At GNYHA's 2000 Annual Meeting, held on April 12, 2000, at the Sheraton New York Hotel in Manhattan, keynote speaker Governor George E. Pataki expressed his gratification over his partnership with GNYHA and the health care community. The Governor, who received a standing ovation, noted how improvements in New York State over the past five years have opened up access to "the world's greatest health care system." He cited the deregulation of the State-controlled rate-setting system for hospitals, the implementation of the Health Care Reform Act (HCRA) of 1996 and its expansion and continuation as HCRA 2000, support for graduate medical education and increased charity care, the phasing out of $155 million per year in hospital assessments, the passage of the Managed Care Bill of Rights and the implementation of an external appeal process to address adverse health care decisions by HMOs, and proposed increased Medicaid payments for physicians. Governor Pataki also noted that the Child Health Plus (CHP) program has expanded dramatically; that the income level of elderly couples eligible for Elderly Pharmaceutical Insurance Coverage will be raised substantially; and that the State has shown its commitment to addressing the uninsured problem by passing the Family Health Plus program, which provides subsidized health insurance to low-income, uninsured New Yorkers, and Healthy New York, which requires HMOs to offer a less expensive product to small businesses and uninsured workers. Governor Pataki concluded by expressing his optimism about Albany's continued investment in health care, as well as pledging his support in making sure that Washington remains committed to New York's health care.
Business Meeting: A number of motions were ratified at the Annual Business Meeting, including the following: 1) Robert G. Newman, M.D., President and CEO of Continuum Health Partners, Inc., was approved to serve on the Board as Past Chairman; and 2) for the Association year 2000 to 2001, Gladys George, Esq., Lenox Hill Hospital, will continue to serve as Chair; Gary S. Horan, Our Lady of Mercy Healthcare System, will continue to serve as Chairman-elect; Theresa A. Bischoff of NYU Hospitals Center and David R. Dantzker, M.D., of North Shore-Long Island Jewish Health System will continue to serve as Vice Chairmen; Arthur Y. Webb of Village Care of New York will serve as Vice Chairman; Edward Stolzenberg, Westchester Medical Center, will continue to serve as Secretary; Stanley Brezenoff, Maimonides Medical Center, will continue to serve as Treasurer; Herbert Pardes, M.D., New York Presbyterian Hospital, will continue to serve as Assistant Treasurer; Mark J. Mundy, New York Methodist Hospital, will continue to serve as Immediate Past Chairman; Barry R. Freedman of The Mount Sinai Hospital, David P. Rosen of Jamaica Hospital Medical Center, and Spencer Foreman, M.D. of Montefiore Medical Center will continue to serve as Past Chairmen. James Foy, St. John's Riverside Health Care System, was approved to serve on the Board in the Class of 2001, with his term beginning when he completes his current Board service in the Class of 2000, which ends in June 2000. The following individuals were approved to serve on the GNYHA Board of Governors in the Class of 2003: Michael Dowling, North Shore-Long Island Jewish Health Care System; David J. Campbell, Saint Vincents Catholic Medical Centers of New York; Alan Morse, Ph.D., The Jewish Guild for the Blind; Harold P. Freeman, M.D., North General Hospital; John LaRosa, M.D., State University Health Science Center of Brooklyn; and Daniel P. Walsh, Winthrop University Health System.
President's Remarks: Following an introduction by Chair Gladys George, Esq., GNYHA President Kenneth E. Raske reviewed the accomplishments of the past year and outlined GNYHA's priorities for 2000, which encompass HMO and insurance reform, long-term BBA relief for hospitals and continuing care facilities, reducing medical errors, insurance enrollment outreach, capital formation, workforce development, and biomedical research funding. GNYHA's strategy for ensuring HMO and insurance reform, he explained, is threefold: legislation (addressing dispute resolution, prompt payment, electronic claims acceptance, prior authorization and utilization review, guaranty fund, disclosure, and HMO liability); outreach and education in the form of an advertising campaign produced by the GNYHA and 1199/SEIU Healthcare Education Project; and litigation involving a broad-based legal challenge to those HMOs that have been perpetrating the most serious abuses. The Healthcare Education Project's television advertising campaign on HMO reform, Mr. Raske said, begins airing on April 16 in the Albany area.
Mr. Raske also discussed the impact of the BBA, noting a discrepancy between the Congressional Budget Office's estimated five-year savings of $44 billion and GNYHA's estimate of $61 billion. He pointed out that, without the BBA, Medicare payments for 2002 to hospitals would be 16% higher than in 1996; however, with the BBA, payments for 2002 are only 1% higher. For teaching hospitals the picture is even worse, with a Medicare payment reduction of -1%. These numbers underline the need for long-term BBA relief, which GNYHA will seek for hospitals through support of Senator Daniel Patrick Moynihan's bill for a permanent freeze of the indirect medical education (IME) adjustment at 6.5%, the elimination of further cuts in the update, and fixing the outpatient prospective payment system (PPS), and for nursing homes through a longer phase-out of cost-based capital reimbursement under the skilled nursing facility PPS. Looking ahead, Mr. Raske said that GNYHA remains committed to superior member services and developing a permanent asset base that allows excellence in advocacy. As part of this effort, GNYHA is channeling its energy into business development activities. Lee Perlman, Executive VP and COO of GNYHA Ventures, Inc., then described the tremendous growth in GNYHA's businesses over the past year, and talked about Ventures' "Internet incubation" program.
General Session I: Kenneth W. Kizer, M.D., M.P.H., President and CEO of The National Quality Forum and former Under Secretary for Health in the U.S. Department of Veterans Affairs, offered advice on how to reduce medical errors and increase patient safety. Dr. Kizer presented a series of interim steps that health care providers should take to increase patient safety until national requirements are developed. First, Dr. Kizer said, patient safety should be a leadership and management priority. Key to accomplishing this goal is the development of a culture of safety that includes continuing education, medical errors reporting mechanisms, nonpunitive mechanisms for responding to and correcting errors, and routine self-assessments. Dr. Kizer also recommends that providers implement known safe practices, including many that focus on reducing adverse drug events, which make up a significant portion of medical errors, and promptly addressing professional misconduct issues. Dr. Kizer also underscored the importance of explaining medical errors to patients and their families, and recommended that patient safety be incorporated into all health care professional training and patient safety research be made a priority.
General Session II: Robert Dieterle, Executive VP and COO of CareInsite, Inc., presented a vision of how the Internet will transform the delivery of health care through improved communications and access to services. He described the explosion of the use of e-commerce throughout the economy and the growing penetration of Internet use among consumers generally. In particular, he noted that, today, 30 million people are seeking health care information online for their own research on diseases, nutrition, drugs, and child development. He pointed out that the new model for Internet-based health care is consumer-centric, providing a seamless, integrated, and accessible approach to services, 24 hours a day, seven days a week. The use of existing and future Internet technologies along with the emerging standard communication protocols for health care will bring major changes to physician practices, hospital care, and patients' involvement in their own care. The Internet, he said, has its greatest potential in the management of the health care system's complex relationships and the support of optimal patient care.