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New York is a medical wasteland.
The state is paying a staggering $1.4 billion in Medicaid payments per year on unnecessary hospital admissions, The Post has learned.
The costly admissions are for patients who could have been treated by family doctors for minor illnesses such as the common cold or asthma, health-care industry insiders say.
Equally troubling is that hospitals have become an expensive revolving door for drug addicts and patients with chronic mental illnesses who are readmitted numerous times because they lack less costly community care. Other patients are readmitted because of postsurgical infections or lack of outpatient follow-up treatment.
In New York City, 26 percent of Medicaid hospital admissions are considered unnecessary or preventable, according to an analysis by the state Health Department. That’s the highest rate of avoidable admissions in the state.
But the problem is prevalent elsewhere. For example, 22.4 percent of admissions at Long Island hospitals were considered avoidable, and in upstate regions, preventable admissions ranged from 18 to 21 percent. The statewide average of preventable admissions is 24 percent.
In order to rein in New York’s $50 billion Medicaid program, Gov. Cuomo is looking at ways to bolster community care and reduce more costly hospital admissions. His Medicaid-redesign team is reviewing various “pay-for-performance” programs that would provide financial incentives for hospitals to reduce admissions and try to shift care to local clinics.
Hospital officials have fought such proposals in the past. They say they shouldn’t be penalized for admitting patients due to the lack of neighborhood primary care.
But state health officials, in a planning document, said the Medicaid restructuring is long overdue. “This will ultimately reduce unnecessary hospital admits and readmits that will lower cost and improve quality,” the analysis said.
Mayor Bloomberg acknowledged that overreliance on hospitals is a problem.
“We spend too much money. We’re sort of focusing on the wrong kind of health care. A lot of people use the emergency room for their [care] instead of having a private doctor,” Bloomberg said last week.
Advocates for community-based care said the state blows money on hospital care because it doesn’t pay doctors enough to become family practitioners in low-income neighborhoods, which would save hundreds of millions of dollars.
“A lot of the care should be in the community, in doctors’ offices,” said Dan Lowenstein, of the nonprofit Primary Care Development Corp.
“There are not enough doctors, so patients end up in hospitals.”