NUHEALTH BOARD UNANIMOUSLY APPROVES SUBMISSION OF RESPONSE TO STATE’S REQUEST FOR APPLICATIONS

FOR IMMEDIATE RELEASE
February 8, 2012

PRESS CONTACT:
Shelley Lotenberg
shelley@numc.edu
516-572-6055

NUHEALTH BOARD UNANIMOUSLY APPROVES SUBMISSION OF RESPONSE TO STATE’S REQUEST FOR APPLICATIONS
–Opportunity to strengthen existing affiliation with the North Shore-LIJ Health System, restructure care delivery model at NuHealth, stabilize finances at NuHealth, and improve health outcomes for patients—

East Meadow, NY….Arthur A. Gianelli, President/CEO of the NuHealth System, announces the board’s unanimous approval for the submission of a response to the state’s Request for Applications (RFA), through a public-private partnership between the NuHealth System and the North Shore-LIJ Health System (NSLIJ). The submission will build on and strengthen the already existing affiliation agreement between the two health care systems, which dates back to 2005.
“We have an exciting opportunity, through this application, to strengthen our existing affiliation with NSLIJ, restructure our care delivery model, stabilize our finances and improve the health outcomes of Nassau’s most vulnerable populations,” said Gianelli. “Our response to the RFA will help to jumpstart our transformation as we strategically integrate NuHealth with NSLIJ through the establishment of various collaborative efforts.”
The State of New York issued a Request for Applications (“RFA”) in November of 2011 to encourage vulnerable providers to restructure their operations to achieve financial stability, establish collaborative affiliations, and improve the health outcomes of the populations of patients they serve.

In response to this RFA (the “Application”), the Nassau Health Care Corporation (“NuHealth”) and the North Shore – Long Island Jewish Health Care System (“NSLIJ”) are proposing the creation of a Transformation Partnership, LLC (“Transformation Partnership”).

The proposed Transformation Partnership is intended to be a limited liability company jointly owned and governed by NuHealth and NSLIJ. The purpose of this public-private partnership is to facilitate through state-action anti-trust protection various collaborative efforts to build on and strengthen the already-existing affiliation agreement between the parties and to:
1. Pursue the goals of the “Triple Aim” by improving the health of the population; enhancing the patient experience of care (including quality, access, and reliability) and providing value through increased efficiencies;
2. Ensure at NuHealth the elimination of unnecessary inpatient capacity, the expansion of primary care and addiction outpatient services, and the creation of a robust care management infrastructure;
3. Guide numerous collaborative efforts, most notably Clinical Integration, between
NuHealth and NSLIJ; and
4. Permit NSLIJ to provide assistance to NuHealth in its contracting with commercial managed care organizations, so NuHealth will be appropriately reimbursed for the vital services it delivers and be positioned to re-invest these funds in the care it offers to its patients.
Through these strategies (together the “Project”), the Transformation Partnership seeks to achieve two essential yet elusive goals: the long-term financial stability of the NuHealth System and the measurable improvement in the health outcomes of Nassau’s most vulnerable populations.

BACKGROUND
NuHealth is a public benefit corporation charged with running the Nassau University Medical
Center (“NUMC”), the A. Holly Patterson Extended Care Facility (“AHP”), and a number of community health centers. It is the safety net provider in Nassau County, delivering care to patients who reside in 33 federally-designated Medically Underserved Areas and with a payor mix heavily dominated by Medicaid beneficiaries and the uninsured.  NuHealth continues to confront very significant financial and clinical challenges. Increases in public pension costs, reductions in Medicaid reimbursement, cuts in County operating support, and uncompetitive commercial managed care contracts have contributed at NuHealth to imbalanced finances, precluded its access to the capital markets, and led most recently to a reduction in force exceeding 300 full time equivalent employees. And despite documented improvement along a number of quality indicators, NuHealth continues to struggle in its efforts to improve the overall health of the vulnerable populations to whom it delivers care.

PROPOSAL
By facilitating the creation of the Transformation Partnership, NSLIJ and NuHealth believe this
Application represents a singular opportunity to restructure the care delivery model at NuHealth, clinically and strategically integrate NuHealth with NSLIJ, stabilize the finances at NuHealth, and improve the health care outcomes of the population of patients served by NuHealth.
Specifically, NSLIJ and NuHealth propose:

I. Restructuring
A. Eliminate fifty (50) staffed inpatient beds at NUMC, including 30 medical / surgical beds, 10 detoxification beds, and 10 residential rehabilitation beds. Five (5) additional inpatient detoxification beds will be surrendered after 18 months assuming the outpatient addiction program described below is successful.
B. Obtain $30 million in HEAL-NY funds to:
1) Build an expanded, integrated, and extended hour primary care, basic mental health care, and care transition service located adjacent to the NUMC emergency department and an in-hospital 340 B pharmacy.
2) Build an integrated, comprehensive, and extended hour behavioral health and substance abuse program that provides outpatient addiction services, treatment for the seriously mentally ill, and access to co-located primary care and care transition services. Some inpatient addiction beds will be maintained to treat those patients for whom outpatient services prove insufficient.
3) Build an observation unit and detoxification holding area adjacent to the emergency department.
4) Build capacity at the LIFQHC to support a new primary care residency program.
5) Create the interfaces required to create a common electronic medical record platform between NuHealth and the NSLIJ System.
6) Purchase mobile and other telecommunication equipment to facilitate immediate communication among care transition personnel and between care transition personnel and high-risk patients.

II. Integration
A. Clinical integration of NUMC service lines and quality management programs with those at the NSLIJ System.
B. Undertake selective clinical service-line program development.
C. Consolidate shared services to the extent agreed to by the parties.
D. Collaboration between NuHealth and NSLIJ in the administration and risk management of NuHealth and NSLIJ employer-sponsored health plans.
E. Connect NUMC and AHP to NSLIJ’s palliative care and hospice programs, and connect NSLIJ to the LIFQHC to reduce unnecessary emergency room visits in the NSLIJ System.

III. Stabilization
A. Obtain 3-year transitional increases in NUMC’s hospital APG payments and hospital reimbursement rates to cover the cost of outpatient program expansion, reduced emergency room visits, less admitted volume, and other operating shortfalls, such as those caused by public pension contribution increases, that would otherwise negatively impact access to and the quality of care provided at the hospital.
B. Obtain a Certificate of Public Advantage to apply State-action anti-trust protection to the projects outlined above and other ways in which NuHealth and NSLIJ can create meaningful collaborations, including permitting NSLIJ to provide assistance to NuHealth in its negotiations with commercial managed care organizations.

In conclusion, Gianelli indicated: “NSLIJ and NuHealth believe that the creation of the Transformation Partnership will lead to the closer integration of the NuHealth and NSLIJ Systems, position NuHealth to succeed in the context of health reform’s accountable care paradigm, and most importantly, improve the delivery of coordinated, cost effective care – in the appropriate settings – to Nassau’s vulnerable populations. It is hoped that these efforts, at NuHealth, will reduce the high incidence of ambulatory sensitive admissions, lower high hospital readmission and mortality rates, and increase the percentage of patients with established relationships with primary care providers.”

ABOUT NUHEALTH
NuHealth is a Long Island health care organization delivering essential medical care and disease and lifestyle management to everyone at every stage of life.  Also known as Nassau Health Care Corporation, NuHealth is a public benefit corporation managing the operations of Nassau Medical Center, A. Holly Patterson Extended Care and a network of Family Health Centers that bring primary and specialty care out into the community.  By emphasizing wellness, cultural sensitivity and collaborative efforts with the North Shore-LIJ Health System, NuHealth is working to make good care more affordable and easier to access.

For more information about NuHealth or its Centers of Care, visit www.nuhealth.net.