New York State has embarked on a substantial effort to restructure its health care system. Rapidly escalating health care expenditures, particularly in the case of Medicaid expenditures for institutional health care, are the immediate drivers underlying the state’s multi-phased initiative.

But policymakers cannot hope to alleviate the financial drain caused by excessive health expenditures without realigning the delivery system, away from costly hospital and nursing home services and toward a health care system that guarantees all New Yorkers accessible, affordable, and high quality primary health care. Indeed, an overwhelming body of evidence points to the fact that it is impossible to alter the costly outcomes that flow from New York State’s health care system without strengthening and expanding the primary care foundations on which that system rests.

Access to high quality primary care is a “bottom line” in health reform. This is true regardless of whether the focus is on people whose health needs predominantly fall along a primary care/acute care spectrum or instead on individuals with chronic and serious physical and mental health care conditions that elevate the risk for medically inappropriate institutional care. Primary care can make an enormous difference to health care outcome and costs in the context of both types of patients.

2008-09 NYS Budget holds major victory for patients and primary care.
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