A newly appointed Medicaid Redesign Task Force has been charged by Governor Cuomo with identifying ways to cut $2.5 billion next year without harming the sickest among us — a nearly impossible task.
Instead of this risky approach, let’s invest in programs that we know help people get better and save money because healthier people are much less expensive to treat. We should start by focusing on people with significant physical and behavioral health issues.
At the East New York Health Hub, run by non-profit social services agency ICL and Community Healthcare Network, we bring doctors, psychiatrists, substance misuse counselors, and social workers together to treat the most vulnerable – and costly – patients. This “whole person” approach helps these patients get better and saves the state money.
Oscar is just one example. He’s a 60-year-old man who suffers from schizophrenia, type II diabetes, hypertension, obesity, and worsening vision problems. When we first met him, his diabetes was out of control, and he wasn’t taking care of himself.
But thanks to the work of our staff at the Hub, Oscar’s glucose readings dropped by half, he began taking the medication regularly and decreased his sugar intake – all signs that point to improved health and less costly care down the road.
At ICL, we’ve applied this whole-person approach across 100 programs serving more than 10,000 New Yorkers, and it works: In 2018, we reduced client emergency room visits by 57 percent and hospitalizations due to mental illness by 62 percent. That translates to huge cost savings.
At the Hub, we have on-site services and multidisciplinary teams that travel to meet patients where they are – homes, jobs, parks, cafes, shelters, literally anywhere –to ensure people get the care they need.
Our clients see their behavioral health counselors frequently. This allows our staff to build trust with individuals, who then are more likely to keep doctor appointments and change health behaviors.
Our staff escort patients to appointments and often stay for the duration of their visits to offer support and reassurance. And when patients can’t get to the Hub, we bring nurses with us to home vis-its. Access to care is an empty promise without measures like these.
The lesson for policymakers is clear: Forget cuts that would allow problems to worsen and costs to grow and invest instead in whole-person care that improves outcomes and reduces costs.
BY DAVID WOODLOCK