hospitals and other providers to the public. &nbsp;Researchers use that information to compare states. &nbsp;One national organization, the \u201c<a href=\"https:\/\/www.leapfroggroup.org\/about\">Leapfrog Group<\/a>\u201d (established by the nation\u2019s large employers in 2000 in order to measure \u201chospital performance, empowering purchasers to find the highest-value care and giving consumers the lifesaving information they need to make informed decisions\u201d) has issued <em>annual<\/em> reports on the quality of American hospital care for over 20 years.&nbsp; Over those two decades <em>New York has been consistently ranked poorly.<\/em><\/p>\n\n\n\n<p>Earlier this month, in its latest annual report Leapfrog Group\u2019s analysis <a href=\"https:\/\/www.hospitalsafetygrade.org\/your-hospitals-safety-grade\/state-rankings\">found<\/a> that New York State ranked <em>39<sup>th<\/sup><\/em> nationwide in terms of quality, well behind large diverse states like California (ranked 19<sup>th<\/sup>), Florida (12<sup>th<\/sup>), Massachusetts (30<sup>th<\/sup>), Pennsylvania (7<sup>th<\/sup>), and Texas (23<sup>rd<\/sup>).&nbsp; Of New York\u2019s 144 hospitals, only 17 <a href=\"https:\/\/www.hospitalsafetygrade.org\/search?findBy=state&amp;zip_code=&amp;city=&amp;state_prov=NY&amp;hospital=\">received<\/a> an \u201cA\u201d grade.<\/p>\n\n\n\n<p>Why do New York hospitals perform comparatively so much worse?&nbsp; In July 2019 the director of Leapfrog Group <a href=\"https:\/\/www.cityandstateny.com\/articles\/policy\/health-care\/why-new-york-hospitals-have-terrible-federal-rankings.html\">explained<\/a> what she knew about New York\u2019s hospital safety:<\/p>\n\n\n\n<p>\u201cThe system as a whole didn\u2019t seem to have emphasized safety. We\u2019ve seen other states work together and look at what\u2019s working well at other states and implement it. It just doesn\u2019t seem to be happening in New York.\u201d&nbsp;<\/p>\n\n\n\n<p>The Leapfrog Group data relies on Medicare information, so these rankings do not directly explain what\u2019s going on in the Medical Indemnity Fund (MIF).&nbsp; But in a state that doesn\u2019t \u201cseem to have emphasized safety,\u201d it isn\u2019t much of a jump to conclude that in too many New York hospitals, the overall quality of care is below the national standard, Leapfrog says.&nbsp; And when it comes to the MIF, that takes a bite out of the state\u2019s revenues \u2013 putting taxpayers on the hook for the substantial costs of caring for children injured by the poor quality of hospital care.<\/p>\n\n\n\n<p>When we go to the hospital, we should expect that all is being done to make us better, not worse.&nbsp; It seems too often that isn\u2019t happening in New York.&nbsp; As state lawmakers deal with the MIF problem, they should look to the broader issue of weak patient safety.&nbsp; When it comes to patient safety, New York policymakers should follow the Hippocratic <a href=\"https:\/\/www.cms.gov\/blog\/first-do-no-harm\">Oath<\/a> to \u201cfirst do no harm.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"<p>In the first year of Governor Andrew Cuomo\u2019s tenure in 2011, he successfully established a Medicaid Task Force whose job was to figure out ways to curtail the program\u2019s increasing costs.&nbsp; The idea was to bring together Medicaid \u201cstakeholders\u201d and design programs to limit Medicaid spending.&nbsp; That effort became known as the Medicaid Global Spending [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-3038","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/www.nypirg.org\/capitolperspective\/wp-json\/wp\/v2\/posts\/3038","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.nypirg.org\/capitolperspective\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.nypirg.org\/capitolperspective\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.nypirg.org\/capitolperspective\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.nypirg.org\/capitolperspective\/wp-json\/wp\/v2\/comments?post=3038"}],"version-history":[{"count":2,"href":"https:\/\/www.nypirg.org\/capitolperspective\/wp-json\/wp\/v2\/posts\/3038\/revisions"}],"predecessor-version":[{"id":3040,"href":"https:\/\/www.nypirg.org\/capitolperspective\/wp-json\/wp\/v2\/posts\/3038\/revisions\/3040"}],"wp:attachment":[{"href":"https:\/\/www.nypirg.org\/capitolperspective\/wp-json\/wp\/v2\/media?parent=3038"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.nypirg.org\/capitolperspective\/wp-json\/wp\/v2\/categories?post=3038"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.nypirg.org\/capitolperspective\/wp-json\/wp\/v2\/tags?post=3038"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}