Re-envisioning Healthcare Through Primary Networks at WPH and Montefiore

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As White Plains Hospital continues to make improvements to its physical structure by adding laboratories for cutting edge medical procedures, hospital beds for growing patient demand, improvements to the hospital entrance and access to parking as well as an extension to the hospital’s Cancer Treatment Center with construction of a new facility adjacent to the Dickstein Cancer Center, WPH is stepping out most aggressively into a future at the forefront of innovation in healthcare.

On May 6, White Plains Hospital signed a comprehensive affiliation agreement with Montefiore Health System, the University Hospital for the Albert Einstein College of Medicine that would make WPH a tertiary hub of Montefiore’s Westchester Network and a member of the Montefiore Health System. The agreement marks an important step in solidifying WPH as well as White Plains securely on the map in a healthcare market that is growing rapidly in Westchester County.

White Plains Hospital had already been actively redefining community healthcare with its advancements in technology, medicine and recruitment that have allowed for increased localized care, but the addition of Montefiore brings academic, clinical and research expertise to the equation, as well as Montefiore’s commitment to taking the healthcare community in White Plains and Westchester to a whole new level.

Steven Safyer, President and CEO of Montefiore Medical Center, was a keynote speaker at HealthTech ’14, held May 8 at the Doubletree Hotel in Tarrytown, just two days after the agreement with WPH was signed.

Dr. Safyer talked about innovation in the healthcare industry and his vision for Montefiore’s future and its involvement in Westchester County.

“New York City is the destination for the best healthcare in the world,” Safyer said, adding that the entire New York Metropolitan area is skewed toward healthcare.

“The Albert Einstein College of Medicine and Montefiore Health System are one institution,” Safyer further explained, “and they form an academic epicenter.”

Where Montefiore departs from the vision of other academic medical centers across the United States is in its balanced integrated delivery system that vigorously focuses on the well-being and health of the population it serves.”

The population Montefiore serves in the Metropolitan area is 3 million, with 1 million located in Westchester County.

“We focus on wellness and don’t wait until people have a serious illness and need complicated care,” Safyer said, although he acknowledged that the high-tech medical services provided by Montefiore made it a hospital system sought out by people around the world.

“Health is not just about the delivery system it is about cohesive communities and cohesive families, availability of good food delivery systems and the ability to exercise. In parts of the Bronx and lower Westchester there are bodegas where once you get past the cigarettes and highly sugared foods it is hard to find good food,” he said.

Fifteen years ago at Montefiore we said that if we are going to be on the cutting edge, we had to educate the next group of physicians, nurses, etc. about where they need to be in the future. We determined that if we wanted to be in the sweet spot, we had to change the way we are paid and the way we deliver care. We had a challenge, Safyer explained.

He continued: “The majority of the American health care system is a fee-based system. The more you do and the more complicated the work you do, the more you get paid. While the vast majority are moral and ethical and want to do the right thing, there is always the consideration that if you do another test … the more you convince yourself that it is necessary, the more you get paid. It is a pernicious way of thinking and there is a stimulus there that is irresistible,” Safyer acknowledged.

Referring to the prepaid Kaiser system as an example, Safyer noted that Montefiore decided to move away from the fee-based care model and developed competencies to keep money within the system instead of going out to the insurance companies. This was accomplished by building a network that grew its physician workforce in primary and ambulatory care and made it regional.

“We don’t want to fight with insurance companies, but would rather take the people working in finance and turn them into social workers,” Safyer said.

“Standalone institutions do not have what it takes to sustain themselves,” Safyer continued. “You need data to understand the patients you are caring for and you have to be able to transfer that information throughout the process. It is not about the claims. Claims are a financial transaction, not a healthcare transaction.”

Safyer was referring to the digitization of patient records and the integration of delivery systems that could be accessed at any point during a patient’s care, technology that has become a major part of the healthcare industry in Westchester.

In looking at Westchester County, Safyer said Montefiore saw many fine institutions, but also many in peril. “Some of these institutions are small and others fairly large. Some were operating in the black, but they were not highly capitalized. That is why we moved into lower Westchester,” he said. “We now have six hospitals in Westchester and the Bronx and we have done a good job in turning these around.”

“Our partnership with White Plains is slightly different,” Safyer said. “There is not enough complex and tertiary care in Westchester County. We believe a place like White Plains Hospital and some other institutions here can be brought to a whole other level. That is the goal and why we are here.”

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