Hospitals and health systems in Central New York and across Upstate are facing a shortage of doctors, especially primary care physicians, according to a new report from the Healthcare Association of New York State (HANYS).

In the 2013 HANYS Physician Advocacy Survey, based on responses from health-care facilities across the state, excluding New York City, respondents reported a need for more than 1,000 physicians, of which 266 are primary care physicians.

From September 2012 to September 2013, the survey found that statewide, a total of 4,027 new doctors joined medical staffs while 4,093 physicians left, resulting in a net loss of 66 physicians.

In Central New York, 163 more physicians retired or moved than began practicing here during the survey time period. This follows the loss of 109 physicians the region experienced in the previous year. 

While Central New York had the highest net loss of physicians in the state, the region isn’t alone in this decline. The Buffalo area lost 123 doctors, while the Rochester region lost 54, according to the report. 

Statewide, 67 percent of respondents said that doctors are leaving their communities because of retirement. The difficulty to retain and recruit doctors to the region is another factor attributed to the shortage.

“Physician recruitment is an ongoing challenge,” Adam Ullman, director of physician support services at Mohawk Valley Health System (MVHS), says in an email. 

“Changes in the health-care system, reimbursement rates, and declining numbers of graduating physicians in certain specialties add to a nationwide shortage in some specialties.”

Due to the shortage, hospitals have had to reduce or eliminate services or transfer patients to other facilities when emergency rooms are not covered by certain specialists, HANYS says. In Central New York, 20 percent of hospital respondents reported having to eliminate or reduce services, and 52 percent indicated that their emergency rooms were not covered for certain specialties.

Rural New York hospitals were nearly three times more likely to reduce or eliminate services, and twice as likely not to have their emergency rooms covered.

A recent brief by the SUNY Center for Health Workforce Studies also found that a large portion of physicians in rural counties plan to retire or reduce patient-care hours in the next 12 months than physicians in urban counties. The brief indicated that Central New York has the highest percentage of physicians planning to retire, while the Mohawk Valley had the highest percentage of doctors planning to reduce patient-care hours.

When Faxton St. Luke Healthcare and St. Elizabeth Medical Center formed MVHS earlier this year, Ullman says it was a positive step in attracting physicians. 

“Recruiting as a stronger, larger health-care organization rather than two smaller hospitals is a plus for our recruitment efforts,” says Ullman. Some specialty areas MVHS is currently recruiting for are primary care, neurosurgery, orthopedics, and its Family Medicine Residency program.

“MVHS is fortunate that there are numerous academic institutions within a small radius for most physician specialties, as well as nurse practitioner and physician assistant programs, that give us exposure to providers entering the workforce,” says Ullman.

To address the shortage, HANYS advocates for increased funding for Doctors Across New York (or DANY), a state-funded initiative that helps hospitals and health systems recruit needed physicians. HANYS suggests bringing at least 250 new physicians to the under-served areas every year. Additionally, HANYS recommends expanded funding for the Primary Care Services Corps to incentivize nurse practitioners and physician assistants to practice in the region in exchange for loan repayment, as well as to make changes to eliminate the competitive procurement process of the program. 

HANYS also pushes for the use of telehealth services, especially in rural communities where some specialties are hard to find.

Contact Collins at ncollins@cnybj.com

Capital District Physicians Health Plan (CDPHP), an Albany–based health insurer with subscribers in Central New York, on May 20 announced a “strategic alliance” with a health insurer based in Western New York.

CDPHP will work with Independent Health, which is headquartered in the Buffalo suburb of Williamsville, to “explore opportunities to enhance their efforts to further transform health care in their respective communities, while remaining independent,” CDPHP said in a news release.

The two health insurers are “non-competing,” regional health plans serving different geographic markets, according to the Albany–based insurer.

In Central New York, its service area includes Broome, Chenango, Herkimer, Madison, Oneida, and Tioga counties, according to the CDPHP website.

CDPHP lost more than $43 million while generating more than $2 billion in revenue in 2013, according to financial figures posted on its website.

CDPHP incurred the loss despite increasing its enrollment from nearly 410,000 in 2012 to more than 447,000 in 2013.

The alliance will allow the insurers to build “innovative” products, tools, and services for providers, employers, and individuals from Albany to Buffalo, Dr. John Bennett, president and CEO of CDPHP, said in the news release. 

The agreement is “not a merger, but a unique alliance” to exchange and implement ideas and strategies that are “essential” to continue driving sustainable health care, Dr. Michael Cropp, president and CEO of Independent Health, said in the release. 

“The learning and discipline that will come from working together will greatly accelerate our respective abilities to meet the needs of our provider partners and our customers,” Cropp said.

As they work together, the two nonprofits are hoping to develop tools to help health-care providers manage their entire patient populations and provide patient care in the “most efficient manner,” CDPHP said.

They’ll also partner with physicians through technology and clinical advancements with a focus on patient care at the “right level of cost.”

They also want to invest in new technology to provide consumers easy access to the information and services they need to navigate the “often fragmented” health-care system, CDPHP said.   

The nonprofits will also work to develop new products focused on the consumer, “rather than the delivery system,” the Albany–based health insurer said.

CDPHP and Independent Health have maintained a “close relationship” for nearly 30 years.  They’re aiming to focus on “innovative” ways to achieve the “Triple Aim,” which includes better health, better care, and lower costs.

“We believe the alliance will help us support consumers as they utilize and navigate increasingly prevalent high-deductible health plans,” said Dr. Cropp. “It will also drive partnerships with providers as we move rapidly to value-based payments and high-performance networks.”

The effort is geared toward providing the two companies with the resources most nonprofit health plans “struggle to achieve” so they can provide better service and products, at a lower cost to customers, said Dr. Bennett. 

“It will advance the goals of accountable and affordable care as envisioned by the passage of the Affordable Care Act and will assure upstate New Yorkers of continued value-driven, patient-centric health care,” Bennett added.

Established in 1984, CDPHP is a physician-founded, community-based nonprofit health plan that offers health-insurance plans to almost 450,000 members in 24 counties throughout New York. 

Independent Health serves nearly 375,000 members.       

Contact Reinhardt at ereinhardt@cnybj.com