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POLITICO New York Health Care: Hospital directors retire; Emblem opts to not renew contracts

Dear readers: POLITICO New York Pro subscribers receive this email at 5:30 a.m. each weekday. If you'd like to receive it at that time, along with a customized real-time news feed of New York health care policy news throughout the day, please contact us at and we'll set you up for trial access.

written by Dan Goldberg and Josefa Velasquez

WAKE-UP SCOOP — Big changes are coming to the leadership of New York City's public hospital system. The executive directors of Woodhull, Coney Island, Harlem and Elmhurst hospitals will retire at the end of the year, and a search is on for their replacements as NYC Health + Hospitals (formerly HHC) attempts to transform its lines of business and adapt to a growing need for ambulatory care. All four hospital leaders, who combined for 107 years of public hospital service, were network senior vice presidents, a position that H+H CEO Ram Raju is eliminating. Raju, in September, announced that he would scrap the traditional network model that has served HHC for decades and replace it with three lines of service: in-patient care, long-term and post-acute care, and ambulatory care.

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EMBLEM RESPONDS TO MSSNY — EmblemHealth's new CEO explained to the state's financial services department last Wednesday why she is choosing not to renew contracts with approximately 750 in-network physicians. The decision, said Karen Ignagni, was made in an effort to ramp up the insurer's value-based business and move away from fee-for-service doctors. Ignagni's move may signal a larger looming fight between insurers and independent physicians. Insurance companies want risk-sharing, which could penalize physicians if a patient is poorly cared for. Independent physicians, who are either unable or unwilling to join larger groups or health systems, don't have the patient base to engage in those types of contracts and rely on fee-for-service contracts to stay in business. Her letter came in response to concerns from the Medical Society of the State of New York, which claimed Emblem's "arbitrary and outrageous" moves will "disrupt access to care to thousands of patients." Read my story here: Read the MSSNY letter here: Read Ignagni's letter here:

NOW WE KNOW — Being punched in the face is one of the leading causes of eye injury in the United States, according to research presented at the 119th annual meeting of the American Academy of Ophthalmology. Falling on your face is also bad for your eye.

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SLOW AND STEADY — Newsday’s Emily Ngo compared the Bloomberg and de Blasio health departments. She finds the de Blasio team is emphasizing a softer sell. “Mayor Bill de Blasio has praised and sought to build on his predecessor's initiatives, but with a lower-key -- and politically safer -- approach that stresses community input instead of executive edicts.”

FINANCES Mount Sinai Hospital reported a $40.5 million operating gain through the first nine months of 2015, according to its most recently released financial statements. That's about 10 percent less than the same period in 2014. The poorer performance resulted from increased union wages, which took effect in October 2014, and investment in infrastructure for population health. Mount Sinai also cited a 7 percent increase in supplies cost related to program growth in cancer and non-cancer infusion therapy, pharmacy, neurology and new cardiac supplies. Read the full report here:

MORE FINANCES — South Nassau Communities Hospital lost $6.4 million through the first nine months of 2015, according to its most recently reported financial results. That compares to a $6.4 million gain for the same period in 2014. Nearly all of that is related to investment income, according to the report. Excluding the investments, income from operations through September 2015 was $1.1 million as compared to $1.2 million for the same period in 2014. Total operating expenses increased $29 million, in large part because South Nassau is acquiring physician practices. South Nassau reported 125 days cash on hand. Read the report here:

PROGRESS REPORT — Gov. Andrew Cuomo will announce this week that prescriptions for Truvada, a daily pill that can protect against contracting HIV, have more than tripled since summer 2014 among people enrolled in Medicaid in New York State, according to The New York Times.

...The New York Times also reported on a federal study that found one-third of primary care doctors and nurses in the United State have never heard of Truvada.

COMING SOON: CUOMO’S HOMELESS PLAN — Gov. Andrew Cuomo will unveil a new plan to address homelessness in his annual State of the State in January, his office said Wednesday, after two days of particularly heated sniping with Mayor Bill de Blasio over the issue.

BILL TRACKER — Sponsors of a bill which would have required the state's Department of Correction and Community Supervision to provide medical disclosure forms to all incarcerated men and women, say they don't mind Gov. Andrew Cuomo's veto because he achieved the same result through administrative actions.

BLOOMBERG’S SODA TAX — Public health advocates, flush from victories in Mexico and Berkeley, California, are plotting to bring voter referendums and legislation to tax soda in as many as a dozen U.S. cities in 2016, according to POLITICO. “It's all part of an international strategy backed by billionaires in New York and Texas, including former New York City Mayor Michael Bloomberg, to reduce consumption of sodas, juices and other sugary drinks in the fight against spiraling rates of obesity, diabetes and other diet-related diseases.”

THE TOP TEN — HANYS’ DataGen, a healthcare analytics firm, produced a white paper called: “10 Things to Know Now that CJR is Final.” Read it here:

BREATHE EASY — Newsday reports: “New York State health officials have released updated guidelines for allocating ventilators in the event of a flu pandemic, emphasizing that the machines — a limited resource — would be distributed to hospitals based on medical need.”

PHARMA REPORT — The Associated Press reports: “Federal health officials have approved a first-of-a-kind flu vaccine that contains a booster to help protect seniors vulnerable to the virus.”


-OBAMACARE UPDATE — POLITICO reports: “Slightly more than half a million people chose health plans on and its Spanish counterpart site during the third week of open enrollment, bringing the cumulative total of plan selections to 1.6 million. During the third week, slightly over one-third of sign-ups came from new customers, consistent with the first two weeks. The call center took in 791,926 calls and the online application was submitted by 858,692 users.”

-TURING DOUBLES DOWN — Turing Pharmaceuticals, the company under fire for increasing the cost of Daraprim, an anti-parasitic drug, from $18 a pill to $750 overnight, will decrease the cost of the drug for hospitals. ABC News reports: “Nancy Retzlaff, Turing's Chief Commercial Officer, pledged that no patient would be denied the drug based on their inability to pay and announced various price cuts to hospitals. ‘Combined with our robust patient access programs, this is an important step in our commitment to ensure ready access to Daraprim at the lowest possible out-of-pocket cost for both hospitals and patients,’ Retzlaff said in a statement yesterday. ‘We pledge that no patient needing Daraprim will ever be denied access.’”

-IN CASE YOU MISSED IT — POLITICO investigated Ben Carson’s charity, which he hoped would provide health coverage to millions of uninsured Americans. "Angels of the OR" was supposed to grow into a massive endowment that would generate enough interest income to cover uninsured patients' expenses for neurological surgeries and other medical costs. But that didn't exactly pan out, according to POLITICO's Kyle Cheney and Isaac Arnsdorf. "Over nine years of operation, Angels of the OR generated less than $150,000 for patient care and helped 34 patients cover portions of their medical bills, according to its tax forms. Carson had said he wanted to raise as much as $20 million in seed money, but the charity collected less than $1 million from donations and celebrity-studded events — like a private benefit headlined by Kenny Rogers and the 2003 film premiere of 'Stuck on You,' in which Carson made a cameo appearance ... Angels of the OR spent $1.03 million during its life span, and at least 53 percent of its funds went to salaries and fund-raising costs, according to POLITICO's review of its records. The charity shut down in 2013 when Carson stepped down as director of pediatric neurosurgery at Johns Hopkins Hospital."

TODAY'S TIP — Comes from the Centers for Disease Control and Prevention. Having a pet dog while growing are positively associated with healthy weight and mental health among children.


-A SENSITIVE MAN — Researchers at the University at Buffalo say men with Type 2 diabetes and low testosterone can benefit from testosterone treatment. “This is the first definitive evidence that testosterone is an insulin sensitizer and hence a metabolic hormone,” Dr. Paresh Dandona, senior author on the paper and SUNY Distinguished Professor and chief of endocrinology, diabetes and metabolism in the Department of Medicine in the Jacobs School of Medicine and Biomedical Sciences at UB, said in a press release. The study was funded by the National Institutes of Health and published in Diabetes Care. The researchers found low testosterone levels were associated with decreased insulin sensitivity, and that while there was no change in body weight, there was a 32 percent increase in the uptake of glucose by tissues in response to insulin. HbA1c levels did not go down, but Dandona found fasting glucose levels had diminished by 12 milligrams per deciliter.

-MOTHER NATURE — Researchers at the University at Buffalo are examining whether plant sterols, a class of steroids, can be used as a natural alternative to drug therapy in expectant mothers who have high cholesterol. “Right now the treatment options are limited,” Todd Rideout, assistant professor of exercise and nutrition sciences in UB’s School of Public Health and Health Professions and the study’s lead investigator, said in a press release. “There’s a real need to find an alternative cholesterol therapy for women who wish to become pregnant or are already pregnant.”

-POTATOES CUT CANCER — A study by researchers at Zhejiang University in China found that people who eat a large amount of white vegetables, like potatoes, cabbage, onions and cauliflower, are a third less likely to develop stomach cancer than people who don’t eat them. The increase of stomach cancer is increased through spirits, beer, salt and preserved food.”

MISSED A ROUNDUP? Get caught up here: 11/25, 11/24, 11/23, 11/20, 11/19

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