State’s pay bump for home health aides spurs reimbursement concerns – Crain’s New York Business
State lawmakers approved a $7.7 billion commitment to increase the minimum wage for home health aides over the weekend as part of the fiscal 2023 budget, but the fine print has home care agencies concerned they will be forced into the red.
The Education, Labor and Family Assistance budget bill calls for a $3 per hour increase to the regional minimum wage that will be phased in over two years. The initial $2 per hour bump will go into effect Oct. 1, and the additional $1 per hour will kick in October 2023.
The city’s minimum hourly rate for home health aides is $19.09, including a required benefits portion.
George Gresham, president of 1199SEIU United Healthcare Workers East, which represents 325,000 health care workers statewide, praised what he called a “meaningful pay raise” in a statement Thursday.
But the change fell short of demands from both workers’ advocates and those in the home care industry. Advocates, including the union and state Attorney General Letitia James, had coalesced behind “Fair Pay for Home Care,” a bill to increase home care workers’ wages to 150% of the regional minimum wage. Industry stakeholders said any raises had to be fully funded with a corresponding bump to reimbursement rates.
Particularly concerning to the industry is that the final budget language does not specify that managed care organizations must accordingly increase the rates they pay home care agencies, said Mordechai Wolhendler, a health care consultant with Albany-based consultancy GlattHealth.
Wolhendler, who is also a former home care executive, said a higher minimum wage comes with higher overtime rates and more payroll taxes for agencies, among other fringe costs. If the managed care plan only adjusts its reimbursement rate for the $3 increase and not the fringe costs, Wolhendler said agencies will be left in a financially vulnerable spot.
“That money has to come from somewhere,” he said.
Mordy Schwab, administrator at Blossom Home Care, a Forest Hills-based home care agency that serves more than 900 New Yorkers, said those fringe costs amount to up to 10% to 12% of wages.
Kathy Febraio, president and CEO of the New York State Association of Healthcare Providers, which represents home and community-based providers, said the wage increase is a step in the right direction but will not be sustainable without higher Medicaid reimbursement rates.
In contrast, the original Fair Pay for Home Care bill explicitly specified that the health commissioner establish regional minimum hourly reimbursement rates that were commensurate with the new minimum wages.
State Sen. Rachel May, who sponsored the bill in her chamber, said she will work with her colleagues in the Legislature in the coming weeks to introduce new legislation “to ensure the money still moves as intended,” meaning from health plans to home care providers to their workers.
In response to Crain’s request for comment on the concerns, Health Department spokeswoman Sam Fuld said aides will receive the minimum wage increase as required by statute.
“Consistent with prior minimum wage increases, the $3 per hour minimum wage increase for home care workers will be incorporated into fee-for-service rates and managed care plan premiums,” Fuld said in a statement.
Wolhendler said the Department of Health typically declines to intervene in disputes over negotiated rates between managed care plans and home care agencies, because they are considered contract disputes, so agencies have little recourse if reimbursement rates come in below-cost—as he said many do.
If the state does not pair the new minimum wages with new reimbursement requirements, Schwab said he worries his agency and others will go out of business.
“If they push this through and there’s no forced reimbursement,” he said, “it’s game over.” —Maya Kaufman
Mount Sinai Hospital’s pediatric emergency department opens after $7M revamp
A fully renovated pediatric emergency department at Mount Sinai Hospital opened Monday, designed to improve patient experience as well as operational workflow.
The Upper East Side facility now occupies 4,788 square feet, a 54% increase from the previous 3,112-square-foot layout. The cost of the new space was approximately $7 million, representing nearly 11% of a $65 million project to redesign the hospital’s entire emergency department.
With more than four years of planning, the new children’s emergency department is the second of five phases. Additional renovations are in the geriatric emergency department, the main emergency room, the critical care area and the observation area.
A key feature of the new pediatric facility is an expanded resuscitation area. Mount Sinai also built a “low stimulation” room to help meet the needs of children on the autism spectrum or with behavioral disorders.
Other suite elements include colorful lighting, iPads and a video feature wall with interactive elements.
“They may seem trivial, but they are important to a child’s patient experience, especially in a hospital setting,” said Dr. Brendan Carr, chair of emergency medicine for the Mount Sinai Health System.
The new department has been designed to improve operational workflow. It is now clearly a separate wing from the adult section, with treatment spaces and waiting rooms planned to enable providers to work in parallel.
“We try in emergency departments not to do everything in series but in parallel,” Carr said. Historically, patients would go through triage, then have a first visit with a provider, who would order tests and wait for results before a consultation, he said.
“We’re integrating best practices in emergency medicine to do things in parallel while ensuring things are as patient-centric as possible, and ideally shaving time,” he said.
The pediatric zone has 22 dedicated treatment spaces, up from 16 that should facilitate a patient volume increase of up to 20%.
Carr said the children’s emergency department is fully connected to all services at Mount Sinai Kravis Children’s Hospital, which sits on the same block.
Founded in 1852, Mount Sinai Hospital is a 1,134-bed facility. The health system has eight hospital campuses and more than 410 ambulatory practice locations. —Shuan Sim
Hoboken value-based senior care startup raises $53M
Vytalize Health, an accountable-care organization in Hoboken, N.J., has raised $53 million in a Series B investment round, it announced Monday.
The company offers a technology platform to doctors servicing Medicare patients to shift to value-based care, where providers enter into risk-sharing with payers based on health outcomes and utilization.
Vytalize’s platform includes partnering with practices as a risk-bearing entity, as well as analyzing data to recognize potential risks among patients, remote monitoring and virtual care. The company said its platform has contributed to a 28% reduction in ER utilization among its partners.
Chief Executive Faris Ghawi said the firm partners often with small primary-care groups and hopes to improve the relationship between doctors and their patients.
“We can bring them the data to show where care gaps exist,” Ghawi said, “and how to close those gaps in care.”
The funding round was led by Enhanced Healthcare Partners, a private investment firm in Midtown. The $53 million round includes $47 million in equity and $6 million in debt.
Vytalize has raised more than $70 million total. With the new funding, it hopes to continue expanding its focus.
“We’re doing a lot of work with the primary-care doctors,” Ghawi said, “and now we’re extending to partner with the hospitals and specialists.”
Vytalize also will invest in hiring, boosting its care delivery infrastructure and partnering with more Medicare Advantage and commercial plans, he said.
Founded in 2014 as a primary-care practice before shifting into the accountable-care model, Vytalize has 120 employees. It is active in 16 states and serves 130,000 Medicare patients through 280 partnerships with doctor practices. Last year it acquired MedPilot, a digital health company in Cleveland focused on patient outreach. —Ryan Deffenbaugh
Englewood Health opens urgent care center in Fair Lawn
Englewood Health opened an urgent care center Monday in Fair Lawn, Bergen County, marking its fourth such facility in the health system’s network.
The center occupies 2,500 square feet on the ground floor of a 3-story 30,000-square-foot multispecialty office, which Englewood Health occupies exclusively, said Dr. Stephen Brunnquell, president of the Englewood Health Physician Network.
With the space previously used for medical purposes, minimal modifications had to be made to convert it to urgent care use, costing no more than $50,000, Brunnquell said. The center had been slated for a March opening, but due to supply-chain issues the opening date was delayed.
“It had been hard to get computers,” Brunnquell said.
The facility opens with one provider, and Englewood Health expects to add up to three as patient volume grows, he said. Optimally, the Fair Lawn center could see 80 to 120 patients per day, he added.
Because the center is in a multispecialty office with existing physician groups, patients can be linked to other services there, including radiology and imaging. A group of 25 Englewood physicians had set up shop in the building five years ago; there are now 80 there.
“It’s convenient for patients if they need linkage to care, but doctors like it too,” Brunnquell said. “I can walk down the hall to consult another doctor if I’m not sure about anything.”
The opening of the Fair Lawn location had been part of Englewood’s announced plan to open four urgent care centers, with one in Jersey City in February and one in Englewood in January. Its first urgent care site was in Cresskill.
The health system had been evaluating additional locations beyond the current four.
“We could go as far as Essex County. But somewhere in Fort Lee, Leonia or Palisades Park could be attractive for a next location,” he said, referring to Bergen County towns. “And perhaps another in Hudson County.”
There are no active building plans for the next urgent care center, he said, as the focus remains on ramping up the existing sites.
The health system, founded in 1890, is composed of Englewood Hospital; the Englewood Health Physician Network, which has 550 providers; and the Englewood Health Foundation. —S.S.
AT A GLANCE
RADIATION THERAPY: Columbia University has installed a new linear accelerator booster that would allow it to conduct research on heavy ion radiation therapy, it announced Monday. Such therapy could potentially be used for hard-to-treat cancers. The $2.7 million equipment was funded in part by New York’s Empire State Development and the National Cancer Institute. The institution claims it would be the first in the country with an instrument dedicated to research on heavy ion radiation therapy.
DATA COLLABORATION: Healthix, a Long Island-based health information exchange, has partnered with Albany firm Hixny to launch Concise, an application that provides a patient record snapshot that quickly delivers data within the provider’s workflow, they announced Monday. The app leverages Fast Healthcare Interoperability Resources standards to enable seamless transfer of data across electronic health records for various health systems.
BIODEFENSE AWARDS: Gov. Kathy Hochul on Monday announced the first round of awardees of the $40 million New York State Biodefense Commercialization Fund. The program was created to accelerate the development and commercialization of life science innovations that address serious infectious disease threats including Covid-19 and its variants. Eighteen grants totaling $15 million were given out in the first round.
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