Year in Health 2015: Interview with ELIH’s Paul Connor
The top issue for Greenport’s Eastern Long Island Hospital in 2016 will likely be the same as it was in 2015: merging with a larger entity.
ELIH decided this year that it would partner with Stony Brook Hospital, but moving forward with that merger and making it happen will take the hospital through the year ahead.
We talked to ELIH chief executive officer Paul Connor about some of the goals the hospital has for 2016 and some of the issues it faced in the past year.
Q: What changes and benefits will results from the merger with Stony Brook?
A: Even before we signed the affiliation agreement, Stony Brook did an analysis for us that showed that many patients from the North Fork and Shelter Island, which are our primary service areas, actually go into Stony Brook on a regular basis to utilize services at Stony Brook University Hospital.
One of our proposals to Stony Brook, and one that Stony Brook supports, is bringing that specialty care closer to folks on the North Fork and Shelter Island by moving the specialty doctors out here. Those procedures that result from that — that we can do in the hospital safely — will then be done at ELIH instead of at Stony Brook on some sort of scheduled basis.
Q: What else?
A: Over the years, we’ve lost four or five primary care physicians from the North Fork and Shelter Island who have never been replaced.
This has caused a problems because we have the oldest population per capita in the state. This is a retirement destination.
The challenge to keeping a primary care facility physician and practice out here is that, under the private practice model, the medical economics don’t work. The reimbursements that private physicians get from third-party insurance companies really are not adequate to maintain the contemporary practice. So what happens is, these doctors go for the cover of employment under the hospital. Hospitals can negotiate reimbursement rates on behalf of the doctors, whereas before, the doctors had no negotiating power. Now, the hospitals are able to negotiate these rates and we think having Stony Brook helping us with the medical economics will be able to allow primary care physicians to be successful out here financially. That’s really a big key.
We also expect to participate in one of their major missions, which is the training of physicians in academic medical care by using Eastern Long Island Hospital as a clinical campus for Stony Brook to train physicians and other allied health professionals as well. We already train nurses, physical therapists and social workers out here.
So let’s start training physicians with Stony Brook. One of the great benefits of training doctors is that it keeps the other doctors on their toes and keeps them contemporary. I think they’re going to like it out here, because it’s such a beautiful spot and it will be a great mechanism for recruiting physicians.
Q: What has been the impact of the Affordable Care Act?
A: The big thing with the Affordable Care Act is obviously the exchanges and the Medicaid expansion, which is a good thing because more people have insurance. The other side of it is that most of the exchange products sold are basically on the low end. That means that individuals have a much higher deductible to meet before the real insurance kicks in. The problem there is that these folks probably didn’t have health insurance before into the exchange. Now they do, but they still have to satisfy these very high deductibles. What hospitals have been seeing nationwide is that those people with high deductibles, a fairly high percentage of them end up not being able to pay, and it turns into a bad debt. So that has the hospital industry very concerned about these high deductibles … We are owed about $380,000 that we don’t think we’re ever going to get. Hospitals in New York State collectively about are owed about $170 million from Health Republic.
Q: Do you see any downsides to the three East End hospitals not being in the same alliance?
A: I would say the downside is that the three hospitals are geographically well situated to coordinate care. The better care is coordinated, the better the service for their patients. On the other hand, having a choice of networks probably has some positives to it as well. You’ve got Peconic Bay Medical Center if you want to access the North Shore-LIJ system and you’ve got Southampton Hospital and ELIH if want to use the Stony Brook system.
Q: What types of health care is the North Fork lacking?
A: We can do with more outpatient mental health services. For psychiatry and for addiction treatment, we are woefully short and there is significant need. You’ve probably read about the heroin crisis, for instance. We have a large outpatient addiction program [Quannacut] in Riverhead but there really is a shortfall of local outpatient behavioral health programs.
Q: Do you see ELIH creating regional satellite medical offices away from the main campus in Greenport?
A: Our primary service area is the Town of Southold and Shelter Island. We have a much larger regional service area for our addiction and psychiatric patients. But we’re going to focus locally as far as medical and surgical cases, with our Stony Brook affiliation dealing more with specialties. We want to stop the so-called outmigration of patients to other facilities and bring those patients back here. Something everyone appreciates is good health care close to home.
Photo: Eastern Long Island Hospital president/CEO Paul Connor III at work in his office last year. (Credit: Carrie Miller, file)