The Situation
SPG was retained by one of New York’s largest and most critical safety net health systems to strategically support it in creating a pathway to long term financial sustainability.
New York’s safety net health systems and health care providers play an essential role in caring for low-income and vulnerable populations. These populations include the uninsured, underinsured, Medicaid and dually eligible. With Medicaid as the primary insurer, safety net health systems and providers who are reliant on this source of payment experience significant financial challenges that threaten their viability. Medicaid pays providers less than Medicare and commercial health insurance plans, placing safety net health systems in a constant state of financial distress, and exacerbating health disparities for the vulnerable populations they serve.
The Strategy
SPG determined that because the safety net health system was a critical provider to its culturally diverse community, most of its vital inpatient, emergency, and ambulatory services must be protected and improved, rather than abandoned, to prevent worsening racial and ethnic health disparities. With a major State capital grant, the health system has utilized the funds to make significant strides towards becoming a clinically integrated system of care. From its efforts in structure modernization, to expansion of its ambulatory network, the health system needs to create an infrastructure that would enable it to achieve operational efficiencies and take advantage of revenue enhancement opportunities. In line with the health system’s current efforts, SPG worked in partnership to develop a long-term strategic plan that would elevate its accomplishments, while transforming and expanding some of its business lines to achieve financial viability.
- Working with the health system’s leadership, SPG identified key operational service areas that would provide the framework for study and strategic visioning.
- SPG and the health system’s leadership were designated to each service area and collaborated to develop a common understanding of the health system’s capabilities and opportunities.
- Recommendations were developed and shared with senior leadership.
- A comprehensive strategic visioning document was developed in preparation for a detailed scalable strategic plan that will guide service redesign and improved financial performance.
The Impact
With the development of a strategic visioning document, the State will gain a better understanding of the present and future direction of the safety net health system and will be better able to partner with it successfully.
Distressed safety net health systems often operate in an environment of continuing crisis that diverts them from developing and executing their long-term vision and strategic plans. The leadership’s time is often spent on urgent events, limiting resources to address the core issues that must be resolved to secure their future. SPG welcomes the opportunity to support New York’s safety net health systems and health care providers to meet the expectations of their payers and the needs of their communities.