Empowering Health Care Consumers

Grantee Name

MergerWatch

Funding Area

Empowering Health Care Consumers

Publication Date

October 2020

Grant Amount

Phase 1: $100,000; Phase 2: $140,000

Grant Date:

November 2016 - December 2019

Hospitals are consolidating at a rapid pace. Although consolidation can provide benefits, it can also reduce competition and consumer choice, lead to cuts in services, and foster higher prices.

The issue is typically debated by health care industry stakeholders and anti-trust monitors, with limited channels for consumer input. As the hospital landscape changes, affected communities and consumers should have a voice in decision-making processes about the future of their local hospitals.

MergerWatch previously published a national study of Certificate of Need (CON) hospital oversight programs, concluding that most need to be updated to be more transparent and consumer friendly, enabling greater input and review from the public. NYSHealth then awarded MergerWatch, through its fiscal sponsor Community Catalyst, a grant to conduct an in-depth review of New York’s CON process to identify potential reforms for consumer engagement and protection in this era of consolidation. Building on this project to analyze the barriers to consumer input, NYSHealth awarded MergerWatch a second grant to conduct a campaign focused on making the CON process more consumer-friendly and transparent for New Yorkers. This project aimed to increase opportunities for consumers to meaningfully engage in the CON process; raise the public’s and influencers’ awareness of the issue; and generate CON decisions that are more oriented to New Yorkers and affected communities and are pro-consumer.

Outcomes and Lessons Learned

  • Produced the report, “Empowering Consumers in an Era of Hospital Consolidation.” Its recommendations included:
    • Require that consumers affected by hospital closures or elimination of key hospital services are notified and engaged.
    • Improve transparency, consumer engagement, and accountability when health systems propose takeovers of community hospitals.
    • Increase consumer representation on State CON review boards and increase consumer engagement in the CON process.
    • Ensure CON-approved projects preserve access to timely, affordable care and advance local and State health-planning goals.
  • Assembled a CON advocacy team to determine which changes could be accomplished administratively and which required regulatory or legislative action, with representatives from Medicaid Matters, Community Service Society of New York, CID-NY, Metro NY Health Care for All, Children’s Defense Fund-NY, New York Immigration Coalition, Empire Justice Center’s office in Rochester, and the New York City Commission on the Public’s Health System.
  • Implemented a campaign to build support for these recommendations and seek their adoption by key policymakers and other stakeholders in New York State.
  • Educated New York State and City lawmakers.
  • Secured adoption of three of its CON recommendations in the Health Care for All New York (HCFANY) policy agenda for 2019 and 2020, as well as presented at HCFANY’s January 2019 annual meeting in Albany.
  • Inspired a bill introduced in the New York City Council in August 2019 that would set up an Office of the Patient Advocate to respond to patient complaints and collect data on issues that could be used to inform the City and the State on hospital policies and regulations.

MergerWatch made significant gains in its campaign. It shared recommendations at a joint public hearing before the New York City Council’s Hospital and Health Committees and at a meeting with the New York Health Plan Association, suggesting that Governor Cuomo appoint two consumer representatives to vacant positions on the Public Health and Health Planning Council (PHHPC). In December 2019, Governor Cuomo directed the New York State Department of Health to appoint two additional consumer representatives to vacant positions on the PHHPC.

MergerWatch also engaged patients in advocacy efforts after Mount Sinai Health System announced plans to close its Beth Israel Medical Center in downtown Manhattan and replace it with a much smaller building. MergerWatch organized community forums to educate residents about the CON process and the proposed downsizing, and then solicited comments about how residents would be affected by having to travel for many acute care services. Its advocacy led the PHHPC to direct Mount Sinai to enlarge the size of the emergency department in the proposed new facility; develop a patient navigation and transportation plan to ensure consumers could find and obtain services at other locations once they were eliminated from Beth Israel; and explore the creation of a birthing center to replace a previously closed maternity unit.

MergerWatch’s campaign created a template for future and successful consumer engagement in New York State on a range of health care issues where consumers have traditionally been shut out of the process. In 2020, NYSHealth awarded a grant to build on this momentum and continue to advocate for greater transparency and consumer engagement in the State’s CON process. In early 2020, both houses of the State Legislature passed a new bill adding two consumer seats to the PHHPC and directing that appointees have expertise in the needs of medically underserved consumers. The bill awaits action by the Governor. The grantee has also expanded its engagement of stakeholders statewide through the creation of a new alliance, Community Voices for Health System Accountability, and will gather patient stories that demonstrate the impact of hospital consolidation, increase support among policymakers, and continue to push for further reforms.

Co-Funding and Additional Funds Leveraged: N/A