This multi-state effort to provide access to important procedures that dramatically improve patients’ quality of life is believed to be the first of its kind in the nation and can serve as a model for how hospitals and self-funded health plans can work together.
“We are proud and excited to be able to expand our Centers of Excellence program outside New York, as it is a proven method of providing affordable and high-quality care to our members,” said Health Fund Chairman and 32BJ President Kyle Bragg. “As the cost of health care continues to rise, it is paramount that we seek creative ways to ensure hard-working Fund participants and their families are able to get the services they need to stay safe and healthy.”
“Thanks to Mount Sinai and our hospital partners outside New York, many more Fund participants will be able to participate in this groundbreaking program,” Bragg continued. “I hope other hospitals and health plans follow suit.”
“When a program grows, you know it is working,” said Stephen Furia, Senior Vice President of Population Health Solutions at Mount Sinai. “We are thankful to have an innovative partner like 32BJ who understands the value the Centers of Excellence programs brings to their members. Through our 5-year partnership, we have seen the programs deliver and we are excited to now be working with top rated hospitals across multiple geographies to bring this same great service to more 32BJ members and their families.”
Direct contracts with hospitals and health systems are one of the many ways the 32BJ Health Fund is striving to lower the cost of care for their participants. Through the Mount Sinai partnership, the 32BJ Health Fund is able to continue to offer high-quality care to participants while saving millions of dollars, leaving more funds available for other benefits and wages.
Centers of Excellence program benefits include:
- No copays for all visits from surgery through 30 days post-treatment
- Access to high-quality bariatric and joint surgeons
- Personal Care Guide who will answer questions and coordinate visits
- Free transportation to and from surgery
Beginning January 1, 2022, the Centers of Excellence program will now be available at the following hospitals and outpatient surgery centers:
- New York
- Mount Sinai Morningside
- Mount Sinai West
- New Jersey
- Valley Health System
- Connecticut
- Saint Francis Hospital and Medical Center
- Saint Mary’s Hospital
- Florida
- Holy Cross Health – Fort Lauderdale
- Massachusetts
- Boston Outpatient Surgical Suites
- Mount Auburn Hospital
- New England Baptist Hospital
- Pennsylvania: Philadelphia
- Penn Presbyterian Medical Center
- Pennsylvania Hospital
- Pennsylvania: Pittsburgh
- AHN Forbes Hospital
- AHN Monroeville Surgery Center
- AHN West Penn Hospital
- AHN Wexford Hospital
- Pennsylvania: Erie
- AHN Saint Vincent Hospital
Recognizing the success of the Mount Sinai program, the Health Fund was eager to replicate the program for participants outside New York.
Participants who live within 50 miles of a Center of Excellence must use both a Centers of Excellence provider and facility for the procedure to be covered under this program. This guarantees that the Fund can continue to provide high-quality care to its participants at an affordable cost.
“Penn Medicine is excited to be part of this drive toward clinical excellence and patient-centered care, and we look forward to serving these members,” said PJ Brennan, MD, chief medical officer of the University of Pennsylvania Health System. “This will allow our top-notch teams to deliver even more people the care that they deserve.”
“We want participants to know that we’re always working to provide them with the best available options,” said Howard Rothschild, President of the Realty Advisory Board on Labor Relations, Inc. “By expanding our widely popular Mount Sinai program, we’re continuing to give participants access to this low-cost, high-quality program at no cost to them.”
“Besides having my son, utilizing the 32BJ Health Fund and its Bariatric Surgery Program was the best thing I’ve ever done,” said Brenda Berisha a 32BJ Health Fund Participant. “I would recommend it to anyone who needs it.”
“Valley Health System looks forward to offering its stellar surgical services to the members of 32BJ,” said Robert Brenner, MD, Valley Health System’s President for Clinical Integration and the Physician Enterprise. “Our Total Joint Replacement Center and our Center for Bariatric Surgery and Weight Loss Management have been recognized for their quality and compassionate care, and we are delighted that more members of our community will be able to take advantage of the comprehensive services each program offers.”
“At Allegheny Health Network (AHN), our goal is to provide patients with convenient access to high-quality, high-value health care services,” said Donald Whiting, MD, AHN Chief Medical Officer. “That’s why we are so excited to participate in the 32BJ Health Fund initiative being led by Mount Sinai, which will enable even more patients to benefit from the exceptional bariatric and joint replacement surgery programs that we offer in the Pittsburgh and Erie regions.”
“As a clinically integrated network focused on population health, SoNE HEALTH is a leader in value-based care. We strive to continually optimize the health outcomes of our patient populations while maintaining affordability,” said Lisa Trumble, President and Chief Executive Officer at SoNE HEALTH, whose network includes Saint Mary’s Hospital and Saint Francis Hospital in Connecticut. “We have always been dedicated to a collaborative approach to healthcare, working together with our network providers, health plans and employers to deliver the best patient care for patients at an affordable cost. Participation in this innovative program represents yet another step on the path from volume to value.”
“For years, our joint replacement and bariatric surgery programs have raised the bar on clinical excellence and patient experience,” said Holy Cross Health CEO Mark Doyle. “We are thrilled to partner, listen to the consumer and make it easier for Fund participants to get the quality care they need and deserve.”
About the Mount Sinai Health System
The Mount Sinai Health System is New York City’s largest academic medical system, encompassing eight hospitals, a leading medical school, and a vast network of ambulatory practices throughout the greater New York region. We advance medicine and health through unrivaled education and translational research and discovery to deliver care that is the safest, highest-quality, most accessible and equitable, and the best value of any health system in the nation. The Health System includes approximately 7,300 primary and specialty care physicians; 13 free-standing joint-venture centers; more than 410 ambulatory practices throughout the five boroughs of New York City, Westchester, and Long Island; and more than 30 affiliated community health centers. The Mount Sinai Hospital is ranked in U.S. News & World Report’s “Honor Roll” of the top 20 U.S. hospitals and among the top in the nation by specialty: No. 1 in Geriatrics and top 20 in Cardiology/Heart Surgery, Diabetes/Endocrinology, Gastroenterology/GI Surgery, Neurology/Neurosurgery, Orthopedics, Pulmonology/Lung Surgery, Urology, and Rehabilitation. Mount Sinai Kravis Children’s Hospital is ranked in U.S. News & World Report’s “Best Children’s Hospitals” among the country’s best in four out of 10 pediatric specialties. New York Eye and Ear Infirmary of Mount Sinai is ranked among the Top 20 nationally for ophthalmology. The Icahn School of Medicine at Mount Sinai is one of three medical schools that have earned distinction by multiple indicators: ranked in the top 20 by U.S. News & World Report’s “Best Medical Schools,” aligned with a U.S. News & World Report “Honor Roll” Hospital, and No. 14 in the nation for National Institutes of Health funding. Newsweek’s “The World’s Best Smart Hospitals” ranks The Mount Sinai Hospital as No. 1 in New York and top five globally, and Mount Sinai Morningside as top 20 globally, and “The World’s Best Specialized Hospitals” ranks Mount Sinai Heart as No. 1 in New York and No. 4 globally and the Division of Gastroenterology as No. 3 globally. For more information, visit https://www.mountsinai.org or find Mount Sinai on Facebook, Twitter and YouTube.