Welcome everyone to the Becker's Healthcare podcast series.
I'm Mariah Muhammad, writer and moderator with Becker's
Healthcare. And I'm thrilled to have with me
today Irfan Karim, chief clinical operations officer at
NYC Health and Hospitals,
Bellevue.
Sari, welcome to the podcast. We're very excited
to have you join us today. To get
us started, would you mind please introducing yourself
and telling us a bit about your background?
Yes. Thank you. Thank you for having me,
Maria. My name is Irfan Karim. I serve
as the chief clinical operations officer at New
York City Health and Hospitals Bellevue. I've been
with New York City Health and Hospitals over
a decade, helping lead system wide initiatives
that span digital health, mobile care delivery, and
clinical operations across the largest public health system
in the country.
But before I was a hospital leader, I
was a patient. I'm a first generation immigrant
who grew up in the best place in
the world, Queens, New York.
Go next. My family and I relied on
Elmhurst Hospital as the only accessible source of
care day to day, as I was growing
up. We didn't have private insurance or financial
flexibility, so Medicaid and the public hospital system
weren't just a safety net. They were essential
lifelines
for us.
That personal experience informs how I approach health
care today, with the deep belief that access
to care should never depend on your income,
immigration status, or ZIP code.
Yeah. Absolutely. Thank you so much for giving
us that background. So,
with everything that you're focused on this year,
what are some of the biggest issues you're
following in health care for this year and
into next year?
Well, as of this morning, the big beautiful
bill passed the house. So one of the
most urgent issues,
is the threat to Medicaid reductions. At New
York City Health and Hospitals,
more than 450,000
patients relied on Medicaid as their primary insurance
in 2024,
and that includes hundred and 75,000
children 18,
nearly thirty eight percent of our Medicaid patients.
So Medicaid is not a marginal problem. It
is the backbone of care for some of
our most vulnerable neighbors.
I'm so closely following that.
I'm also closely following
how the health systems adapt post COVID. You
know, during the public health emergency,
temporarily,
Medicaid recertifications
were paused that increased access.
But since recertification has
seen a drop in Medicaid enrollment, especially amongst
adult children who may not realize they're eligible
or face administrative hurdles to stay covered.
So finally, we're watching the ripple effects across
core services. For example, Medicaid and uninsured patients
typically use the emergency medicine, emergency rooms,
OBGYN or maternal health services, being for health
and primary care. And if funding is cut,
these very services will be most impacted.
So we'll be adding nearly 10,000,000
additional uninsured patients,
in the country to the general populations.
And, also, more locally at Bellevue,
we had a recent closure of,
our neighboring community hospital, Mount Sinai in Beth
Israel, and that has intensified the demand for
our services, challenging challenging us to uphold the
same exceptional standard of care we've maintained for
nearly three centuries with additional patients coming on.
Wonderful. Thank you so much for giving us
that information. Yeah. I definitely read about that
this morning.
And I think that's one of the things
that's making me nervous. Is there anything else
that,
I guess, is making you nervous from the
news, or anything you're working on personally or
anything that's making you excited?
So, I mean, I think everything's not always,
in the negative. Right? I think we should
focus on positives as well. So I'm incredibly
energized by how we're reimagining
access through innovations such as virtual care, home
based care, juvenile health, especially for the Medicaid
population that I just spoke about with historically
face barriers to traditional brick and mortar systems.
But, again, the concern exists,
for our patients in the Medicaid funds. Right?
Seventy five seventy percent of our patients are
18, cover Medicaid.
Seventy percent of our inpatient discharges are covered
by Medicaid. Sixty percent of our patient visits
are covered by Medicaid.
So, you know, you can't just divest in
Medicaid without divest
disinvesting
in kids,
seniors, working families, and communities of colors.
And then I'm worried about how the economics
are impacted
for
our community. Right?
Over 80,000
patients of us, experience homelessness or housing insecurity,
and that includes 17,000
children.
So we need more, not less investment in
public health infrastructure. Right? Health and hospitals
has a workforce of seventy seventy thousand plus,
and our team members reflect our communities
and create almost 18,000,000,000 in economic activity as
does many hospitals throughout the country. So these
cuts are going to deeply impact the day
to day of patients' lives, but our communities
and our workforce.
Yeah. Yeah. Absolutely. Thank you so much for
giving us that info. And then last, lastly,
before I let you go, in your opinion,
what would the most effective health care leaders
need in order to be successful in in
the next two to three years, do you
think?
Great question. I think, I think every generation
said these are changing times, but the most
effective leaders will,
have to operate at the intersection of operational
discipline and social mission. They'll need to be
fiscally responsible while relentlessly
protecting the care of those who have the
least.
They'll need to champion innovations that extend beyond
the four wheels of the hospital that includes
mobile care, telehealth, community partnerships, but then they
still have to maintain the excellence across our
traditional delivery models. Right? It's additive,
not a replacement.
And finally, I think leaders must be policy
savvy advocates as health care today is deeply
shaped by legislation as we've seen this morning.
Preserving Medicaid, you know, it just isn't good
public health policy. It's essential
for millions of,
people throughout the country, nearly 80,000,000,000. Right? In
New York City, we serve nearly 1,000,000 New
Yorkers, with 6,000,000 visits, including 50,000
Medicaid covered births. So this isn't about abstract
numbers. It's about real people, real lives, and
a public system that reflects our shared value
as a country.
Absolutely. Thank you so much for those final
thoughts. It's definitely been a very informative discussion.
So, again, I wanna thank you so much
for coming on Becker's Healthcare, especially for the
first time, and I look forward to connecting
with you again soon.
Likewise. Thank you for having me.