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Q&A
Discussion on potential impact of Medicaid cuts on H+H
1:31:47
·
3 min
Council Member Restler and Dr. Katz discuss the potential devastating impact of proposed Medicaid cuts on NYC Health + Hospitals. Dr. Katz explains the challenges these cuts would pose and the potential need to constrain services.
- Potential cuts could amount to hundreds of millions of dollars for H+H
- 85% of H+H's budget is allocated to personnel, meaning cuts would likely result in staff reductions
- Dr. Katz explains that for every dollar cut, H+H would need to reduce services by $5 due to their current revenue model
- The discussion touches on the possibility of facility closures or service constraints if the cuts are implemented
Lincoln Restler
1:31:47
There are a couple of things I just wanted to touch on today.
1:31:49
First is just briefly, the Medicaid cuts would be absolutely devastating for our public hospitals.
1:31:58
I think it's, you know, if they were to fully fulfill these cuts, 10% Medicaid cuts nationally could be even worse.
1:32:06
You know, we would no longer be in the black as you have been through the first six months of this fiscal year.
1:32:12
Can you speak just briefly to the scope of impact of the Medicaid cuts?
Dr. Mitch Katz
1:32:17
From what they're discussing, it could certainly be hundreds of millions of dollars to us.
1:32:22
And, know, the the two facts that I think help people understand why it would be so difficult, 85% of our budget is people.
1:32:31
So, you know, cuts cuts has to mean fewer people taking care of people.
1:32:36
Right.
1:32:37
And the other in part, my the success that you refer to will also make dealing with cuts harder because part of the success was to stop subsidizing for profit health insurance companies, which is what New York City was doing when I arrived by, you know, not enrolling people, not billing them correctly, not, you know, appealing decisions, not documenting them correctly so that the insurance companies were off the hook.
1:33:10
And part of what I did is say no, that's we're not gonna do that.
1:33:13
We're gonna learn how to bill appropriately, not excessively, and not patients.
1:33:17
I'm interested in billing insurance companies.
1:33:20
But because of that success, we now earn about 80¢ on the dollar for any service.
1:33:27
So in order for me to cut a a dollar, I have to cut $5.
1:33:38
And, right, there's no there's almost nothing that is a pure a service that we do that doesn't generate revenue in some way.
1:33:48
And I've insisted on that because that's in all the cities I've worked.
1:33:52
That's that's always been my model is you have to if you want something sustainable, build revenue into it.
1:33:58
Right.
1:33:59
But then if your revenue suddenly drops, you have to close much more in order to
Lincoln Restler
1:34:06
Do you think that that would mean we'd have to close facilities?
1:34:10
If these cuts were to come forward at their full
Dr. Mitch Katz
1:34:12
We would if the cuts came through forward, we would certainly have to constrain services.
1:34:17
Okay.
1:34:17
Whether, you know, whether it's the buildings or the or the service model, I don't know.
1:34:23
And it would depend on, you know, it would depend on how large is the cut, how much, you know, is the state prepared.
1:34:30
I mean, the state does have reserves.
1:34:33
Medicaid dollars flow through the state.
1:34:36
Sure.
1:34:37
Does the state choose to use reserves hoping for a better time or not?
1:34:43
What is the city's situation?
1:34:45
But but I think it would certainly cause the need to constrain the services that we provide.
1:34:52
Alright.
Lincoln Restler
1:34:53
I wanna try and get to a couple more questions if I can.