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SOS Hand & Wrist Center Expedites Patient Care

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By Molly English-Bowers

It’s been a busy few months at Syracuse Orthopedic Specialists’ Hand & Wrist Center. Last fall, physicians moved into new space on the second floor at 5719 Widewaters Parkway, DeWitt. And just over a month ago in March 2023, physical and occupational therapists moved into the same location. 

“Bringing everyone who treats hand, wrist and elbow injuries under one roof means better collaboration between therapists and doctors,” said director of hand therapy at SOS Benjamin Brightman, MS OT/L, CHT, of the move from 5823 Widewaters Parkway, East Syracuse. “It also allows patients to have easier, same day services. If a patient is being fitted for a custom splint and needs therapy the same day, we’re able to accommodate them more easily. It was more complicated for patients to leave one office and go to another. Our new location gives us and them immediate access, which is better for the patient. We’re better able to streamline our processes and have better protocols, so everyone on the team knows what is expected and what the outcome should be.” 

Now, when a patient sees a physician for a post-operative appointment, that patient can  cross the hall to visit PT or OT during the same appointment, if need be. Likewise, if a therapist needs a doctor’s expertise, a patient can walk across the hall. It’s comprehensive treatment in one location. Both departments share a waiting room, with doctor offices on one side and therapy offices on the other. 

The new hand center has two dedicated X-ray machines and state-ofthe- art equipment, allowing for a more efficient continuum of care and even better patient outcomes. 

The Hand & Wrist Center’s treatment team includes six fellowship-trained orthopedic hand and wrist surgeons and five certified hand therapists and assistants. One of those physicians, Devon Ryan, MD, joined SOS in August 2022 as the newest member of the medical team. He’s been very pleased with his transition to the practice. “Everyone working at the Hand Center, from the front desk to the other hand surgeons, has been incredibly accommodating and helpful, so getting my practice up and running has been as streamlined as possible.” 

“I think part of our expansion is population-driven within the broader Syracuse area, and with Amazon expanding and Micron on the way, our population will only get larger as more people move here for jobs ” said Ryan. 

Brightman has worked at the Hand and Wrist Center for almost six years. He supervises two occupational therapists and two occupational therapy assistants who treat more patients year over year. “There’s more awareness within the general population, so they seek care more,” he said. “We’ve grown every year that I’ve been here. Before we moved in, it was more complicated for patients to leave one office and drive to another. Our new facility gives them and us immediate access.”

Wrists and hands present a variety of conditions, both chronic, like Carpal Tunnel Syndrome and trigger finger, and acute, such as sprains and fractures. It’s that variety that appeals to Ryan. “I really like the complexity; there’s quite a bit of intricate anatomy involving the hand and wrist,” he said. “You work with all different tissue types—more than skin and bones.”

Among the conditions treated by physicians at SOS are ganglion cysts, finger dislocation, trigger finger and tendon injuries. Carpal Tunnel Release is the most common operation performed at SOS. In 2022, over 1,600 carpal tunnel surgeries were performed at The Specialists’ One-Day Surgery Center. The cause of Carpal Tunnel Syndrome, however, isn’t always as simple as occupational or repetitive motions such as typing at a computer keyboard.

“It’s hard to know for sure if those are the causes,” said Ryan. “What’s more clear is that those types of activities worsen the symptoms. I suspect that mild Carpal Tunnel Syndrome is more symptomatic than it was 10 or 20 years ago given the increasing usage of computers and smartphones. In addition, 30 to 40 years ago, the surgery for Carpal Tunnel Syndrome was a bigger deal; there was a larger incision and longer recovery.” 

Now most of these surgeries are endoscopic, with a single 1/2-inch incision in the wrist. “Recovery is often as short as a 2-3 days, which allows for a quicker return to work,” Ryan said. “Sometimes the full recovery can take a few months, but the typical patient sees almost immediate relief. A lot of patients, when they finally pull the trigger on Carpal Tunnel surgery, say they wish they had taken the leap sooner.”

Indeed, according to clevelandclinic. org, the success rate for carpal tunnel surgery is 95 percent. If you need treatment for hand and wrist ailments, contact the SOS Hand & Wrist Center at 315-251-3162 or visit sosbones.com. There you will find information on the center’s physician and therapy team, as well as conditions
treated. 

 

Left:  Devon J. Ryan, MD

Right: Benjamin Brightman, MS, OT/L, CHT

Seven Steps To Medicaid Compliance Program Readiness

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By Maureen Dunn McGlynn

The mission of the New York Office of The Medical Inspector General (OMIG) includes enhancing the integrity of the Medicaid program by preventing and detecting fraudulent, abusive and wasteful practices within the Medicaid program. Pursuant to this mission, New York implemented compliance program requirements in 2009. Recently, amended regulations were adopted governing the implementation and operation of effective compliance programs for certain required Medicaid providers. These revised regulations include significant changes to the original regulations and will require affected Medicaid providers to review and revise their existing compliance programs. So, what steps should Medicaid providers take now to meet these new requirements?

1. Determine whether you are a required provider. As a condition of receiving payment under the Medicaid program, a “required provider” must adopt, implement and maintain an effective compliance program that satisfies the new regulations. “Required providers” include providers subject to Articles 28 or 36 of the Public Health Law, Articles 16 or 31 of the Mental Hygiene Law and managed care providers or managed long term care plans (MMCOs). Also included are providers who provide care services or supplies under the Medicaid program for which the Medicaid program is or should be reasonably expected by a provider to be a “substantial portion” of their business operations. A substantial portion of business operations means the provider claimed or received $1 million in any consecutive 12-month period, directly or indirectly from the Medicaid program.

2. Identify your risk areas. A required provider’s compliance program must apply to the provider’s risk areas. Risk areas are areas of the provider’s operations that are or should with due diligence be identified by the provider through its organizational experience. Areas of operations included in a compliance program must include billings, payments, medical necessity and quality of care, governance, mandatory reporting, credentialing, ordered services and contractor, subcontractor, agent or independent contractor oversight. An effective compliance program should be designed to be compatible with the provider’s characteristics (i.e. size, complexity, resources and culture) and be well-integrated into the provider’s operations.

3. Review and update your written policies and procedures and review them at least annually. Compliance programs must have written policies, procedures and standards of conduct accessible to everyone affected by the provider’s risk areas, including employees, chief executives and other senior administrators, managers, contractors, agents, subcontractors, independent contractors and governing body and corporate officers. The policies and procedures must describe compliance expectations, the provider’s fundamental principles, values and commitment to conduct its business in an ethical manner. In addition, the policies and procedures must include specific guidance on dealing with potential compliance issues, identify methods and procedures for communicating compliance issues to the appropriate compliance personnel and describe how potential compliance problems are investigated and resolved.

4. Appoint a compliance officer and plan compliance training. The compliance officer, who is not required to be an employee, reports directly to the chief executive or other senior administrator and periodically reports directly to the governing body. The compliance officer leads and coordinates the compliance committee, which is required to meet at least quarterly, have its own charter and consist of senior managers. Compliance training must be provided annually and must be part of orientation for new employees and occur promptly upon hiring.

5. Create and maintain effective lines of communication to ensure confidentiality. It is important that lines of communication directly to the compliance officer are publicized and available to all staff and Medicaid recipients of service by the provider, including a method for anonymous reporting of potential fraud, waste, abuse and compliance issues. With certain exceptions, the confidentiality of the reporter must be maintained.

6. Monitor and respond to compliance issues. A key component of an effective compliance program is a system for routine monitoring and identification of compliance risks. Monitoring activity results should be promptly shared with the compliance officer and appropriate compliance personnel. It is crucial that compliance issues are promptly investigated and corrected.

7. Take advantage of available resources. There are several resources available to assist in meeting compliance program obligations on the OMIG website (omig.ny.gov), including a compliance library, webinar, Compliance Program Review Module and OMIG’s Compliance Program Guidance. 


Maureen Dunn McGlynn is a member at
CCB Law, a boutique law firm focused
on providing counsel to physicians and
healthcare professionals. She can be reached
at 315.477.6276 or mmcglynn@ccblaw.com.

Medical Malpractice Insurance Expert Provides Tailored Risk Protection For Physicians

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Jenn Negley, Vice President, National Healthcare Practice at Risk Strategies

By Becca Taurisano

For the past 30 years, Jenn Negley has worked in medical malpractice insurance, currently serving as Vice President of the National Healthcare Practice at Risk Strategies, a top, national independent specialty insurance brokerage firm. Along the way, she learned every facet of the business from managing accounts to production and brings that detailed expertise to her clients in New York state. 

With 6,000 clients representing over $120,000,000 in physician premiums nationwide, Risk Strategies represents every major medical malpractice insurance carrier in the market and offers programs designed for independent physicians, self insured programs, large practices and hospitals. In addition to medical malpractice, Risk Strategies provides managed care stop loss and reinsurance protection, property and casualty coverage and customized programs for employee benefit plans. “We are specialists with in-depth knowledge of healthcare and the carriers that serve the industry,” said Jenn. “That experience is beneficial for delivering the right protection for our clients so they can prepare for the unexpected.” 

Experts like Jenn ensure that providers have the necessary coverage in an everevolving field. If a provider were to go directly to an insurance carrier, they may not know all the questions to ask to make sure they are completely covered. Insurance brokers work to protect their clients but are paid directly by the insurance carriers. The coverage required varies by specialty, size of practice, and can even vary by provider within a practice. Jenn monitors issues that providers or practice managers may not consider, until a malpractice claim brings it to their attention. “That’s when it’s too late,” she said. “We are foremost advocates who know the specifics of your practice, make sure your coverage is appropriate, free up your staff for more important tasks, and provide cost effective coverage with the discounts you deserve from your carrier.”

Jenn is keenly aware of market trends that impact her clients. When office visits were down during the pandemic, she actively engaged practices to make the appropriate adjustments to their policies, so they were not overpaying for coverage when their income was impacted. Jenn also understands how to keep her clients in compliance with the terms of their malpractice policy. Restrictions on telemedicine appointments that were rolled back during the pandemic, are now being put in place again. If a provider doesn’t inform the carrier that they are still doing telemedicine, they might unintentionally void their coverage.

In New York state, working with medical malpractice insurance brokers is fairly new. “The state had been a closed market with a limited number of options for so long, that few practices were being provided the unbiased and independent market evaluations we offer,” added Jenn. As practices evolve, the coverage that worked a decade or more ago may no longer be sufficient. Risk Strategies works with every medical malpractice carrier in New York such as MLIMC, EmPro(PRI), The Doctors Company (TDC), HIC, and risk retention groups like MedPro RRG, Coverys RRG, ProAssurance RRG, TDC RRG, and AMS RRG. Jenn works with the carriers to determine what is the right solution for each client. While the New York insurance market is changing to be more physician-friendly, it is still difficult for providers to navigate alone. “As specialists, we are well versed in the benefits of the carriers we represent,” said Jenn. “One point of emphasis is always the financial strength of the carrier and the specific protection for the practice based on their needs.”

The Risk Strategies Healthcare Practice is currently rolling out a unique discount program for practice managers and administrators who are members of the New York Medical Group Management Association. The best-in-class protocols practice managers employ before a patient even sees a doctor are a front line in reducing claims. The program was approved at the end of 2022 and provides a 10% discount for physicians who qualify, potentially generating significant savings. “We are proud to bring this discount to NYMGMA members and look forward to assisting practices in signing up,” said Jenn. “Understanding our industry is what allows us to find creative ways to deliver premium relief.”.

For more information on insurance program for your practice, contact Jenn Negley at 267- 251-2233 or jnegley@risk-strategies.com.

Upstate Cancer Center: Improving Cancer Outcomes for All

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BY BECCA TAURISANO

On our cover: The Upstate Cancer Center has been continuously accredited by the ACS Commission on Cancer since 2006 and is supported by services to meet its mission. Clockwise from top: the Clinical Pathology Lab on the fifth floor of the Cancer Center provides advanced testing and diagnostics. • Upstate’s mammovan covers 10 CNY counties. • TrueBeam technology provides precision radiotherapy at nearly any angle. • Interiors of the Cancer Center reflect the theme of healing supported by nature. • A dedicated nursing team at the Cancer Center location at Community Hospital. • The newest Cancer Center site in is opening in Verona, NY, this summer. • The infusion area at the Cancer Center at Community site on Onondaga Hill. • Surgeons provide leading-edge treatments and participate in the Cancer Center’s many tumor boards.

THE UPSTATE CANCER CENTER has a role that extends far beyond providing state-of-the-art care. Its mission to improve outcomes in the community is further supported by delivering preventative education and services, conducting biomedical research and clinical trials, and improving access for underserved populations. By expanding locations and support services, along with investing in cancer-fighting technology, the Upstate Cancer Center offers interdisciplinary treatments that are on par with national cancer centers and aligned with the Cancer Moonshot goal to cut the death rate from cancer by 50% over the next 25 years. 

Multidisciplinary Approach to Care

With a team of more than 90 board-certified physicians, the Upstate Cancer Center organizes cancer care into tumor-specific programs. While all types of cancer are treated, there are multidisciplinary programs for bladder; breast; gynecology oncology; head and neck; kidney; liver, gallbladder, and pancreas; melanoma; neuro oncology; prostate; thyroid and thoracic oncology. Tumor boards for the programs are comprised of surgeons, medical oncologists, radiation oncologists, radiologists, pathologists and other specialists, as well as a dedicated research associate to identify and recruit patients for clinical trials. “Patients who require decision-making that spans these disciplines are discussed at our tumor boards,” says Interim Director Thomas J. VanderMeer, MD, FACS. “The multidisciplinary team determines the best course of care involving multiple modalities.” The high degree of specialization and frequency of the tumor boards at Upstate Cancer Center is not found elsewhere in Central New York.

Clinical Innovation

The Upstate Cancer Center has numerous innovations in medical oncology, radiation oncology and surgery. Gennady Bratslavsky, MD, Deputy Director of the Upstate Cancer Center and chair of Urology, says the robotic surgery program has initiated novel surgeries not done elsewhere in the world, such as the first-ever robotic replacement of the vena cava and a level III inferior vena cava thrombectomy first performed here 10 years ago. Such technical advances on the surgical side allow patients to receive modern care as well as faster recovery and return to home.

“Our clinical pathways are very strong,” says Dr. Bratslavsky. “The expertise of our surgeons is unparalleled for the area.”

For radiation oncology, physicians offer numerous approaches in improved targeting, which minimizes potential damage to nearby healthy tissue and offers improved and shorter treatment regimens. “The radiation team offers treatment
with such precision the approach is on par with that of our surgical team,” says Dr. Bratslavsky. Radiation Oncology also works with several departments to provide opportunities for theranostics: a novel approach combining therapy with diagnostics. The radiation is delivered intravenously, only released at the molecular level where the tumor cells are located. “Theranostics is only just now becoming a concept in medical therapy, and yet at Upstate, our first patient was treated well over two years ago with this approach,” says Dr. Bratslavsky.

On the medical oncology side, the Upstate Cancer Center has committed to innovations in both preventative care and combination cancer therapy, currently serving as a site for cancer vaccine clinical trials. Oral chemotherapy is prevalent as well, allowing patients to take chemotherapy at home under the guidance of the Upstate Cancer Center. 

Expanded Locations and Telemedicine Options
In order to make cancer care more convenient for patients, the Upstate Cancer Center has expanded to several new locations and offers follow-up appointments by telemedicine. Upstate Cancer Center Associate Director, Richard J. Kilburg says “Our strategy was to establish satellite offices that could provide the same high-quality care, treatment and advanced research as our main cancer center location. That care is now closer to home for many patients.”

This summer, a new location in Verona will provide patients in Oneida and Rome nearby access to radiation oncology and medical oncology and, due to its proximity to the New York State Thruway, the location will be convenient to additional communities as well. A comprehensive Upstate Cancer Center offering radiation oncology and medical oncology is scheduled to open by January 2024 at Auburn Community Hospital, underscoring the importance of regional partnerships

Opening this summer, Verona is the newest Cancer Center location providing a convenient location for residents of Madison and Oneida counties. The 30,000-square-foot facility is located off NYS Thruway Exit 33 and will provide medical oncology, radiation therapy, radiology, laboratory, pharmacy and consultative services. The Verona site will provide multidisciplinary care with surgeons, medical oncologists, radiation oncologists and other specialists who consult together to manage each patient’s specific treatment and provide information back to referring physicians.

The Upstate Cancer Center Hematology/ Oncology location at Upstate Community Hospital has been open for just over a year and is already outpacing third-year projections. The location allows Upstate to provide life-saving cancer treatments for the southern

suburbs of Syracuse and as far away as Ithaca.  At the Madison-Irving Building in Syracuse, an Upstate Gynecology Oncology location has been open for nearly two years. This office specializes in gynecologic cancers and offers patients surgery and infusion therapy treatment options. “In all our satellite offices, we provide that convenience and state-of-the-art care available at our main campus,” says Kilburg.

During COVID, it became necessary to limit patients from coming into the
hospital if they were not receiving treatment. “It was evident that we needed
to treat more people from home,” says Kilburg. “We established the technology and moved many follow up visits to telemedicine.” While limitations have been lifted, telemedicine continues to be popular with patients who like the option for their follow-up appointments.

Improved Experience for Patients and Staff

Besides telemedicine and satellite offices, there are a wide array of support services to improve the patient experience. Services like integrative therapies, financial counseling, nutritional counseling, genetic counseling, palliative care, spiritual care, support groups, survivorship, tobacco cessation and free valet parking help patients and their families feel supported during treatment. The Upstate Cancer Center has expanded its look and feel to all its satellite offices, including integrating music and art in a healing way for patients. “Our patient satisfaction ranks us in the top 1 or 2% in organizations across the country,” says Dr. VanderMeer. “Cancer is a difficult disease to take care of, but our staff never let the challenges they face affect the patient experience. We want our employees to be able to provide excellent care to our patients.”

Dr. Vandermeer says a focus on clinical operations at the cancer center and regional sites is also key for the patient and staff experience. “We want to make this a people-first organization,” he says. “That goes for patients as well as healthcare providers.” A new Director of Clinical Operations at the Cancer Center, JJ Yakowec, DrPH, MPH, is helping improve workflows and making processes more efficient for the entire team. “Thanks to Dr. Yakowec’s efforts, we are already establishing improvements saving time and space to see patients in a more efficient manner,” says Kilburg. “That kind of operational efficiency is important to our patients and staff.”

Investment in Technology

Offering the latest technologies to treat patients ensures fewer side effects and better quality of life. “Our cancer treatment and quality of care is excellent as evidenced by our American College of Surgeons Commission on Cancer accreditations 18 consecutive years,” says Kilburg. Radiation oncologists are able to deliver radiation with extreme precision, even to difficult-to-reach areas in the body, using CT Simulators to plan and Varian TrueBeam linear accelerators to treat. “We are able to treat within millimeters of accuracy and spare vital surrounding tissue and organs.” The main campus of the Upstate Cancer Center houses three linear accelerators, and each satellite office will have a linear accelerator as well. Next year, they are planning to add a Magnetic Resonance Imaging Guided Linear Accelerator (MRI-LINAC) which has specific advantages in treating soft tissue tumors. The Cancer Center also offers the latest in cancer-fighting drug therapies that can be delivered orally or by infusion.

Research Integration

Upstate’s integration of research supports both discovery at the bench as well as treatments at the bedside, and every patient is evaluated for clinical trials. Upstate has streamlined its research focus to three areas: Cancer Cell Biology and Genetics, Cancer Therapeutics, and Cancer Prevention and Population Health. Leszek Kotula, MD, PhD, the Associate Director for Basic and Translational Research at Upstate Cancer Center says it is important to connect knowledge that is gathered in the laboratory to create potential treatments and diagnostic procedures at the bedside. “The number one requirement for novel medicine is help patients; not harm them. Clinical trials are so important because they allow us to understand side effects and provide improvement for treatment and prolong patients’ lives,” Dr. Kotula says. With over 72 open clinical trials at the Upstate Cancer Center, patients have the opportunity to participate in research to improve efficacy of treatment. Serving an area with two million people in population the Upstate Cancer Center is the only medical university in Central New York and has the highest participation and enrollment in clinical trials in the region. The integration of clinical innovation and research allows for the same therapies found at national cancer centers. One such innovative program utilizes immunotherapy to treat metastatic disease. “We can take cells from the patient, modify them in vitro, introduce genes or disrupt genes as needed, and then use them as a drug to treat the patient’s cancer,” says Dr. Kotula. “The big promise of immunotherapy is that we will be able to successfully treat metastatic cancer. Thanks to basic, clinical and translational research, we are able to use cutting-edge therapies at Upstate.”

In addition to the weekly tumor boards, a monthly molecular tumor board is run by Jeffery Ross, MD, world-renowned pathologist and co-founder of Foundation Medicine. Dr. Bratslavsky says the program is able to profile cancers in their advanced stage and identify specific genetic mutations that could be responsible for prognosis as well as response to therapies. “The molecular genetics language is agnostic to a specific tumor type, and we learn that many drugs can be effective in more than one cancer type when a specific gene mutation is present. Through this unique program we have been able to identify certain genetic mutations that allow us to alter the therapy and prolong patients’ lives,” says Dr. Bratslavsky.

One of the Upstate Cancer Center’s key new hires is Director of Clinical Operations JJ Yakowec, DrPH, MPH. As a key member of SUNY Upstate’s Cancer Center, she is leading the development, implementation and growth of its operational excellence program. This program supports continuous and sustainable operational improvements to benefit staff and patients. Dr. Yakowec has a background in data-driven strategic planning, process re-design, and was previously at Dana-Farber Cancer Institute in Boston, most recently as the senior manager for health systems improvement.

Reducing Disparities
Christopher Morley, PhD, Chair of the Department of Public Health and Preventative
Medicine and Telisa Stewart, DrPH, Associate Professor of Public Health and Preventative Medicine are working to reduce disparities among the rural, urban and refugee communities that Upstate serves. Each group has distinct challenges, ranging from financial factors, lower health literacy, historic mistrust of the healthcare industry, transportation issues or geographical distance from primary and specialty care. Studying and monitoring data at the population level helps to both identify social determinants of cancer rates in populations, as well as to design preventive interventions. “We can use large national data sets to examine the presence of different risk factors in different subsets of the population,” says Dr. Morley. “We can also use qualitative data by having conversations with people to explore what barriers people experience in their communities.” 

Data surveillance plays a part as well. If the data show an uptick in one kind of cancer, the researchers will determine where those instances of cancer are occurring and determine whether interventions could be put in place. Merging data analysis and community partnership is important for communities to adopt change and for there to be behavior modifications in health. “When you build community partnerships for cancer- based interventions, they are more successful,” says Dr. Stewart. “It has been proven you will have better adherence to certain behaviors, screening and treatment if you work with those communities to identify what works for them.” Upstate offers several programs in the community, including She Matters and We Matter for breast and colon cancer prevention and to reduce disparities, and
a mobile mammography van covers 10 counties for screenings.

By utilizing artificial intelligence and natural language processing, researchers can scour medical records and connect eligibility criteria to identify clinical trials and increase enrollment for patients in underserved populations. “We are making cancer prevention and control a priority for programmatic development to understand how to reach those populations more effectively,” says Dr. VanderMeer. “Part of providing cancer care is ensuring that you are meeting your constituents where they are.”

Meeting Cancer Moonshot Goals
In 2022, President Biden highlighted new national goals for the Cancer Moonshot program: to reduce the cancer death rate by half within 25 years and improve the lives of people with cancer and cancer survivors. As the academic medical center for the region with nationally and internationally renowned physicians and an emphasis on clinical trials, the Upstate Cancer Center is providing the groundbreaking cancer research the Cancer Moonshot is seeking. “At Upstate, we are addressing disparities in care and finding cures,” says Dr. VanderMeer. “We are recruiting basic and translational researchers so we can improve outcomes. All of the things we are doing to improve outcomes in our region, we are ensuring everyone experiences the gains.” 

For more information, please go to upstate.edu/cancer

The staff on Upstate’s Mobile Mammography van brings screenings to residents of 10 counties in CNY, many of whom would otherwise might not have access to care. The mammovan provides the same 3-D mammography available at all Upstate’s breast imaging locations and the images are read by board-certified radiologists. In addition, fecal immunochemical tests are provided in conjunction with We Matter, an outreach program to provide colon cancer screening.

Mental Health in the Workplace

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By Elizabeth Landry

Over the past several years, many in the U.S. have suffered poor mental health and suicide rates have remained steady. Working people tend to be affected by these issues at a high rate. A rise in remote employment leading to feelings of isolation as well as high-stress, fast-paced work environments are contributing factors to these patterns.

According to Dr. Omar Colon, Medical Director of Behavioral Services at Oswego Health, there are several warning signs employers can monitor for to help recognize workers who may be suffering and at risk for suicide. Arriving late to work, working excessive hours, increased stress at work or at home, mentioning access to weapons and generally any behavior out of the norm for a specific person are all red flags indicating an employee may be suffering poor mental health.

Addressing these issues in the workplace can seem daunting due to the unfortunate stigma that often surrounds mental health and suicide. However, Dr. Colon emphasized it’s important for gatekeepers in the workplace, such as managers and HR personnel, to help break down this stigma by simply asking their employees how they’re feeling and offering a welcoming environment where workers can feel comfortable having discussions about what’s happening in their lives.

“When we see these red flags in our work, we have to pay attention as gatekeepers and be ready to receive these messages. We need to be thinking, ‘Wait a minute – does this person need some help? Are we making it easy for this person to access the help they need?’” explained Dr. Colon.

In addition to identifying when employees may be at risk for poor mental health or even suicide, employers can strive to boost mental well being in the workplace by encouraging employees to practice good mental health habits when they encounter stressful situations.

“We’ve been focused on creating a culture where it’s OK to take a break from stress at work and come back refreshed, even if that means just a five-minute walk,” said Alissa Viscome, Employee Engagement Manager at Oswego Health.

The COVID pandemic has also created additional mental health-related difficulties in the workplace. An increase in remote employment, virtual meetings, masks and physical occupancy limitations have all made it more difficult for employees to create important bonds with one another.

The staff at Oswego Health has been working to create more opportunities for employees to connect with one another, even if those connections must be virtual. Employees at Oswego Health have participated in activities like sharing photos of pets with one another on National Pet Day and collectively taking part in self-care opportunities during the different themed months of the “Action for Happiness” calendar. Although these initiatives may seem simple, they can make a big impact that encourages interpersonal connections and helps boost mental wellness among teams in the workplace.

Residents of Oswego County and beyond can find treatment resources at one of several inpatient and outpatient facilities, including the brand-new Lakeview Center for Mental Health and Wellness. Additionally, the Oswego Health website offers a Wellness Library where employers can find educational awareness articles about mental health and suicide as well as practical tips to help support general mental well being both in the workplace and at home.

Workforce Challenges

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BY KATHRYN RUSCITTO, ADVISOR

My mother has encountered the hospital, rehab and homecare-based workforces over the past several months; it has allowed me to see up close the challenges that have developed in the healthcare workforce. From food service to transportation to nursing, all areas have been impacted. This results in a number of bumps in care delivery for a 98-year-old patient: Lost dentures, lost hearing aids, lost glasses, missed meals, delayed appointment arrivals and delayed bathroom stops.

It has made our family more aware and ready to advocate when she need better support. I complained a lot, but this is really not the fault of the organizations and their current workforce; COVID broke our systems and put undue burden on the remaining healthcare workers. Employees are looking for us to do better in finding new approaches to recruitment and training to rebuild their teams.

These workforce issues are also coming at the very time we are seeing a dramatic increase in the age of our community residents. How do we solve these challenges?

I am spending some of my time talking to my foundation and donor contacts and demonstrating that workforce development funding is essential right now. Programs that fund scholarships, training, support entry into the health field by offering day care support to employees while in school and other incentives are desperately needed.

Ultimately, recruiting outside traditional employee segments and reaching out to other countries may be in our future. Syracuse University is working to connect veterans with opportunities, and LeMoyne College is focused on growing nurses, clinical affiliates and the physical therapy workforce. LeMoyne also is retraining foreign-trained health employees through HARC (www.lemoyne.edu/Values/In-the Community/Healthcare-Advancement-Resource-Center).

SUNY Upstate, St. Joseph’s Health and Crouse Health continue growing nursing and medical staffs. In one organization, they have found a shift to part-time positions drew in employees who would not consider full-time work. Remote work for others has helped with backroom operations. Technology is allowing for expertise of one nurse or physician to be spread across many states.

Particularly successful are several demonstrations around the state drawing foreign-born health workers into retraining; others are reaching out to high schools to create work-study slots while still in school with a seamless progression to a job. In talking to Gwen Crosett, founder of Constant Care247 – a provider of home-based care, she said many caregivers never finish nursing school because they are too busy working to keep a roof over their families’ heads.

“Recently, I sponsored a graduate from nursing school who was having a difficult time passing her boards,” Crosett said. “She did not have the money and resources to hire a tutor. ConstantCare247 invested in a tutor, bought her the books and, hopefully, mid-year she will be able to call herself an RN.  I feel, as an employer, investing in her success will help all of us in the long run.”

This environment requires unique approaches and creativity to draw new candidates into the health-care workforce. Reaching out to schools, welcoming refugees to our community and drawing retirees back to unique models is in all our futures.

Upstate Community Giving
Campaign Raises More Than $570,000

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More than 1,200 members of the Upstate community donated more than $570,000 to Upstate’s 2022 Community Giving Campaign, bringing Upstate’s total giving to the CGC to $13.5 million since Upstate began the campaign in 1986. 

“Upstate’s engagement with the community and its role in helping people have a brighter future continues to impress,” said Campaign Chair Lawrence Chin, MD, professor and dean of Upstate’s Norton College of Medicine. 

New donors to Upstate’s Community Giving Campaign rose 44 percent in 2022, bringing the number of new donor employees to 277. More than half of all new donors were nursing employees. 

“Our nursing staff goes above and beyond every day to serve our patients and this commitment extends to this campaign,” said Chief Nursing Officer Scott Jessie.

The success of the campaign is due, in large part, to the 163 employees who served as department representatives. They help promote the campaign within their departments and answer employee questions about the campaign. A complete list of department representatives is available.

Serving on the 2022 Campaign Committee were Dr. Katherine Beissner, Tammy Blackburn (ad-hoc) Catherine Cadley, Leah Caldwell, Tree Carter, Dr. Lawrence Chin, Mark Congel, Dr. Mantosh Dewan, Kelly Dolan, Amy Green, Zanette Howe, Michael Longo, Katherine Magnarelli, Nancy Prott, Linda Veit. Serving on the committee from United Way of Central New York were Nancy Kern Eaton and Meghann Sandak.

Upstate has won numerous honors awards for its Community Giving success from the United Way of Central New York, including the Spirit of Caring Award for Campaign Excellence, Leadership Development Award, Volunteer Service Award, and Campaign Volunteer of the Year Award.

Excellus BCBS appoints three new senior leaders
Excellus BlueCross BlueShield has appointed three new members to its senior leadership team. Mona Chitre, PharmD; Lisa Harris, M.D.; and Tony Vitagliano will take on new roles as part of the health plan’s Population Health Engagement leadership team working to ensure equitable access to high-quality, affordable
care. Meet our staff on the next page;

Mona Chitre, PharmD, Chief Pharmacy Officer, President Pharmacy Solutions

Mona Chitre, PharmD has been named President of Pharmacy Solutions, in addition to her role as Chief Pharmacy Officer. In her expanded role, Dr. Chitre will focus on delivering clinically sound pharmacy solutions to enable growth and diversification and bolster investments and innovation in all areas of the rapidly changing pharmacy landscape. She joined the health plan in 2000.

Chitre oversees Excellus BCBS’ pharmacy program, focusing on ways to drive affordable drug costs, quality outcomes, and appropriateness of care for the health plan’s 1.5 million upstate New York members.

Under Chitre’s leadership, the health plan’s pharmacy program has developed numerous programs to improve the health and well-being of the communities it serves. The introduction of the innovative RxConcierge savings outreach program and initiatives focusing on generic medications, medication adherence, and specialty medications have helped members access quality, affordable medications and earned the health plan national recognition. During her tenure, the health plan’s Medicare Part D prescription drug plan has received a 5-star rating from the Centers for Medicare and Medicaid Services, its highest rating, for seven consecutive years, making it the longest leading, and one of only two 5-star plans in the nation.

Lisa Harris, M.D., Senior Vice President and Corporate Medical Director

Lisa Harris, M.D. has been appointed Senior Vice President and Corporate Medical Director for Excellus BlueCross BlueShield. In her new role as SVP Corporate Medical Director, she will work closely with senior leaders to drive engagement, innovation, clinical quality, equitable access, and affordability, as well as enable efficiency and satisfaction among the health plan’s provider partners. Dr. Harris joined the health plan in 2018.

Harris previously served as Vice President of Medical Affairs for Commercial Lines of business where she was closely aligned with the sales team serving as a clinical liaison for the commercial side of business and leading the clinical affordability strategy. 

During her career at Excellus BCBS, Harris maintained a focus on the larger strategy of improving health care for all as she collaborated on innovative solutions including a clinical queries system allowing key stakeholders to receive a coordinated response to clinical questions within 24 hours. She worked with a team to develop a high-cost claimants team – a multifunctional team designed to engage case managers earlier on in the member experience.

Tony Vitagliano, Senior Vice President, Provider Network Engagement

Tony Vitagliano has been named Senior Vice President, Provider Network Engagement. In his new role, Vitagliano will continue to focus on the health plan’s provider partnership strategy in addition to now leading the areas of payment integrity, medical policy, and risk adjustment. He will also serve as a member of the health plan Executive Team. Vitagliano joined the health plan in 1993.

Tony Vitagliano Vitagliano began his career with the health plan as an Actuarial Analyst and has held several positions during his time with the organization. Most recently, he served as Vice President, Provider Network Management and Operations leading teams dedicated to provider contracting, provider relations, value-based payments, and reimbursement.

During his career, Vitagliano led the development of Excellus BCBS’ Accountable Cost & Quality Agreement (ACQA) model, providers partnership strategy, and the alignment of clinical quality and efficiency.

“Through their partnership with our providers and community members, each of these leaders has made a significant impact in achieving our health plan’s mission of ensuring equitable access to affordable, high-quality care,” said Jim Reed, President and CEO of Excellus BCBS. “I’m excited to see our efforts in the area of population health engagement continue to grow under the strategic leadership of these highly skilled and experienced individuals.”

St. Joseph’s Health Welcomes
Primary Care Physician

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St. Joseph’s Health is pleased to welcome Dr. Kathleen Farry-Leggiero, MD, to St. Joseph’s Physicians Primary Care. In her role, Dr. Farry-Leggiero will provide patients with high-quality, personalized health care. Primary care physicians diagnose and treat a variety of illnesses in pediatric and adult patients, while also providing routine and preventative care to improve their health. Dr. Farry-Leggiero is passionate about applying her medical knowledge and skills to enhance the health of our community. “Having gone to medical school in Syracuse, I’ve had the opportunity to explore Central N.Y. and I have grown to appreciate the pleasantries that it provides,” she said. “I am excited to work for St. Joseph’s Health and provide care to people from all walks of life.” Dr. Farry-Leggiero is a board-certified family physician. She completed her residency at St. Joseph’s Health, earned her Doctor of Medicine from SUNY Upstate Medical University and her Bachelor of Science in Biology from Siena College in Loudonville, NY. Dr. Farry-Leggiero is accepting new patients at St. Joseph’s Primary Care in Liverpool at 5100 West Taft Road, Liverpool, N.Y. To schedule an appointment, please call: (315) 452-2828 

Nephrology Associates of Syracuse, P.C. Give Patients a Comprehensive, United Approach to Kidney Care

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By Daniel K. Brantley

[Deck] Over the past 44 years, Nephrology Associates of Syracuse, P.C. has continued to grow and enhance the kidney care they provide, making them a top choice for advanced, compassionate care.

Founded in 1978, Nephrology Associates of Syracuse, P.C. began with a small team that held an important but simple goal: “To provide high-quality nephrological care for our patients.” However, achieving that goal requires nephrologists and other specialists to work closely together. When they do, remarkable things can happen.

“If you get 10 nephrologists in a room, you’re going to have 10 different opinions,” says Matthew Chaffin, MD, a nephrologist with Nephrology Associates of Syracuse and Medical Director of the DaVita Central New York Dialysis Clinic. “Our unified way of practicing and approaching patients is unique for nephrologists, and it is ultimately better for the patient.”

Integral to their practice is taking a comprehensive, holistic approach to kidney care by looking at each of their patient’s medical conditions to determine if and how they might be affecting the kidneys. Dr. Chaffin says they view nephrology “not solely as the practice of caring for kidneys, but for the overall person.”

Over the years, Nephrology Associates of Syracuse, P.C. have increased their locations and grown their service area. They’ve also established an in-house laboratory to provide rapid blood-test results that clinicians can discuss with their patients the same day. The main office, numerous satellite locations and six dialysis units are located in and around Syracuse, accessible to patients from Canada, Pennsylvania and everywhere in between.

Pandemic-Proven Care

As it was for all healthcare facilities, the COVID-19 pandemic was challenging for Nephrology Associates of Syracuse, P.C. But in time, the stresses of the pandemic also offered growth opportunities that ultimately improved how they provided nephrology care.

“The pandemic changed a lot of what we do — especially during the early stages when everything shut down,” says Antoine Azar, MD, nephrologist and internal medicine physician with Nephrology Associates of Syracuse, P.C. and Medical Director of the DaVita Dialysis Clinics in Syracuse and Ithaca. “We had to improvise, to find ways to see kidney patients and ensure they remained stable during unstable times.”

While much of the world shut down, that wasn’t an option for the practice. When serving patients with chronic kidney failure (CKD), closing the doors — even temporarily — could be disastrous. However, some patients started to miss necessary appointments because they were afraid of contracting the virus. That’s when the organization implemented some creative solutions. In addition to setting up virtual visits, the group established alternate, standalone blood test locations that allowed patients to receive necessary tests near their homes, with minimal interaction with others. All visitors and staff must wear masks and be screened upon arrival. The results were forwarded to Nephrology Associates of Syracuse, P.C., for review, and a nephrologist discussed the results with patients in the office or via video conference.

Most patients have returned to in-person visits, where extra precautionary steps continue in place, as kidneys can suffer substantial damage from COVID-19, particularly among ICU patients placed on ventilators. Patients remain isolated from others throughout their visit, reducing their infection risk. Telemedicine is available for patients who cannot make in-person appointments.

Prioritizing Value-Based Care

Today, nearly $114 billion (20%) of Medicare spending goes toward kidney disease care, according to CMS. Value-based programs were designed to reduce the cost of care to patients with CKD and improve the quality of care they receive, ultimately reducing hospitalizations and readmissions.

Nephrology Associates of Syracuse, P.C. makes sure every laboratory test ordered is necessary and that patients receive the appropriate when and where they needed it. An essential element of delivering value-based care is coordination.

“In general, Syracuse-based providers do a good job of coordinating care amongst hospitals and physicians from the moment of discharge until the patient returns to the clinician’s office,” Dr. Chaffin says. “But every step along the way could use improvement.”

One of those improvements is rooted in better communication, particularly with the release of ICD-10, the medical coding system that makes condition recordkeeping more specific. CKD coding is more fragmented, and diagnostic details require even more specificity. While certainly helpful for improving patient outcomes, inputting so much more data is time-consuming. To improve the speed and specificity of data entry, Nephrology Associates of Syracuse, P.C. modified its software. The IT improvement can now more accurately describe a patient’s condition, enhance the patient transition from hospital to office setting and improve the ability to predict potential expense and real-world risk of future events.

Identifying Risk of Rapid Decline

Until recently, clinicians who attempted to predict kidney function decline couldn’t be 100% certain. Nephrology Associates of Syracuse, P.C. now uses KidneyIntelX™, which provides sophisticated and precise data to help forecast rapid decline among their CKD patients. Primarily limited for use on patients with diabetes and those who are nephrotic, KidneyIntelX scores patients based on their risk of experiencing rapid kidney failure progression.

“Although we can use charts and graphs to look at the rate at which a patient’s creatinine is rising, you’re only estimating what [that future level] is going to be,” Dr. Chaffin says. “KidneyIntelX uses a set of newer, novel blood and urine tests to give better predictive values of whether someone is at high risk for kidney failure progression that will ultimately lead to a need for dialysis.”

To complement these new advancements, Chaffin says they are considering the value of offering genetic testing. For example, certain genes, such as apolipoprotein(a) in Black patients, are more common among those at highest risk for progressive CKD and they will eventually require dialysis. Even among patients experiencing mild kidney failure, the presence of certain genes increases the potential risk for future dialysis. Genetic testing can empower providers to further educate their patients to take control of their health in ways that may postpone the need for dialysis.

Smarter Patients Are Healthier Patients

The goal of kidney care is the same for both patients and clinicians: to find ways to maintain optimal kidney health throughout life. Reaching this goal requires medical expertise and patient participation.

“Patients are a key part of their own care team, and to play their role well requires appropriate and frequent education,” Dr. Azar says. “When patients know what’s going on and understand their disease, they tend to be more compliant and follow up.”

In the U.S., 9 of 10 people with kidney disease are unaware they have the condition. These same statistics are mirrored in Syracuse. When referred patients come in for their initial appointment at Nephrology Associates of Syracuse, 90% don’t know why they were referred by their primary provider. Dr. Azar says even among patients who have advanced kidney disease, an estimated 50% to 65% are unaware of their condition.

“This lack of education is striking,” he says. “So we try to shed some light on things.”

In many cases, diagnosis is the first bit of light shedding to take place. Since so many patients are generally unaware of their health problem, and are unfamiliar with kidney disease in general, education is the critical next step. Patients immediately receive education from their care team during each visit and are offered additional educational opportunities.

During CKD education classes, patients learn the specifics of their disease, what may happen to their kidneys in the coming years, available treatment options that are most likely to succeed, diet and lifestyle modifications and more. These one-on-one classes give patients the opportunity to learn at their own pace and engage with an advanced practice provider in person or online about their disease.

Patients who want to learn more can sign up for advanced education classes which go into greater depth on a variety of topics. Classes are also tailored to meet patient needs. They may learn the difference between hemodialysis and peritoneal dialysis, survival rates for their condition and other information that helps them get a firmer grasp on their health. Each educational session concludes with an opportunity for patients to ask clarifying questions that help ensure they’re understanding what they’ve learned and can put it into action.

“No matter what disease a patient comes to us with, we strive to make their lives better every day,” Dr. Chaffin says. “It’s why we’re here, and that united philosophy we follow drives everything we do.”

Nephrology Associates of Syracuse, P.C. diagnose and treat the following conditions:

  • Acute kidney conditions
  • Anemia management
  • Autoimmune disease of kidneys
  • Blood pressure management
  • Chronic kidney disease (all stages)
  • Diabetic nephropathy
  • Electrolyte abnormalities
  • Glomerulonephritis
  • Metabolic bone disease management
  • Polycystic kidney disease
  • Renal-related diabetes management
  • Renal transplant care, pre- and post-transplant

Nephrology Care Begins With Primary Care

With so many patients unaware of their kidney disease, many present to Nephrology Associates of Syracuse, P.C. with late-stage disease. As a result, nephrologists often have limited treatment options when a patient arrives for evaluation and therapy. An earlier diagnosis goes a long way toward changing that circumstance.

To increase the number of people diagnosed in the early stages of kidney disease, primary care providers should screen patients regularly. Annual blood and urine tests, especially for those with high blood pressure or diabetes, can detect kidney disease before it progresses.

However, early detection is not always sufficient, as patients may not understand, listen to or act on their provider’s advice. That’s why PCPs should do what nephrologists do: educate their patients until the education has an effect.

“When someone hears they have kidney disease, they may not pay attention or they may be in denial, because it’s a silent disease in the early stages,” says Antoine Azar, MD, nephrologist and internal medicine physician with Nephrology Associates of Syracuse, P.C. and Medical Director of the DaVita Dialysis Clinics in Syracuse and Ithaca. Because it doesn’t cause symptoms early on, Dr. Azar estimates more than 50% of PCP-referred patients neglect their initial nephrology appointment.

“Unfortunately, the majority come back in a year or two with worse kidneys and symptoms,” he says. “By that time, it may be too late to intervene.”

To combat this tendency to ignore kidney disease, patients must understand the severity of their problems and take appropriate action. For this to occur, clinicians should educate patients at each visit, underscoring the fact that they themselves are their best advocate for improved health.

Early Referral Improves Results

Declining kidney function commonly leads to dialysis, whether hemodialysis or peritoneal, in-home or at a dialysis center. When dialysis is insufficient or inappropriate, transplant becomes an option. In these cases, Nephrology Associates, P.C. providers refer patients to the nearest transplant center. They also prepare patients for their transplant and resume care when patients get discharged post-transplant.

But with an early referral, patients may eliminate the need for transplant. Studies have found patients who are referred to a kidney specialist prior to needing dialysis have reduced mortality. Providers are urged to continue referring patients when urine or blood tests indicate kidney disease.

Whether transplant or dialysis is necessary or appropriate, Nephrology Associates of Syracuse, P.C. has the expertise and experience to diagnose and treat all forms of kidney disease.

Satellite Services

When the COVID-19 pandemic exacerbated the need for convenient care, Nephrology Associates of Syracuse, P.C. adopted telemedicine technology, which they continue using to this day. Virtual medicine is not, however, the only convenience-enhancing approach they use.

Satellite locations throughout the area make it easier for those with kidney disease to receive the care they need, close to home. Nephrology Associates of Syracuse, P.C. satellite offices can be found in the following locations:

  • Camillus
  • Fayetteville
  • Fulton
  • Vernon

Additionally, nephrologists visit patients weekly at Crouse Hospital and St. Joseph’s Hospital and rotate through Central New York dialysis centers.

To refer patients to Nephrology Associates of Syracuse, P.C. in Syracuse or a satellite location, visit nephrologysyracuse.com/contact or call 315-478-3311

Excellus BlueCross BlueShield Advances Maternal Health Equity

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By: Becca Taurisano

Childbirth is inherently risky, but for minority women, it can be life-threatening. Consider the birth experience of global tennis star Serena Williams. Williams had a history of pulmonary embolism and, while recovering in the hospital after giving birth via c-section, she had difficulty getting her providers to acknowledge her symptoms. After repeatedly advocating for herself, doctors eventually found several small blood clots in her lungs and administered life-saving treatment. Sadly, hundreds of women each year are not as fortunate.

To advance health equity for all and address implicit bias and structural racism in health care, Excellus BlueCross BlueShield appointed Gina Cuyler, MD, as vice president of health equity and community investments in November 2021. A graduate of the University of Rochester School of Medicine and Dentistry, Dr. Cuyler is a board-certified internal medicine physician who is passionate about improving health outcomes for everyone. Using a cross-functional, data-driven approach, Dr. Cuyler is working to embed health equity across every aspect of Excellus BlueCross BlueShield’s organization and addressing maternal health disparities is one of her top priorities.

Maternal health is the continuum of care that includes the time before pregnancy, pregnancy itself, and one year postpartum. The health conditions of mothers before pregnancy impacts maternal and child health outcomes and, under Dr. Cuyler’s leadership, Excellus BCBS is working to address negative outcomes such as severe maternal morbidity (SMM). The U.S. Centers for Disease Control and Prevention defines SMM as “unexpected outcomes of labor and delivery that result in significant short- or long-term consequences to a woman’s health.” The many drivers of maternal health include socioeconomic status, access to maternal health providers, geographic location, structural racism and implicit provider bias.

“Women of color are particularly at risk for negative maternal health outcomes independent of socioeconomic status, education or other factors. A Black mother with a college education is likely to have worse maternal health outcomes than a White mother without a college education,” notes Dr. Cuyler. A Blue Cross Blue Shield Association study on racial and ethnic disparities in maternal health revealed that preexisting health conditions, such as hypertension, diabetes and asthma, strongly correlate with higher SMM. The study found that Black women ages 35-44 have a 66% higher rate of SMM and are more likely to suffer pregnancy-related complications than white women in the same age range. The U.S. maternal mortality rate is the highest among similarly developed countries, with 17.4 deaths per 100,000 live births. “With all of the wealth, resources and knowledge in our country, we must do better,” says Dr. Cuyler.

Maternal health affects more than just mothers and their babies, but the community as a whole. When pregnancy complications arise, premature birth, low birth weight and prolonged stays in neonatal intensive care units increase as well. There is a societal cost when maternal health is not a top priority, says Dr. Cuyler. From the family members who suffer the loss of their loved one, to employers and co-workers bearing the burden when a parent has to take time off to care for their child, or worse, when an employee dies from pregnancy complications, maternal health affects families, businesses and communities. “It has a comprehensive impact on everyone,” Dr. Cuyler says, “we all bear the cost.”

Dr. Cuyler is addressing the drivers of higher SMM in a data-driven way. “Health equity work requires metrics,” Dr. Cuyler says, “you can’t manage what you can’t measure and you can’t measure what you can’t define.” After creating a health equity strategy for Excellus BCBS, Dr. Cuyler brought on health equity data analysts to help her capture and analyze the metrics required to determine actionable solutions. Collecting robust data is also dependent on identifying the attributes of the people in underserved communities, and that requires patients to submit complete attribute information so they can be identified appropriately in the data.

The COVID-19 pandemic highlighted health disparities in our nation, especially for people of color and, Dr. Cuyler says, the narrative surrounding health equity is expanding. Aligning with the health equity frameworks of New York state, the National Committee for Quality Assurance and the Centers for Medicare and Medicaid Services, Excellus BCBS is advancing equity along with quality in the healthcare arena. Dr. Cuyler’s goal is to embed health equity in every part of the organization. “Health equity is an enterprise initiative and we work in a cross-functional manner. I have deputized an army of ambassadors in our organization to understand how their work contributes to being able to provide meaningful health outcomes and improve health equity for all.”

In October 2022, Excellus BCBS announced the first round of recipients of Member and Community Health Improvement (MACHI) grants to address SMM and related health equity issues in upstate New York. Eight non-profit organizations were selected within the Health Plan’s 39-county service area to share $1 million in grant funding over the next three years. “We assembled a cross-functional, interdisciplinary team to determine these grant recipients to address depression, education, safety, lactation and homelessness,” says Dr. Cuyler, “we are very excited about the opportunity to impact at multiple points of the maternal health care continuum.” Additionally, Excellus BCBS provides bias in maternal health training to health providers in the region through a partnership with the March of Dimes.

Health equity is personal for Dr. Cuyler. Born in Panama, she immigrated to the United States with her mother when she was a young girl (her father died when she was two years old). Dr. Cuyler recounts an experience at a public hospital in New York City after her mother burned herself cooking. For over 16 hours, they sat in “a room full of black and brown people in agony. I realized that for some people, the health care system isn’t always equitable or kind,” Dr. Cuyler recalls.

Dr. Cuyler states that many patients have better health outcomes when a provider shares the same attributes of a patient population (race, gender, language, cultural background), and thus, she co-founded the Black Physicians Network of Greater Rochester, an organization whose mission is to reduce health disparities and improve the health of the community by increasing the number of black physicians. “I do believe it helps for you to see a physician that came from the same circumstances,” says Dr. Cuyler, “I am passionate about mentoring because I didn’t have a mentor. I had to figure everything out the hard way.” 

Dr. Cuyler wants every single person in the United States to have access to equitable healthcare and, to achieve that, she wants every person to ask themselves what they are doing to advance health equity in their sphere of influence. For those in the health care community, it is important to build trust. “Today we are committed to doing better not just for some but for everyone. We want to help patients feel engaged, educated and empowered, and for health care providers to understand how important they are in advancing health equity,” says Dr. Cuyler, “everyone has a role to play.”

Health equity is when each person has a chance to have optimal health. – Gina Cuyler, MD

At the end of the day, we have to make sure we are making progress in maternal health equity because the stakes are so high. – Gina Cuyler, MD