Community Catalyst, Inc.

Provider consolidation in New York’s health care delivery system is raising concerns about reduced competition, higher prices, reduced access, and restricted consumer choices.

Some acute care hospitals have closed or downsized, while others have merged into large regional health systems. There are few free-standing, independent hospitals left, and newer forms of health providers, such as ambulatory surgery centers and urgent care centers, are proliferating. Although these newer options can fill some access gaps, they are less available to lower-income patients. Despite the stakes involved with provider consolidation, affected patients and communities have little say in New York State’s regulation of health facilities, including the Certificate of Need (CON) process, which governs the establishment, construction, and renovation of health care facilities. The Women’s Health Program (WHP) of Community Catalyst is dedicated to equipping consumers with the skills to influence decisions that affect health care access and delivery. Under previous NYHealth grants in 2016, 2017, and 2020, WHP and Community Catalyst made great strides in advocating for greater transparency and consumer engagement in proposed hospital closures and mergers. In 2021, NYHealth awarded WHP a grant to further develop models for consumer engagement in the State’s CON process.

Under this grant, WHP worked in partnership with a team of New York State consumer health allies to empower affected consumers and made them a bigger part of decision-making. It engaged coalitions in communities that are facing consolidation proposals. WHP conducted outreach to increase consumer awareness of the changes and created channels to solicit community input before the CON application is submitted to the State. Once the CON application was submitted, WHP assessed implications for the community such as access to care, quality, and costs. It conducted educational workshops, coached community members on effective messaging, launched a social media campaign to encourage public comments, and organized forums for consumers to support or oppose aspects of proposals. To support other communities replicating this work, WHP documented the community engagement models and best practices, developing a how-to guide that will include examples of community health needs assessments, sample agendas, model presentations, an explanation of the CON process, and examples of comments and testimony. It disseminated the toolkit broadly through webinars and presentations; social media channels; blog postings and e-mail blasts; and its strong network of health advocacy organizations.