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POLITICO New York Health Care: De Blasio's claim of HHC stability; PCMH challenge

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

A STABILITY QUESTION During a press conference at Lincoln Hospital on Thursday, Mayor Bill de Blasio was asked what he had done to help the South Bronx. The mayor responded with a list of his greatest hits including, he said, stabilizing the Health and Hospitals Corporation. “We have stabilized the finances of the Health and Hospitals Corporation,” de Blasio declared. “Let’s face it, the South Bronx would have a much greater health challenges if it weren’t for Lincoln Hospital. HHC for years was dealing with profound fiscal challenges. We took under the city budget the new labor costs associated with the labor pattern. We’ve invested in HHC. Dr. Raju is doing an amazing job of strengthening the finances.”

...HHC is many things, but it is not financially stable. The corporation is so short on cash that it is considering seasonal borrowing from New York City to help it make payroll. The CFO said in July that the coming fiscal year will be a “a very difficult cash year.” HHC is projecting a $914 million budget gap in fiscal year 2017 and a $1.5 billion gap by 2019. It is true the mayor has helped with $20 million for Ebola treatment, money to offset the new labor contracts and allowing some payments to be foregone. But no one familiar with the situation would honestly say the corporation has turned a corner and is now financially stable.

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PATIENT CENTERED MEDICAL HOME REPORT New York State leads the nation in implementing patient centered medical homes (PCMH), the type of medical practice that offers care teams, uses electronic medical records, registers complex patients and has a dedicated staff to act as care managers and offers expanded access. The challenge for health officials will be figuring a way to expand this approach to smaller practices, which don’t have the resources to invest in these new models, according to a report from the United Hospital Fund. “Finding a way to adapt this model to the state’s small practices will be critical to achieving the hoped-for spread,” according to the report, which was released this week. Read the full report here: [PRO]

NOW WE KNOW Break ups are harder on women than men, but women are better at recovering, according to research from (my alma mater) Binghamton University, which was published in Evolutionary Behavioral Sciences. This research was conducted via a survey asking participants to rank the pain of breaking up on a scale of 1 to 10. Women averaged 6.84. Men were 6.58. Craig Morris, research associate at Binghamton, said the reason is obvious. Women have more to lose by dating the wrong guy. "Put simply, women are evolved to invest far more in a relationship than a man," Morris said in a press release accompanying the article. "A brief romantic encounter could lead to nine months of pregnancy followed by many years of lactation for an ancestral woman, while the man may have left the scene literally minutes after the encounter, with no further biological investment.” Not sure if that description fits the definition of “romantic,” but his point is well taken.

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-BILL PASSED — The City Council unanimously approved a bill Thursday that will require city building owners to register and periodically test and clean cooling towers. Mayor Bill de Blasio is expected to sign the measure next week. After the signing, building owners will have 30 days to register the towers with the city’s Department of Buildings before facing fines and possible jail time.

-HARD PRAISE — The Centers for Disease Control and Prevention on Thursday praised Mayor Bill de Blasio and his administration's handling of the Legionnaires' outbreak, refuting criticisms it acted too slowly. Matthew Moore, a medical epidemiologist from the CDC, said during a press conference at Lincoln Hospital in the Bronx that the city's response was "swift, diligent and robust." Moore said the city health department deserved praise for remaining open-minded and for resisting the temptation to jump to conclusions. Elected officials, including Governor Andrew Cuomo, Rep. Hakeem Jeffries, Bronx Borough President Ruben Diaz Jr. and city Comptroller Scott Stringer have implied the city's response lacked urgency and have criticized the administration to varying degrees. The mayor and his staff have consistently pushed back, and de Blasio did so again Thursday. "I listen to medical personnel when it comes to medical matters," the mayor said. "They are the ultimate word."

-SOFT CRITICISM City Comptroller Scott Stringer offered a conditional critique of the mayor's handling of of Legionnaires' disease in a radio interview Thursday morning. Stringer told WCBS that Mayor Bill de Blasio and the city's health department developed "a strong protocol" to fight Legionnaires'. "But this is my critique," Stringer said. "We cannot wait for a disease to come to us. We must be more proactive about combating whatever comes our way. If you look at the last 10 years in this country and this city, Legionnaires' has been growing every year." It hasn't actually increased every year, according to the health department. There were fewer cases in 2010 than there were in 2006. [PRO]

-MONEY FOR LEGIONNAIRES’ Assemblywoman Latoya Joyner introduced a bill Thursday that would provide New York City with up to $50 million to fight Legionnaires' disease. See the bill here:

SMOKING BILL SIGNED Governor Andrew Cuomo on Thursday signed legislation that prohibits smoking tobacco in and around after-school programs. This bill, sponsored by Sen. Gustavo Rivera and Assemblyman Victor Pichardo, two Bronx Democrats, expands the already-existing ban on smoking within 100 feet of the entrances, exits or outdoor areas of public and private schools. The law applies only during the hours when an after-school program is running, and residences are exempt. It requires the after-school programs to post signs alerting the public to the times during which smoking is banned.

FINANCES — Montefiore Medical Center reported $30.3 million in operating income for the six months ending June 30, far less than the $56 million it reported for the same period in 2014. Patient service revenue went up 6 percent year-over-year, or $112 million, according to the most recently filed financial report. Operating expenses rose 6.3 percent, or $139. Read the report here:

MORE FINANCES Memorial Sloan Kettering Cancer Center reported operating income of $109.4 million for the six months ending June 30, $30 million less than what it reported for the same period in 2014. Operating revenues increased by 8.6 percent, or $140.7 million, according to the hospital's most-recent financial report. Outpatient visits were up 6.1 percent, helped in part by the opening of new clinical facilities, including a 114,000-square-foot regional site in West Harrison, and a 90,000-square-foot site on Madison Avenue. Operating expenses increased by 11.4 percent, or $170.5 million, the report said. That was primarily due to a 10 percent increase in compensation and fringe benefit costs.

MOVING EAST Crain’s reports: “Memorial Sloan Kettering’s agreement with Nassau County to build a $140 million outpatient cancer center was sent to the county legislature on Tuesday. MSK is buying five acres of the site of the Nassau Veterans Memorial Coliseum. The hospital is building a two-story, 105,000 square-foot facility, with expansion possible to 140,000 square feet.”

GRANT LAND The University at Buffalo has been awarded a four-year, $16 million Clinical and Translational Science Award from the National Institutes of Health. The money will be used to establish a the UB Clinical and Translational Research Center that will facilitate the delivery of new drugs, diagnostics and medical devices to patients.

PHARMA REPORT: Nicholas Bagley examines the “long-running dispute over the First Amendment, [which] flared up this past Friday, when a federal judge in New York told [the] FDA that it couldn’t prevent a drug manufacturer from discussing research supporting an off-label use of its drug.”


-COMING CLARITY Modern Healthcare reports: “The Federal Trade Commission may soon define more clearly what constitutes unfair competition. Healthcare players would welcome the clarity in a nebulous area of antitrust law, experts say, but it's not likely to change the FTC's enforcement approach.”

-RISING STEADY POLITICO reports: “The cost of employer-based health plans did not spike significantly under full ACA implementation last year, according to a new government survey. The cost of the average individual employer-based plan increased 4.7 percent to $5,832 in 2014, according to data from the Agency for Healthcare Research and Quality. Premiums for family plans increased by 3.9 percent, to $16,655. While premiums grew faster than inflation, they also grew at a similar pace in 2013, prior to implementation of the ACA’s insurance marketplaces and Medicaid expansion. Premiums for individual employer-based coverage increased by 3.5 percent in 2013, while rates for family plans rose by 3.6 percent, according to AHRQ.”

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TODAY'S TIP — Comes from the Mayo Clinic: “Feel too busy to work out? Consider the stress relief benefits of exercise.”


-WHAT THE DENTIST CAN DO Researchers at Columbia University’s Mailman School of Public Health say dental screenings can detect drug abuse, according to an article in Addiction, The study found 77 percent of dentists ask patients about illicit drug use, and 54 percent of dentists believe such screenings should be their responsibility. “There are a sizeable number of people whose visit to a dentist represents their sole interaction with the healthcare system, highlighting the significance of the dental visit as a key opportunity to identify substance use disorders,” Carrigan Parish, associate research scientist in the Department of Sociomedical Sciences, said in a press release accompanying the article. “However, our findings underscore a significant barrier in dentists’ attitudes that may limit the potential of the dental venue to play a role in screening for substance misuse.”

PROS AND CONS JAMA explores the potential hazards of hospital consolidation.

MISSED A ROUNDUP? Get caught up here: 8/13, 8/12, 8/11, 8/10, 8/7

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