For SUNY medical schools, difficult choices ahead

Cut to cure: SUNY medical schools, including Stony Brook University Hospital, may have to eliminate services to survive federal funding reductions, according to a top SUNY officer.
By GREGORY ZELLER //

With various D.C. follies choking off federal funding, SUNY’s academic medical centers are starting to feel the pinch.

And the State University’s teaching hospitals – including Stony Brook University Hospital – may have to roll back certain services to remain solvent, according to a top SUNY officer.

As reported this week (subscriber content) by Politico, Ricardo Azziz, SUNY’s chief officer of academic health and hospital affairs, on Nov. 15 told a Board of Trustees subcommittee that numerous funding issues – particularly at the federal level – were directly affecting SUNY teaching hospitals in Syracuse, Brooklyn and Stony Brook.

Addressing the Academic Medical Centers and Hospitals Committee, Azziz – the former (and founding) president of Georgia Regents University and founder of the Georgia Regents Health System (now the Augusta University Health System) – cited repeated attempts to undermine the Affordable Care Act and the current tax-reform effort for destabilizing federal funding channels.

Other primary culprits, according to Azziz: President Trump’s announcement this month that he was slashing provider reimbursements through Medicare’s 340B drug-discount program by $1.6 billion, and $329 million in federal cuts to the Disproportionate Share Hospital program, which reimburses hospitals that treat indigent patients.

It’s all pretty bad news for Stony Brook Medicine, the SUNY Downstate Medical Center in Brooklyn and Syracuse’s SUNY Upstate Medical Center, which rely heavily on federal dollars to fuel both research programs and patient services – and may have to begin limiting both, Azziz told the SUNY trustees, to ensure financial stability.

Ann-Marie Scheidt, SBU’s director of economic development, deferred questions Friday to a government relations spokesperson in the university’s Community Relations office, who declined to comment.

Reached Monday, Yacov Shamash, Stony Brook’s vice president for economic development, stressed that he had no knowledge of budgets or programs at Stony Brook Medicine – but acknowledged that all of SBU’s research and development programs were keeping a close eye on federal budget negotiations.

So far, university programs funded by federal continuing resolutions – which sustained funding levels from prior years in lieu of a FY2017 federal budget, and are now doing the same while lawmakers hammer out a FY2018 spending plan– are unaffected. But “we are certainly concerned about the R&D budget from the feds,” Shamash said, referencing President Trump’s FY2018 federal budget proposal.

That plan, revealed this spring, eliminated nearly $6 billion in National Institutes of Health funding, among other cuts to medical and scientific research programs.

“If what was initially proposed was implemented, we would obviously have some drastic cuts,” Shamash told Innovate LI. “In Congress, there has been a lot of discussion about reinstating some of those cuts.

“But whether that’s going to take place, we don’t know.”

As the budget negotiations sway, Stony Brook is “looking at other sources” as potential backers of research programs, the vice president added, including industry partners.

“We’re always looking for other sources, of course,” Shamash said. “We also need to increasing our philanthropy fundraising.”

Ricardo Azziz: Reassessing roles as fed funds fizzle.

Stony Brook University’s economic-development brass have voiced concerns before over federal-funding cuts proposed by the current administration. In April, Scheidt called the president’s FY2018 federal budget proposal “backwards-looking” and said university leaders were “absolutely worried” about their funding prospects.

Others within the SUNYsphere have also criticized the Trump administration’s handling of federal funding for healthcare programs, including David Amberg, vice president for research at SUNY Upstate Medical Center. In a July editorial, Amberg noted that “China is predicted to outspend the U.S. on science by 2020” and decried the proposed $5.8 billion cut in NIH funding – “equivalent to cutting the entire cancer research budget of the NIH,” Amberg wrote on Syracuse.com.

The research VP predicted dire consequences from the proposed “shortsighted budget cuts,” and not only for SUNY Upstate.

“Upstate would no longer be able to financially support its research mission, and neither would most other universities,” Amberg wrote. “In concert with a collapse of the U.S. biomedical R&D pipeline would be a collapse in our educational programs to train the next generation of scientists.”

Also teeing off on the federal funding fiasco has been frequent Trump critic Gov. Andrew Cuomo. In an Oct. 16 letter to Vice President Mike Pence, Cuomo blasted decisions to cut $138 million in federal support for 650 “federally qualified health center sites” and to “dismantle the Affordable Care Act bit by bit,” which will “drain billions from the system, while slashing benefits and raising premiums.”

The governor also lamented those chunky cuts to the Disproportionate Share Hospital program, which “hit New York harder than any other state” and threaten to “dismantle our public and at-risk hospital system.”

Absorbing those fiscal blows is difficult, agreed SUNY’s Azziz, who last week echoed a notion floated by Scheidt back in April, when SBU’s economic development director noted the likelihood of federal cuts had “certainly increased Stony Brook’s interest in collaborating with industry.”

Azziz repeated that theme last week, suggesting to SUNY trustees that paring back existing services – particularly those that could be readily provided by private practitioners – might be a good place to start.

Curtailing primary care services and other more-basic practices – certain scans and X-rays, for instance – would potentially allow the SUNY teaching hospitals to focus more on developing and providing specialized services.

For a university system that “can’t be everything to everybody,” it’s an avenue that must be explored, according to Azziz.

“We need to decide what an academic health center should be,” he said in Politico.