As Catholic Health continues to grow, it is increasing access to healthcare while connecting people with the resources they need to thrive.
Much of this starts with addressing one of the nation’s most challenging issues: Food insecurity, which triggers chronic disease and even health crisis.
“It’s a big problem,” said Dr. Patrick O’Shaughnessy, Catholic Health’s president and CEO.
“If we can bend the disease curve, we bend the cost curve,” O’Shaughnessy said. “It’s not sustainable to have healthcare expenditure north of 20% of the total gross domestic product even though we have great outcomes of care. We’re expecting far too much.”
In New York, more than 2.4 million people face food insecurity, including nearly 230,000 Long Islanders, 68,000 of whom are children and 4% are seniors, O’Shaughnessy said.
O’Shaughnessy discussed these challenges and more with Joe Dowd, editor and associate publisher of Long Island Business News, at LIBN’s annual Healthcare Forum, which aired Tuesday.
As Catholic Health expands across Long Island and into Brooklyn and Queens, it is investing in its hospitals and developing ambulatory spaces. The health system is focused on fostering its staff. It is also counseling patients on nutrition, providing them with the resources they need to eat nutritiously and avoid processed foods that trigger disease.
COVID-19 and the subsequent increase in food costs, O’Shaughnessy said, “really exacerbated the issue,” making it difficult for some to pay for nutritious grocery items.
Now, Catholic Health, the region’s second largest healthcare system, is seeking to reduce the disease burden. The health system has 1,900 licensed beds across six hospitals, three nursing homes, as well as home care and hospice. The system has 2,500 providers and is growing, including through its digital capabilities, working to make the region healthier, O’Shaughnessy said.
“I believe food is medicine,” O’Shaughnessy said. “Having good, healthy, nutritionally dense foods available for folks will give long benefit to reducing chronic disease … keeping people healthier.”
Now, O’Shaughnessy said, people at the county, state and national levels are realizing food’s potential impact on health.
But in households with persistent food insecurity, people are 40% more likely to be “diagnosed with a chronic condition,” O’Shaughnessy said. That includes “a higher probability of diabetes, stroke, hypertension, obesity, cancer, asthma, COPD and kidney disease.”
Food insecurity costs the region money. “On average food insecurity actually adds about 11% to the total healthcare cost of older adults,” O’Shaughnessy said.
In addition, food insecurity can create lifelong health challenges for children that can begin at an early age.
“You can have issues around increased body-mass index obesity,” O’Shaughnessy said. “We’re seeing more, younger patients with cardiovascular disease. It used to be cardiovascular disease was a disease of middle age, but you start laying down plaque in your arteries when you’re young, and if you’re eating the wrong foods consistently because that’s all you can afford,” the consequences can strike early.
“It is a big issue – it spans across all age groups,” he said. “It spans across all zip codes, and I believe by focusing on food insecurity, as a system, we can improve the patient’s quality of life and their overall health, trying to keep them out of the hospital.”
To foster health, “we screen people on time of admission to see how their diet is and what we could do to make improvements,” O’Shaughnessy said.
When needed, patients are given a bag of nutrition-dense food from Long Island Cares that will last several days.
“Then we plug them into other supplemental support,” O’Shaughnessy said, including through Catholic Charities, Health and Welfare Council of Long Island, and get them enrolled in Supplemental Nutritional Assistance programs and other programs, so they have more long-term sustainability to get good healthy food.”
O’Shaughnessy said “90% of these patients showed positive health outcome improvement, and in the cohorts that we treated in the home-care side of the organization [there were] zero emergency room visits and hospitalizations.”
Looking forward, “we have to have the very best and most talented workforce we have to offer state-of-the-art care, but we also have to grow and expand and make key investments in brick and mortar and new innovations with state-of-the-art facilities that can see patients in environments of which they want to be seen.”
The health system invested $500 million into a brand-new patient care pavilion at Good Samaritan University Hospital in West Islip that will have a state-of-the-art large emergency room, 22 new state-of-the-art operating rooms and private patient rooms, O’Shaughnessy said.
The health system is also expanding on Long Island’s East End and into New York City with ambulatory care centers that range in size, offering urgent care, and where patients can see their primary care physician, see a specialist, get an image and “even have a great cup coffee,” O’Shaughnessy said.
“It’s delivering the right care in the right place at the right time by the right people,” O’Shaughnessy said.
“I’m very excited to lead Catholic Health into its future,” he said. “Our future is very bright.”
Here are some highlights from the panel discussions at LIBN’s Healthcare Forum.
A Helping Hand in Healthcare: How nonprofits are providing much-needed mental health services
Moderator: Jeffrey Friedman, CEO, CN Guidance & Counseling Services
Panelists: Martha Carlin, Director, Long Island Field Office at NYS Office of Mental Health; Robert Detor, CEO, Advance Health Network/ Recovery Health Solutions; Kathy Rivera, CEO, North Shore Child & Family Guidance Center
The need for mental health services on Long Island is escalating.
Since COVID-19, “the mental health crisis on Long Island continues to grow and reach epidemic proportions,” Friedman said. “Over the last couple of years, we’ve seen a dramatic increase in the rates of depression, suicide, anxiety disorder and PTSD, in addition to the increase in substance use disorder.”
Now, mental health experts in the region are working to reinvent services to dramatically change how patients can access treatment and improve healthcare while reducing costs.
“Funders have been moving toward a value-based care reimbursement” model, Friedman said. Rather than using a fee-for-service model, a value-based care model is “contingent on the quality of care provided, and it’s directly correlated to the patient’s outcome. Benefits include reducing overall spending and better overall health.”
Research shows that the advancement of the information technology and the inclusion of behavioral health into a primary medical care system can help improve care and reduce costs, Detor said.
“You would impact the quality of care. You also change the utilization patterns away from the emergency room and inpatient care and you also significantly reduce the cost, especially for chronic conditions,” Detor said.
New York Gov. Kathy Hochul “has invested close to $1 billion in mental health,” Carlin said. The governor has put a priority on finding ways “to have more services in the community” with the “idea of integration being critical especially when it comes to children and families,” Carlin said. This focus can help prevent the need for emergency room visits, she said.
And although everyone was impacted by the pandemic, people managed to access mental health care through telehealth.
“We were able to pivot quickly,” Rivera said. That included training staff and families and ensuring that families had access to telehealth services.
“We created a sense of equity and reduced access barriers,” Rivera said.
“Single mothers with multiple children with special needs were now able to participate more actively in services because they didn’t have that parental stress of trying to get to us,” she said. “We’re talking about a very vulnerable population.”
Now, nonprofits – both in healthcare and other sectors – are struggling to attract and retain talent for these much-needed services.
Despite these challenges, Carlin said, “the hope is that with the appropriate funding for these programs, we are going to expand capacity.
– ADINA GENN
Workforce Development: Shaping the next generation of healthcare workers
Moderator: Gordon Schmidt, Dean of School of Health Professions, New York Institute of Technology
Panelists: Djimmitry JeanLouis, Alumnus, New York Institute of Technology; John Karaptis, Alumnus, New York Institute of Technology; Dr. Donna Marie McMahon, Associate Dean of Student Affairs and Associate Professor, College of Osteopathic Medicine, New York Institute of Technology
Developing a workforce in healthcare presents many challenges, as burnout from the pandemic and myriad opportunities in other sectors are pulling talent away.
To address the issues involved in workforce development, Gordon Schmidt, a dean with the School of Health Professions at New York Institute of Technology, moderated a panel discussion on the challenges of educating and training and how to best shape the next generation of healthcare workers.
“Sometimes we find that the need for employees does not meet the availability,” said Schmidt. “It’s estimated there are probably 500,000 employees still needed in healthcare and possibly because of the pandemic we see that this is more critical than ever.”
McMahon said that about 53 percent of NYIT graduates enter primary care and the rest of them enter subspecialties, some of which are more in demand.
“We have a need in developmental pediatrics, those professionals who evaluate and treat children with developmental disabilities are on the autism spectrum,” she said. There’s a big need for more pediatric neurologists and we need more psychiatrists who are able to have a large impact on the community instead of just in small private practices that don’t accept any insurance.”
When it comes to physicians’ assistants, Karaptis said the demand is currently being met in the New York area, but he added that the demand is sure to increase, since the trend is to employ more PA’s at reduced costs than doctors.
“What we’re seeing now in some of the ancillary areas of healthcare, particularly with respiratory therapy and anesthesia technicians, there is a severe shortage currently for these positions in hospitals and it’s a very big problem. There are not enough training programs and the current training programs aren’t large enough, so that is an area that’s going to have to be looked at.”
One area where there’s been shortages of staff is nursing. JeanLouis said the nurses now have the upper hand in negotiating their salaries and the industry is seeing a shortage when it comes to the ancillary staff. And that’s why more health systems are looking to employ nursing assistants.
“With the nursing assistants, there are not that many programs, so we have seen employers working with those respective unions to basically have small programs geared towards getting support,” JeanLouis said.
One big change in healthcare education, says McMahon, is that residency programs have picked up on the importance of cultural competence.
“Before, it wasn’t about you, it was about me, and now we’ve finally turned the tide and it’s about you, it’s not about me,” she said. “So I’m happy to say that I can see it within the institution, and I can see it certainly with our students that they see the importance of that cultural competence.”
– DAVID WINZELBERG
Behavioral Health Crisis Response and Care: Why immediate response is crucial
Moderator: Jeff Steigman, Chief Strategy Officer, Family Service League
Panelists: Melissa Coscia, Director of Clinical Crisis and Stabilization Services, Family Service League; Bridget Topping, Police Officer, Behavioral Health Unit, Suffolk County Police Department
The need for crisis response in behavioral health is more pressing than ever. And programs like the Family Service League’s Diagnostic Assessment and Stabilization Hub (DASH) have developed into essential tools, forging critical relationships with law enforcement that can relieve the burden that police face in dealing with those struggling with mental health issues.
“If you provide the crisis services at the right time and in the right setting and by the appropriate professionals, it will result in better outcomes in the shorter and longer term,” Steigman said. “One of our goals is to be able to move as far upstream as possible to be able to provide alternative interventions and alternatives from higher levels of care to be able to do something that’s more preventive than reactive.”
Steigman says the DASH program has “really moved the needle” in coming up with new approaches on partnering with law enforcement to provide the best outcomes.
“It removes law enforcement from that de facto position of being a substance abuse counselor or mental health counselor, where really that’s not their role,” he said.
Coscia said that DASH operates 24/7, 365 days a year and participation is 100 percent voluntary.
“DASH is designed so that we can break down barriers to make it easy for people to access care and that we can engage a variety of different individuals experiencing a variety of different behavioral health crises,” she said.
Coscia added that DASH is located in an industrial park and very private.
“Our length of stay is about three hours for a typical assessment, but we can work with somebody up to 23 hours and 59 minutes if they need more support or more services,” Coscia said. “We are very flexible with the way that we use our space. Sometimes we have an individual coming in alone, sometimes they come with multiple family members. Minors on site always have to be accompanied by an adult because we treat children from five and up in an unlocked environment.”
Topping said the Suffolk County Police Department created its Behavioral Health Unit in August 2021 and it’s been working with the Family Service League’s DASH to assist officers in the field.
“Telehealth is an option for officers working in crisis intervention where they can engage with a licensed clinical social worker at DASH who can assess the individual and make the determination to see if that person should be transported to the Stony Brook CPEP (Comprehensive Psychiatric Emergency Program) or can come to DASH,” Topping said. “Our officers love it. They are using it constantly. The community loves it, which is most important. People are really seeing this collaboration between the police department and mental health field where they’re just really happy to see this multifaceted approach.”
– DAVID WINZELBERG
Healthcare Compliance Regulations for the Business Community: Why does it matter?
Moderator: Adina Genn, Long Island Business News
Panelists: Roy W. Breitenbach, Partner, Harris Beach PLLC and Health Care Industry Team Leader; Marc Lion, Partner, Mazars
With the increasing number of consolidations and acquisitions in the medical field, paying attention to healthcare compliance regulations is more critical than ever. And where most healthcare professionals concentrate on their individual disciplines, compliance regulations can’t be ignored and engaging professionals well-versed in the topic is becoming more and more necessary. It even has consequences for owners of medical office real estate.
“It’s important for all providers because if they want to do any type of business, they want to go out and get private equity, they want to run an efficient practice, they want to talk about merging with a hospital, compliance is fundamentally at everything,” Breitenbach said. “You don’t want the government knocking on your door with the problem. You want to nip problems in the bud, so all healthcare providers have to be very aware of compliance and the growing importance every time you deal with the payer, every time you deal with the government, you need to make sure that you have an effective compliance program.”
Lion said people go to medical school to learn how to become physicians, but not necessarily business owners.
“I hear they are starting some programs here and there where they do teach some portions of business to the younger folk, but they don’t teach you how to run a business and they don’t teach you how to start a business,” Lion said. “We probably have a six- or seven-page checklist with the things that you need to do to start up your own practice.”
Lion added that besides renting space, hiring staff, and buying supplies and equipment, there’s also a lot of regulatory components, including which forms need to be in place, how patient intake will work and how to properly train staff.
“We’re still seeing a good bit of consolidation in the industry, and this is where having a good compliance regulatory program in your practice comes into play,” he said. “Because if you are going to entertain an offer from a private equity group or a large practice that’s backed by private equity, some of the things are going to come in during the due diligence exercise.”
Breitenbach cautions that compliance issues can also arise in many healthcare mergers and partnerships.
“If you’re partnering with a group of healthcare providers and those group of healthcare providers actually have or potentially could have referral relationships among them, that could impact things like lease terms and valuation,” he said. “Because so many of the healthcare abuse laws are meant to capture people inducing referrals or inducing kickbacks or things like that.”
– DAVID WINZELBERG