Protecting a vision
Staying the course on longer-term policy priorities is difficult under any circumstances, but especially so in today’s divisive political atmosphere. With healthcare reform, which is an incredibly complex issue, it’s hard to understand the course, much less stay on it.
In New York, however, Governor Cuomo and lawmakers deserve credit for their drive to improve access to quality healthcare while reducing per capita spending, and for staying on this course even as Washington makes abrupt policy changes.
As part of this effort, the Governor proposed an initiative in January dubbed “The Healthcare Shortfall Fund.” He argued this fund would help protect the state and providers from an onslaught of proposed federal healthcare cuts. Shortly after the Governor proposed the fund, Congress reconsidered some of its proposed cuts and averted an immediate financial crisis in healthcare.
So how — and why — did the Governor and state lawmakers agree to the creation of what came to be known as the “Healthcare Transformation Fund”?
Well, as the debate was raging over the proposed federal healthcare cuts, deeper, chronic healthcare funding challenges came to the forefront. Lawmakers began to realize that the state’s shortfall in federal healthcare dollars was not a one-time thing, but an ongoing challenge. In addition, the Governor and lawmakers had the vision to see how the state’s structural budget issues and intense competition for state revenues might impact healthcare in the future.
The “Healthcare Transformation Fund” wound up in the final budget deal as a solid placeholder. The name changed to clarify the broader intent of the fund, and the budget language expanded on this intent to stay the course on New York’s healthcare path: “To support health care delivery, including capital investment, debt retirement and restructuring, housing and other social determinants of health, or transitional operating support to providers.“
It’s hard to estimate the impact of this new fund, particularly since we don’t know when or to what extent it will be funded (it’s capped at $750 million per year and sunsets in 2023). What’s easier to identify is the impact on local decision-making by a whole range of healthcare entities. In this regard, stability and predictability go a long way in the healthcare world. Planning for multi-year projects, recruiting new physicians, being prepared for flu and disease outbreaks, and investing in new technologies all take time and resources. Without faith in the state’s strong commitment to reform, providers would not be able to recruit talent, meet consumer demands, or invest in the future.
One thing is clear: This new fund provides an important strategic impetus to stay the course on healthcare reform. While it remains a work in progress, it has already succeeded in generating trust and partnership in the provider community.