Survey findings: New Yorkers are losing access to care as a fiscal crisis hammers hospitals statewide
“Three out of five hospitals are underwater and the fourth is on thin ice,” says HANYS President Bea Grause, RN, JD
Albany, NY, Dec. 14, 2022 — Escalating care delivery costs and persistent workforce shortages are causing New Yorkers to lose access to healthcare services – and providers expect this access to further deteriorate. A new report from New York’s state and allied hospital associations calls on policymakers to recognize this grim reality and make immediate and sustained investments and policy changes to stabilize the healthcare system.
New York’s hospital associations surveyed their members in fall 2022. Their new report, Critical Condition, explores the survey’s findings and provides context for the challenges hospitals face. Survey findings include:
- 49% of hospitals report reducing and/or eliminating services to mitigate staffing challenges while ensuring their most critical services remain available for patients.
- 100% of hospitals report nursing shortages they cannot fill; over 75% said that other key worker positions cannot be filled — directly impacting the accessibility of healthcare services.
- 64% of hospitals report a negative operating margin (losing money when comparing care-related revenue and expenses); 85% report negative or unsustainable operating margins of less than 3%.
The report highlights hospitals’ troubling fiscal condition as uncontrollable costs continue to rise, revenue lags and workforce shortages persist. With pandemic-related government support ending and expenses continuing to escalate, hospitals’ dire fiscal crisis is likely to only get worse. Hospitals’ continued viability as healthcare providers and key job creators in their communities is in immediate jeopardy.
The severe fiscal challenges facing hospitals nationally were noted in a November 2022 hospital flash report from the Chicago-based research firm Kaufman Hall. The report found that the nation’s hospitals, including those in New York, “continue to face the significant weight of high expenses outpacing revenues, particularly when it comes to the cost of labor,” and that “the high cost of materials due to inflation has not abated.” Kaufman Hall also noted, “As the year comes to a close, compounding months of poor performance could signal continued difficulties for hospitals in the near future.”
Amid national for-profit health insurance companies’ abusive practices that threaten care delivery and misguided ad campaigns on hospital prices, New York’s hospitals continue to deliver high-quality patient care, serving on the front lines 24/7 during the current “tripledemic” of influenza, RSV and COVID-19 and a worsening mental health crisis.
New York’s hospital associations are committed to working with our government partners in Albany to find constructive solutions to hospitals’ financial and workforce challenges.
“Three out of five hospitals are underwater, and the fourth is on thin ice,” said Bea Grause, RN, JD, president, Healthcare Association of New York State. “We face a very real danger of hospitals closing, patients losing care, healthcare workers losing their jobs and communities losing their lifeblood. The state and federal governments must immediately provide new funding, enact common sense policy changes and make no cuts to existing vital healthcare funding.”
“Our hospitals continue to face relentless financial pressures, including a pandemic in its third year,” said Kenneth E. Raske, president, Greater New York Hospital Association. “Without a financial margin, hospitals cannot invest in the necessary services and facilities to modernize our healthcare delivery system. The hospital community looks forward to working with New York’s policymakers to address this crisis.”
“Workforce shortages are causing vacant positions to go unfilled and services to be cut. Policymakers must immediately invest in the healthcare workforce and our hospitals to ensure they can serve their communities for years to come,” said Gary J. Fitzgerald, president and CEO, Iroquois Healthcare Association. “Hospitals’ labor costs are forever changed. Without help they face hard choices with dire consequences.”
“Hospital margins are absolutely going in the wrong direction, and everyone should be alarmed,” said Wendy Darwell, president and CEO, Suburban Hospital Alliance of New York State. “The pandemic and recent natural disasters have proven we need strong, well-resourced hospitals that are ready for anything. New Yorkers are better off when their hospitals are thriving.”
“The help hospitals need is nowhere on the horizon,” said Ken Schoetz, vice president, Healthcare Association of Western and Central New York. “Inadequate reimbursement and soaring expenses are pushing hospitals to the brink, begging for emergency relief just to keep the doors open, make payroll and repeat the situation all over again in a few months. It’s an incredibly stressful cycle for everyone involved and it’s absolutely unsustainable.”
Read our report and key takeaways to learn more about the challenges facing New York’s hospitals. Severe workforce shortages, uncontrollable upward pressure on costs and dramatic downward pressure on revenue are already causing communities to lose important healthcare services. Without urgent and sustained structural change, some communities could lose their hospitals completely.
About the survey
Conducted in fall 2022, the survey asked New York hospitals fiscal, nursing workforce and patient volume questions for the period 2019 through projected 2022. Responses are from hospitals and health systems in all regions of the state with a participation rate that reflects over 90% of the annual revenue New York hospitals and health systems generate. Data points on Medicaid and Medicare volume and payment are from hospital cost reports. “Unsustainable” margin levels reflect a standard from Kaufman Hall. This survey was a joint effort of the Healthcare Association of New York State, Greater New York Hospital Association, Healthcare Association of Western and Central New York, Iroquois Healthcare Association and Suburban Hospital Alliance of New York State.
About the Healthcare Association of New York State
The Healthcare Association of New York State is New York’s statewide hospital and continuing care association, representing nonprofit and public hospitals, nursing homes, home care agencies and other healthcare organizations. HANYS is a nonprofit organization whose mission is to advance the health of individuals and communities by providing leadership, representation and service to healthcare providers and systems across the entire continuum of care.
About the Greater New York Hospital Association
Greater New York Hospital Association is a dynamic, constantly evolving center for healthcare advocacy and expertise, but its core mission — helping hospitals deliver the finest patient care in the most cost-effective way— never changes. GNYHA is a trade association comprising approximately 280 member hospitals, health systems and continuing care facilities in the metropolitan New York area, throughout New York State, and in New Jersey, Connecticut and Rhode Island. GNYHA uses its policy expertise, vast analytical tools, and uncommon resources to advocate for our members. From fighting for their interests in Washington and Albany to working with them to improve patient care to helping them prepare for and respond to emergencies, GNYHA works to ensure that its members have the tools to succeed.
About the Healthcare Association of Western and Central New York
An affiliate of HANYS, the Healthcare Association of Western and Central New York is the regional advocate for not-for-profit healthcare providers from Western New York to the Finger Lakes. HAWCNY works to improve the collective health of Western and Central New Yorkers while helping our members maintain an efficient, cost-effective and high-quality healthcare system. HAWCNY represents member advocacy needs at the state and federal levels, facilitates the exchange of information and sharing of best practices, promotes collaboration among members to advance healthcare in the region and helps members develop as emerging hospital and healthcare leaders.
About the Iroquois Healthcare Association
The Iroquois Healthcare Association is a regional healthcare trade organization representing more than 50 hospitals and health systems, spanning over 28,000 square miles, across 32 counties of upstate New York. IHA is the leading resource for facilities and professionals bringing quality healthcare to the region. IHA represents the unique needs of rural, small community safety-net providers to large, academic medical centers in upstate New York’s urban areas through advocacy, education and information, cost-savings initiatives and innovative business solutions.
About the Suburban Hospital Alliance of New York State
The Suburban Hospital Alliance of New York State, LLC, is a consortium of not-for-profit and public hospitals advocating for better health care policy for all those living and working in the nine counties north and east of New York City: Nassau and Suffolk counties on Long Island, and Dutchess, Orange, Putnam, Rockland, Sullivan, Ulster and Westchester counties in the Hudson Valley. The Suburban Hospital Alliance ensures that the specific concerns of suburban hospitals from the Hudson Valley and Long Island regions are heard in Albany and Washington. SHANYS was founded by the Northern Metropolitan Hospital Association and Nassau-Suffolk Hospital Council; NorMet and NSHC continue to represent their individual regions for region-specific matters.