City's New Public Hospital Chief Seeks More Paying Patients

Dr. Mitchell Katz is a Brooklyn native who spent the last six years running the country’s second largest public health care system in Los Angeles. Now he’s taking the reins in New York, and it’s no easy task.

The city’s perpetually beleaguered system consists of 11 public hospitals, several dozen community health centers, a handful of nursing facilities and more. It’s been hemorrhaging money for years. The annual budget deficit is expected to reach $1.8 billion by 2020.

But Katz says he has a plan to shrink that number. One of the main components is simple: get more people to pay for care.

Public hospitals traditionally treat the city’s most vulnerable. They don’t turn anyone away. But about 70 percent of their patients are low-income or uninsured, which means the hospitals don’t generate much revenue from them.

Katz hopes to attract more insured patients by focusing on primary care. If patients build a relationship with one doctor, he said, they are more likely to come back. And good primary care can keep people healthier, avoiding medical emergencies that cost the hospital more.

“I harp on primary care care because it’s the one thing that consistently comes up as providing better outcomes at lower cost,” Katz said.

Sometimes attracting new patients will involve an upfront cost, he added. For example, getting a van to pick up patients who can’t travel by themselves would be a new expense.

“If you’re bringing in elderly people who have Medicaid and Medicare, you’re going to more than make up for the cost of that van,” Katz said. “I’m talking about spending money in the right ways to generate additional revenue.”

He also suggested hospitals could provide more services to the patients they already see. For instance, public hospitals serve more mental health patients than any other providers in the city. The hospital should start offering those patients primary care, as well, he said.

In Los Angeles, public hospitals set up primary care clinics inside mental health clinics, Katz said. That helped patients get more comprehensive care, while also helping the hospital. Katz said he hopes to replicate those types of successes here in New York. The public should see improvements in two to three months, he said.

Katz’s public health career began in San Francisco in the early 1990s, where he headed the city’s AIDS office. There he created the first publicly funded needle exchange program in the country, and went on to lead the city’s health department for 13 years.

He became head of the Department of Health Services in Los Angeles in 2011. He inherited a multi-million dollar budget deficit, but left the department seven years later with a surplus.

Katz comes to New York City Health & Hospitals as the third new leader in four years. He will replace interim president Stanley Brezenoff, a former private hospital administrator who took over after Dr. Ramanathan Raju stepped down in 2016.

Raju told WNYC that Katz is in for a difficult job, but it is also a fulfilling one. His main advice for Katz is to always remember who matters most.

“Patients are the centerpiece of system,” Raju said. “Everything we do and value we create should be based on what’s the value for the patients. That will probably help [Katz] in the long run to achieve his goals.”