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Reports to the Board

October 22, 2015

Good afternoon. As customary, I will highlight just a few items from the full version of my report to the board. The full version is available to all here and will be posted on our website.

MetroPlus Gold – Now Available to All NYC Employees

MetroPlus Gold commercial health plan is now available to all employees of New York City plus other local entities such as CUNY, the MTA and Port Authority. The premium plan had previously only been available to our own employees. This agreement between HHC and the New York City Department of Labor Relations to add MetroPlus Gold as a health insurance option is an important step in our goal of reaching one million MetroPlus members by the year 2020.

MetroPlus Gold – with no co-pays for most in-network services in 27,000 locations — has long been available to our own employees. Now, nearly 800,000 additional New York City employees, non-Medicare eligible retirees, their spouses or qualified domestic partners and eligible dependents will be able to choose this option during October's "Open Enrollment."

MetroPlus representatives will participate in benefit fairs hosted by agencies throughout October. An advertising campaign will accompany the new MetroPlus Gold expansion, focusing on government-themed publications and websites.

Contract with PAGNY to Provide Patient Care Services for Correctional Health

On your agenda today is consideration of a contract with the Physician Affiliate Group of New York (PAGNY) to help provide patient care services in New York City correctional facilities.

The contract is for $192.8 million for two years, and will employ approximately 900 direct patient care providers. The majority of these funds will be dedicated to competitive salaries and benefits, as well as costs associated with recruitment and staff retention. Through our partnership with PAGNY, we will be better able to attract and retain qualified medical and mental health professionals to care for our patients in correctional health.

PAGNY has deep ties to many of our hospitals and community health centers, and understands our essential mission. I strongly urge your support of this contract.

OneCity Health Update

The OneCity Health Centralized Services Organization (CSO) is on-track to submit its October 31 DSRIP quarterly report to NYS DOH.   The report details our progress in reaching the in Delivery System Reform Incentive Payment program transformation commitments, as defined by NYS DOH mandated milestones across 23 projects.   

We plan to formally initiate projects using a phased approach across our four OneCity Health hubs according to community need, our commitments to NYS DOH, and partner interest.  We have identified three projects that will be initiated earliest and expect to operationalize them over the next several months:  asthma home-based self-management; integration of palliative care into the Patient Centered Medical Home (PCMH); and Project 11.  We are especially excited for the opportunity to involve multiple partners and Community Based Organizations (CBOs) across the city in Project 11, which involves the engagement of the city's uninsured and Medicaid non- and low-utilizers and linking them as needed to strong primary care teams.  

Federal Update

At end of August the Health Resources and Services Administration published its long anticipated Mega Guidance for the 340B Drug Pricing Program. HHC hospitals, in Fiscal Year 2015, spent over $71 million on 340B pharmaceuticals. HHC saves about $40 million through participation in the program. The proposed definition would end the practice of 340B pricing for discharge medicines; for drugs used during Emergency Department or observation stays that lead to an inpatient admission; and would exclude some infusion drugs from 340B pricing.  In essence, the proposed changes in the definition of patient eligibility for 340B drugs would severely limit 340B pricing to drugs ordered or prescribed only to patients who have outpatient billable events. These proposed changes could increase HHC's pharmaceutical costs by $15-$20 million per year. HHC is submitting a comment letter to HRSA advocating against these proposed changes.

HHC Bands Together to Make Some Noise!
And End Breast Cancer

Last Sunday, I joined HHC staff members across New York City as they participated in the American Cancer Society's Making Strides Against Breast Cancer walk. I walked in Central Park, where our presence was impressive in both numbers -- about 900 staff members -- and volume. Our contingent took our theme for the year -- Let's Make Some Noise! -- to heart. This marks the thirteenth year that we have served as a flagship sponsor of the event to end breast cancer, and we have raised more than $1.5 million over that time. I'd like to offer my heartfelt thanks to Dr. Martha Sullivan, Antonio Martin, Joe Schick, and all the Team Captains for banding together to make this year's Making Strides a team-building event that represents our NYC Health and Hospitals family and our close ties with our patients and communities. Join me in thanking all of our staff who participated in the Making Strides walks or made a donation to ACS to help win the fight against breast cancer.

Bellevue Doctor Elected President of American Pediatric Association

Dr. Benard Dreyer, Director of Pediatrics at NYC Health and Hospitals Bellevue, has been elected as the new national president of the American Academy of Pediatrics (AAP), an organization of 64,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists.

For more than 30 years, Dr. Dreyer has led the pediatric primary care program at Bellevue, including mental and oral health services for children.

He is passionate about improving the lives of children and continues to make significant contributions in pediatric research, especially in the area of children living in poverty.

I am proud that Dr. Dreyer is one of our own and congratulate him on his election as President of AAP.

October is Take Care New York Month

As we commemorate the twelfth anniversary of our Take Care New York campaign this October, we will once again remind patients, staff and the community to get preventive immunizations, health screenings, and to live the healthiest life possible. We will also continue our effort to curb obesity and increase fitness with our "Move to Improve" message to challenge New Yorkers to eat healthier and add more physical activity into their routine. Our facilities will offer flu shots and screenings for HIV, blood pressure, cancer, asthma, diabetes and other health conditions at over sixty events. We will augment our fitness message with a "Move to Improve" contest at our facilities to allow staff, patients and visitors to win guest-passes to Crunch fitness centers. We will aim to engage New Yorkers through social media and PSAs in local community newspapers to promote and increase traffic to our Take Care New York events.

Our health plan MetroPlus will be a key partner of the Take Care New York Campaign and have representatives available at the education and screening events. October is a prime enrollment period for MetroPlus and the TCNY campaign can be a helpful platform for them to maximize enrollments.

One Year Anniversary of New York City's Ebola Patient

Tomorrow, October 23rd, marks the one year anniversary of when Dr. Craig Spencer – New York City's only Ebola patient – entered Bellevue Hospital Center for care.  On November 11, 2014, he left Bellevue cured of the disease.  On this occasion we should look back on the remarkable performance of HHC throughout the Ebola crisis.  HHC was the first health system in New York City to be prepared to receive an Ebola patient and played a great role in the City's response. 

Our foresight and readiness helped calm and reassure the City at a time when many were worried that the virus might spread here uncontrolled.  While all of our hospitals studied and trained to recognize and isolate potential Ebola patients, Bellevue prepared its staff and upgraded its facilities so that when the day came we were ready for action. 

And since that time Bellevue has assumed a prominent role in the national fight against Ebola and other dangerous pathogens:  the hospital was later named by HHS as one of 55 designated Ebola treatment centers nationally; in June it was named one of just nine national referral treatment centers for patients with Ebola or other severe, highly infectious diseases; and in July, along with Emory University and Nebraska Medical Center, Bellevue was named one of three medical research institutions to co-lead a new National Ebola Training and Education Center.  I am pleased to report that Dr. Spencer visited the staff at Bellevue earlier this week for a reunion with those who cared for him.

"Caring Neighborhoods" to Bring Primary Care to
Underserved Neighborhoods across the City

This week Mayor de Blasio announced the "Caring Neighborhoods" program, designed to increase access to primary care services in high-need areas through the City.  HHC will play a prominent role in Caring Neighborhoods by creating five new community health centers and expanding capacity and services at six other existing ones.  In addition, the New York City Economic Development Corporation will provide support to at least 30 private, non-profit health centers that are looking to expand into high-need neighborhoods. 

The neighborhoods were determined through a City-commissioned analysis conducted by the Community Health Care Association of New York State (CHCANYS), with supplemental areas identified at the recommendation of the New York City Department of Health and Mental Hygiene (DOHMH).  We estimate that the 11 HHC centers involved will be able to accommodate over 60,000 new patients each year as a result of Caring Neighborhoods.  The City will provide $12 million in capital support to HHC for the project.  The expansion of primary care availability directly supports HHC's long-term financial goal of stabilizing its budget by expanding its patient base and improving patient retention through better access to care and improved patient experience at HHC facilities.

Guns Down, Life Up Collaboration with Cleveland, Ohio

The city of Cleveland is struggling with record homicide rates —indeed, one of the highest rates per capita for a major American city. Cleveland has suffered through more than 100 homicides so far this year for a population of only 400,000 people. New York City has seen more than 200 homicides with a population of 8 million people. Earlier this year, Cleveland City Councilman Zackary Reed visited New York to meet with The Fund for HHC's Guns Down, Life Up team and learn about our innovative strategies to address violence. The meeting led to an invitation for GDLU Senior Director Erik Cliette to serve as the keynote speaker at a Solutions for Violence in Our City summit in Cleveland on October 13.

Cliette addressed a crowd of more than 200 key community representatives from a variety of youth, law enforcement, education, faith based, healthcare, and art organizations. He outlined GDLU's comprehensive response to violence and injury prevention as a public health model for Clevelanders to follow. After the address, Cliette travelled to John Adams High School where he spoke to a body of students regarding the value of mentoring and graduating high school.

Going forward, the Guns Down, Life Up team will advise Cleveland's civic leaders on community violence reduction and will share the GDLU resource guide.

Program of the Month:
Our Obesity Prevention Efforts

So many problems keep healthcare leaders like us up at night.
Few however, pose as clear a danger to the public health as obesity.

Probably everyone in this room today is familiar with its grim impact as a leading cause of Heart Disease, Stroke, Type 2 Diabetes and certain types of Cancer.

Nobody understands the scope of this threat better than we do.

At the Health and Hospitals Corporation we are drawing on our deep roots in the community, and using the most advanced tools and methodologies available, to provide the preventive care that is so urgently needed.

It is these efforts that I'd like to highlight today as our Program of the Month:

All Health and Hospitals Corporation pediatric practices screen for obesity.

All pediatric practices record body-mass-index percentiles into EMRs for every patient.

And all counsel patients on four key healthy behaviors that impact weight, by using the 5-2-1-0 per day approach , which for those of you who may be unfamiliar, stands for: 5 fruits and vegetables, 2 hours maximum of screen time, 1 hour of physical activity and 0 sugary beverages EVERY DAY.

Each and every pediatric patient receives a "Fit Kid" cards to help them set goals for healthy diet and physical activity, and to better understand and keep track of nutrition, blood pressure and BMI.

We also have very active obesity prevention initiatives going on at particular facilities, among them are –

  • The Family/Teen Weight Management Program at North Central Bronx Hospital Center.
  • The Fit Kid & Fit Teen Coaching Program at Gouverneur, Kings County, and Lincoln Hospital Centers
  • The Fruit And Vegetable Prescription Program at Bellevue, Elmhurst, and Harlem Hospital Centers
  • The Starting Early program at Bellevue Hospital Center
  • The Healthy Lifestyles Program at Queens Hospital Center
  • The Pediatric and Adolescent Weight Loss Clinic and YMCA Program at Coney Island Hospital

I couldn't be prouder that our healthcare system has been at the forefront, and fully engaged for over a decade, in the battle with obesity, and I commit to you that we will continue to be aggressive until we prevail.

Please join me in welcoming Dr. Susan Kansagra, Assistant Vice President for Population Health, who oversees our obesity prevention efforts. 

Individual of the Month:
Dr. Rand David,
Directory of Ambulatory Care, Elmhurst Hospital

One of our practitioners leading the charge on chronic disease prevention is Dr. Rand David, the Director of Ambulatory Care at Elmhurst Hospital Center, who is our Person of the Month for October.

Dr. David has dedicated tireless efforts over several decades towards reducing our patients' risk of cardiovascular diseases,  including obesity, as well as hypercholesterolemia, diabetes mellitus, hypertension, and cigarette smoking. 

In this regard he has participated and led several City-wide Health and Hospitals Corporation task forces, producing clinical guidelines that have educated countless physicians, nurses, medical students and residents, as well as members of the many communities we serve.

Dr. David is not only committed to addressing health disparities and wellness. He's been a leader on healthcare transformation as well. He has captained efforts to develop new models for more efficient, and compassionate care delivery.

By working to level provider workloads at Elmhurst's ambulatory care services, while also reducing patient wait-times, Dr. David has championed the sort of innovation that will improve our patient experience and help us become a far more patient-centric organization in the future. 

Join me in congratulating Dr. David for work well done.

HHC in the Media Highlights


Childhood Obesity Among Latino Community, News 12 Brooklyn, Kings County: Dr. Lee Waldman; Dr. Sheila Perez-Colon 

New York Holds Summit on Synthetic Marijuana, Also Known As K2, WCBS, Jacobi

Bellevue Hospital's Long, Twisted Road to Resiliency, WNYC, Dr. Ram Raju, HHC President

FEMA Emails Say de Blasio Administration Sought to Quash Bad Press on Sandy Recovery, WNBC, Dr. Ram Raju, HHC President

New York Summit on Synthetic Marijuana, News12 Bronx, Jacobi
Ebola Survivor, Caregivers Unite One Year Later, WABC (AP), Bellevue: Dr. Nate Link, Chief Medical Officer; Dr. Laura Evans, Director of Critical Care; David McCollum


Dr. Raju ... and Putin, Crain's Health Pulse, Dr. Ram Raju, HHC President

At IHT2 New York, CEO of Largest Public Health System Outlines Bold Vision for "Healthcare Nirvana", Healthcare Informatics, Dr. Ram Raju, HHC President

Panel examines challenges in moving from coverage to care, AHA News, Dr. Ram Raju, HHC President

CEO: What hospitals don't understand about the patients of the future, The Advisory Board Company, Dr. Ram Raju, HHC President

De Blasio to create new health centers, partially fulfilling campaign pledge, Politico New York, Dr. Ram Raju, HHC President

NYC Health and Hospitals Expands Its MetroPlus Health Plan to Public Employees in Effort to Reach 1, Million Members by 2020, Insurance news Net, Dr. Ram Raju, HHC President; Seth Diamond, Chief Operating Officer, MetroPlus

MetroPlus Gold is now available to all City Employees, The Chief Leader, Dr. Ram Raju, HHC President

MetroPlus option for city workers, Crain's Health Pulse, Dr. Ram Raju, HHC President

MetroPlus Gold expands offering to all city employees, Politico New York, Dr. Ram Raju, HHC President

Health insurer allies with NYC hospitals, Newsday, HHC, Bellevue, Elmhurst, Coney Island, Kings County, and NCBH

CareConnect reaches deal with HHC, Politico New York, Kings County, Bellevue, MetroPlus

Municipal IDs help prevent medical mishaps, provide access to care, Modern Healthcare

Ebola Survivor, Caregivers Unite One Year Later, The Wall Street Journal, Bellevue: Dr. Nate Link, Chief Medical Officer; Dr. Laura Evans, Director of Critical Care; David McCollum

Ebola Survivor Dr. Craig Spencer Returns to Visit the Hospital That Saved Him, New York Magazine, Bellevue: Dr. Nate Link, Chief Medical Officer; Dr. Laura Evans, Director of Critical Care

As healthcare landscape changes, city hospital authority charts new path, Gotham Gazette, Dr. Ram Raju, HHC President

Meet crises head-on with advance planning, Business Insurance, Dr. Ram Raju, HHC President; Bellevue

Present health plan for undocumented immigrants in New York, El Diario, Dr. Ram Raju, HHC President

HHC, ProHealth and Beacon Health chat about ACOs, Crain's Health Pulse, Dr. Dave Chokshi, Assistant Vice President

MetroPlus Health Plan Sponsors Mother-Love & Father-Love Awards Luncheon, Bronx Chronicle, MetroPlus

Lincoln Medical gets grant to study obesity, hypertension in inner city, Amsterdam News, 
Lincoln: Milton Nunez, Executive Director; Dr. Balavenkatesh Kanna, Dr. Maria Espejo

Health Insurance 101 Workshop, Open Enrollment 2015, Harlem World, Gouverneur

Master of Doctors, Brooklyn Daily, Coney Island: Dr. Terence Brady, Associate Chief Medical Officer; Dr. John Maese, Chief Medical Officer; Dr. Paul Gitman, Quality Management

Au Bon Pain revises hospital menu to meet NYC nutritional standards after complaints of unhealthy food, New York Daily News, Jacobi; Elmhurst; Coney Island; Bellevue

Take Care New York, NY Daily News, HHC, MetroPlus

Breast Cancer Awareness Events and Fundraisers, Bronx Times, NCBH


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