Employees of the 1199SEIU Training and Employment Funds (TEF) gathered with hundreds of other healthcare professionals in the Sheraton New York Times Square Hotel on November 17 to hear TEF Executive Director Sandi Vito speak on a panel addressing the future of New York’s healthcare workforce. The event, Crain’s Health Care Summit, brought together prominent national and local leaders to reflect upon the changing healthcare landscape and how jobs in the industry are changing to respond to new funding mechanisms such as DSRIP and other value-based payment systems.
The morning began with the keynote speaker Bernard Tyson, chairman and CEO of Kaiser Permanente, describing his organization’s “total health” concept, which drives its use of resources. Kaiser Permanente serves 11 million people and employs 200,000 staff nationwide. Tyson explained that incentives and measures are based on a patient’s health and functionality rather than on volume of services. Referring to Kaiser Permanente’s approach to public policy, Tyson noted that “every person in the country, regardless of income, must have access to the front door of healthcare.”
Tyson described the importance of collaborating with labor, noting that frontline staff are the ones most able to contribute effectively to improving the quality of care and services. He described a shifting paradigm that includes increased use of technology (“52% of primary care encounters were done virtually last year at Kaiser Permanente”) and a shift from an emphasis on jobs to one of roles for employees. “We need to rethink how people will add value,” he said. “It’s important to have labor at the table because the change is going to impact everybody.”
A panel including Vito, Mount Sinai Health System President and CEO Kenneth Davis, Montefiore Medicine President and CEO Steven Safyer and Victor Politi, president and CEP of NuHealth/NUMC discussed changing job roles. Reflecting on the implications of the recent presidential election, the panel noted that a move to block grants for Medicaid could have a profound effect on New York State providers, and would be particularly detrimental to safety-net hospitals. Vito indicated that we must organize “with a laser-like focus” to ensure that health care funding is maintained. When discussing the shifting jobs and responsibilities, Vito reminded the audience that there must be a “willingness to lead the change in ways that are good for workers, which ultimately is good for patients.” She also noted that in the short term, as new jobs are being defined, training can be offered based on competencies.
The second panel discussed emerging models that extend the healthcare team to ensure effective and comprehensive care. Amanda Alick Ascher, chief medical officer of DSRIP Bronx Partners for Health Communities, Joseph Conte, executive director of Staten Island Performing Provider System, Nicole Fenton, program director of SI CARES at Staten Island Behavioral Network, and Stephen Ferrara, associate dean of clinical affairs, Columbia University School of Nursing discussed approaches such as pre-visit planning, health coaches, connecting patients to social services and health education, and integrating primary care with behavioral health services. Conte discussed the importance of taking a social justice stance that “goes beyond bricks and mortar to ensure that there is cultural competency that gets people into an orbit of care,” through means such as employing community health workers. Rona Shapiro, 1199SEIU executive vice president for home care, queried the panel regarding the role home care workers can play on the newly expanded healthcare team. She noted that home care workers have experience, skills, and connections to the community and could play an expanded role.