NYC dialysis transfer plan causes controversy

New York's state government is set to turn over dialysis care at four New York City public hospitals to a for-profit franchise, despite data indicating mortality rates are higher for dialysis at for-profit institutions, the New York Times reports.

New York City's Health and Hospitals Corporation (HHC), which oversees public hospitals, approved the deal more than a year ago, claiming the transfer would save the city's hospital system $150 million over the next nine years. Under the arrangement, the state would shift dialysis patients at Kings County Hospital, Lincoln Hospital Center, Harlem Hospital and Metropolitan Hospital to Big Apple Dialysis, according to the article.

To finalize the contract, Big Apple must approve the state Public Health and Health Planning Council's "certificate of need." Some medical groups oppose the transfer, pointing to mortality data that show the four hospitals performed 17 percent better than the national average from 2009 to 2012, while Big Apple's parent company, Atlantic Dialysis, performed 3 percent worse than the norm.

"We believe that selling patients into the commercial dialysis market is in direct conflict with H.H.C.'s public service mission and governing statute," Carl Ginsburg, a spokesman for the New York State Nurses Association, told the planning council committee, the Times reported.

The state believes the deal will save millions by replacing nurses with lower-paid technicians and increasing each dialysis unit's patient capacity. Public hospitals don't have this option because they must pay higher fringe benefits and do not have the revenue to add 60 dialysis stations, according to the article. Nurses won't lose their jobs as a result of the deal, however. The deal means nurses will transfer to other positions.

"It is unusual for a public system to contemplate doing this kind of thing," outgoing HHC president Alan Aviles told the Times. "But we did it because we had an operator with a track record."

Despite the better dialysis numbers for public hospitals, this disparity is not universal for all types of care. A 2013 study found for-profit hospitals outperform nonprofit and public hospitals in emergency care, leading to higher Medicare bonuses, FierceHealthcare previously reported.

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