The federal government, Tallon said, will want a lot of details about where the money is going and what kind of improvements are happening. He acknowledged the Crain's Health Care Summit as a meaningful step towards figuring that out, "In this room today we have doubled the number of people in the state who have some understanding of what is going on."

Creating meaningful jobs


Kevin Finnegan, political director of 1199EIU United Healthcare Workers East, addressed what perhaps many people regarded as the elephant in the room. Berger had addressed it too, although from a very different perspective: in the interest of a more efficient system, hospitals will be downsized and jobs will be lost. How does the state justify the loss of jobs and, more importantly, what will be done with those displaced workers?

Finnegan acknowledged the necessity for change but emphasized the importance of not leaving workers behind; allowing them to retain their current wages and benefit structures. "The federal waiver involvement in this process allows for the creation of new jobs and a more holistic approach to new jobs," said Finnegan. "Nevertheless, we have concerns for the new ambulatory system and how workers will fit into it."

As health care moves towards a more community based system and away from hospital based, Finnegan says we can learn from the history of home care services. "Our state was forward-thinking in making home care Medicaid reimbursable," said Finnegan, "but originally the providers were going to make minimum wage." He said that the low wage meant workers could not support their families and, in turn, quality of service diminished, turnover was high, and training was insufficient.

"Personal care worker wages eventually increased by nearly 50 percent," said Finnegan, "And now workers provide better care and can have career advancement in the health care field."

Finnegan stressed building on the strength and experience of the current work force. Finding meaningful ways for them to contribute to the redesigned community-based health industry, said Finnegan, must be a priority as the state moves forward.

Health care, not sick care

The last speaker for this portion of the Crain's Health Care Summit was Kathleen Shure, senior vice president, managed care and insurance expansion for the Greater New York Hospital Association. Shure addressed the way health care should look if the DSRIP funds are utilized successfully.

"To me, it's about focusing not just on the patient that's in front of [the physician], but the patient who is not in front of them," said Shure, "Focusing on what those people need to stay healthy in the community."

Healthcare Act