Your Services are at Risk

Because of a plan by former Governor Andrew Cuomo to have the State of New York keep 340b medication savings that rightfully belong to the pharmacies that fill the prescriptions, your health services at The Chautauqua Center are at risk. Read more in the following op-ed that appeared in the Jamestown Post-Journal on October 8, 2022. This op-ed was submitted by The Chautauqua Center CEO Michael Pease.

America is facing a significant physician shortage, and nowhere is that more obvious than in rural upstate New York.

According to the Association of American Medical Colleges (AAMC), the U.S. is projected to lack up to 124,000 doctors by 2034, as practitioners age out of the profession or opt to depart due to the stresses brought on by the Covid-19 crisis. Upstate – and Western New York, in particular – has been struggling for years to attract enough doctors to meet demand and ensure residents have access to high-quality, affordable care.

Rural residents also have to travel greater distances to get treated, living on average at least five miles further away from the nearest hospital than their suburban and urban counterparts. Extreme weather, lack of public transportation, and high gas prices make these trips cost-prohibitive for many patients – particularly those who are lower income.

That’s why the Chautauqua Center has prioritized meeting patients where they are and bringing services directly to them whenever possible. Our home medication delivery service drops life-saving prescriptions on the doorsteps of more than 760 individuals every month. And we regularly provide transportation to appointments for the more than 12,000 patients we serve.

These critical services are made possible through our participation in 340B – a 30-year-old federal program that requires drug manufacturers to provide deep discounts so safety-net providers can use the savings to provide care for uninsured and underserved New Yorkers. This funding stream enables safety-net facilities to offer services not covered by Medicaid.

In addition to medication delivery and transportation, the Chautauqua Center uses 340B funds to provide free blood pressure monitors, in-house translation services, help with chronic pain management, and nutrition counseling – all at no additional cost to the taxpayers.

This critical funding stream is now in jeopardy as a result of a change first proposed by former Governor Andrew Cuomo prior to the Covid-19 crisis and scheduled to be implemented next spring. In short, the state Health Department (DOH) wants to divert 340B savings away from safety-net providers and into its own coffers, resulting in more than $250 million in annual losses for community-based healthcare facilities annually.

According to the DOH, carving the pharmacy benefit out of Medicaid will result in at least $125 million in savings in the first year of implementation. But a 2020 Weakley Consulting Group report found the state will, in fact, incur an additional $154 million in costs, and that would grow to $1.5 billion over five years.

These funds support life-saving care and are also flexible and predictable, enabling providers to respond to unexpected public health crises like Covid-19 more quickly and effectively. Without this revenue, services will be cut, jobs will be lost, and some clinics in medically underserved communities will close altogether. Almost two-thirds of the Chautauqua Center’s annual budget is made up to 340B funds.

Loss of 340B funds will disproportionately hurt lower-income members of communities of color, who have long experienced disparities in access to quality health care. Forty percent of the Chautauqua Center’s patients are members of racial or ethnic minority groups, and just over 80 percent are at or below 200 percent of the federal poverty line.

The pandemic forced providers to reimagine how they provide care to vulnerable patients and keep them safe. Telehealth, which enabled individuals to speak virtually with medical professionals, was an important tool – particularly in the case of underserved rural areas – that remains a key aspect of our services. But access to medication and in-person treatment are still necessary to ensuring high-quality care.

The Chautauqua Center is experiencing a growing demand for services for difficult-to-reach individuals, including members of the Amish community, migrant farm workers, and urban homeless – all of whom face transportation challenges. We are dedicated to continuing to provide the high level of care for these emerging populations as well as our existing patients, but we will not be able to do so if Albany insists on forging ahead with the carve-out.

We call on the governor to repeal this outdated and harmful plan, and hope our local elected officials will support us in this effort.