SCHENECTADY — Two health care providers that form a safety net for tens of thousands of the poorest Capital Region residents are considering an affiliation that could range from partnership to merger.
Hometown Health Centers of Schenectady and Whitney Youth Health Center of Albany announced the move Wednesday, a few weeks after their respective boards began discussion and their staffs became involved.
They said about 18 months of research and deliberation will come before any decision is made. Officials with the centers also said the discussions were launched because both entities are strong and stable, and because it’s better to prepare for challenges before they arise than respond to them after they materialize. “Challenges” could mean any number of things in the evolving health care industry.
Hometown CEO Joe Gambino and Whitney Young CEO David Shippee said major factors are that their organizations are very similar in size, identical in mission and serve geographic areas that adjoin one another but have minimal overlap.
Hometown employs 137 at two medical facilities in Schenectady and Amsterdam. It also operates two school-based clinics in Schenectady. Whitney Young has 180 employees at three medical facilities in Albany, Troy and Watervliet, two Albany drug-treatment facilities and three school-based clinics in Albany, plus a 28-foot mobile clinic.
The idea is not to cut facilities or staff, Shippee said. The goal more likely would be to expand staff to address needs neither operation currently meets, he said.
“It’s really about the ability to strengthen the safety-net providers,” Gambino said, noting that each provides certain services the other does not.
What exactly would be accomplished by an affiliation, and how, is the point of the conversations now underway.
Shippee said actions and outcomes could include sharing resources and best practices; finding efficiencies and economies of scale by effectively doubling in size; and standardizing and upgrading electronic record-keeping.
An affiliation would also continue a long-running trend in the health care industry. St. Peter’s Health Partners now comprises five hospitals and scores of small facilities, employing more than 12,000 people; Albany Medical Center and its two affiliates serve a 100-mile-long region with more than 100 facilities that employ more than 9,000 people.
Hometown and Whitney Young are in a different category from the hospitals. Both are Federally Qualified Health Centers in inner cities, and a large percentage of their patients are Medicaid recipients.
Combined, they serve about 40,000 patients a year over the course of about 140,000 visits. Both function as safety nets for a poorer population that may not otherwise receive medical care except during emergencies. Both also serve refugees and immigrants. Whitney Young, in 2016, saw patients who speak a total of 44 languages. Its employees speak 12 languages, and the centers use a remote translation service for the rest.
Underlying all this are the continual policy gyrations over health insurance regulations. Shippee and Mangino said the latest attempt to derail Obamacare is on their radar but not driving the discussion between Whitney Young and Hometown Health.
“There’s always going to be speculation on the federal level on how best to finance health care,” Shippee said. “One way or another, the patients that look to the two of our organizations are going to continue to look to the two of our organizations.”
He added that Federally Qualified Health Centers, which also serve rural areas, historically have experienced bipartisan support.
(The FQHC is a Medicare designation created in 1990. They are safety net providers that primarily provide services typically furnished in an outpatient clinic and include community health centers, migrant health centers, health care facilities for the homeless and public housing primary care centers.)
Gambino said that, regardless of whatever changes are made at the federal level, the need at the local level will continue unchanged.
“We both care for a large number of Medicaid members,” he said. “We both have missions that focus on access — extraordinary access — to children and indigent families.
“I wouldn’t say that what’s happening in Washington is the motivation; it’s more because it makes sense.”
Gambino and Shippee said there is not a target date for completing the exploratory phases, but sometime in early 2019 is the best guess at this point.
“This is not a hard and fast timeline, but we’re hoping to come to some sort of conclusion in 18 months,” Gambino said.