The health care industry in Westchester County is experiencing rapid growth like never before. There have been significant expansions at White Plains Hospital, Westchester Medical Center, and Northwell Health’s Phelps Hospital and Northern Westchester Hospital. These institutions are investing in new state-of-the-art services and infrastructure, promising patients improved access to advanced care without having to travel to New York City.
However, the rise of health care giants like Optum, which recently acquired Mount Kisco-based CareMount Medical and more than 80 other health care practices in New York State alone, raises concerns about the true impact of this growth in health care. Patients and professionals have voiced significant complaints, including a decline in care quality, increased bureaucracy, and erosion of long-standing doctor-patient relationships. Critics also highlight the pressure placed on physicians to prioritize efficiency and cost savings, often termed “profits over patients.” Many physicians have left large practices, resulting in a serious shortage of clinicians and longer wait times to see them.
As Westchester’s health care landscape transforms, this article examines whether the expansion ultimately benefits the community or introduces new risks — or both, perhaps.
Hospitals Expand Services and Square Footage in Westchester
White Plains Hospital (WPH) has been a member of the Montefiore Health System, comprised of 10 hospitals and more than 200 outpatient ambulatory care sites since 2015. Already a recognized leader in the health care system, WPH leveraged this partnership to strengthen the hospital’s ability to serve as a hub for advanced care.
Susan Fox, president and CEO of White Plains Hospital, says, “We have successfully partnered [with Montefiore] to bring an array of complex programs and procedures to the hospital. This includes advanced cardiac care, such as open-heart surgery, neurosciences, and cutting-edge cancer trials and treatments.”
In 2021, White Plains Hospital opened its nine-story, 250,000-square-foot Center for Advanced Medicine and Surgery, an outpatient facility adjacent to the original hospital building. Fox says that among the many services the center offers is a PET/ MRI (Positron Emission Tomography/Magnetic Resonance Imaging) scanner. “We are the first hospital in New York, outside of New York City, to have this technology that provides unparalleled imaging capabilities and is used in diagnosing several cancers as well as neurological conditions, like dementia, epilepsy, stroke, traumatic brain injury, and movement disorders,” she says.
Plans have been announced for a second expansion, a 500,000-square-foot addition to open in 2028, which will double the size of the hospital’s emergency department, create additional state-of-the-art operating rooms, and new inpatient hospital rooms, all private with single beds.
Located just a bit north of White Plains Hospital is Westchester Medical Center (WMC) in Valhalla, part of the Westchester Medical Center Health Network (WMCHealth).
In addition to WMC, there are two other hospitals on the Valhalla Campus (Maria Fareri Children’s Hospital and the Behavioral Health Center) plus six hospitals in the Hudson Valley that also are part of the system.
WMC is home to one of the busiest and most comprehensive Level 1 trauma centers (the highest level of trauma care) in the Hudson Valley, treating patients ranging from gunshot wound victims to survivors of severe car crashes. The hospital is also recognized for its tertiary and quaternary care, serving the most acute-care patients in the region. For example, organ transplants and highly specialized surgical procedures (such as complex pediatric heart surgery or neurosurgical interventions for rare brain conditions) are performed at WMC.
According to Michael D. Israel, president and chief executive officer WMCHealth, the hospital recently broke ground on a new five-story, 162,000-square-foot Critical Care Tower. The project, which is expected to cost $220 million, will be funded mostly by tax-free bonds as well as a $25 million capital campaign. Located adjacent to WMC’s main tower, the facility will house 128 private patient rooms, all equipped with the latest and most advanced medical technologies for intensive care.
Phelps Hospital in Tarrytown and Northern Westchester Hospital in Mount Kisco, both part of Northwell Health (the state’s largest hospital network), also have grown significantly in recent years. Of particular note is the expansion of the maternity programs at both hospitals.
“Westchester has seen a growing focus on patient-centered care, which, in many ways, has resulted in the expansion of responsive facilities and the acquisition of top talent.”
— Jan Fisher, executive director of Nonprofit Westchester
David Seligman, deputy regional executive director for Northwell’s Western Region, says, “As the health system caring for more mothers and babies than any other in the state [approximately 3,000 annually], we are thrilled to introduce our refreshed, state-of-the-art, and private environment for expectant families at Phelps Hospital … [completion was set for the end of October 2024] and look forward to similarly modernizing our facilities at Northern Westchester Hospital in the coming years.”
In April, Phelps launched the Northwell Health Maternal Outcomes (MOMs) Navigation program, an initiative designed to provide resources, education, and social support to high-risk patients throughout their pregnancy and postpartum periods. According to Dr. Karen Murray, chair of obstetrics and gynecology at Phelps, the program is based on a recent study that aims to decrease preventable illness and death in medically complex patients, including those who suffer from diabetes and high blood pressure, as well as those experiencing socioeconomic risks and mental health issues.
Murray says, “This study underscores the program’s potential to address racial disparities in maternal care. It also highlights our commitment to providing equitable, high-quality care to all mothers in our community.”
Phelps also works with the Open Door Family Medical Center, a nonprofit organization that operates community health centers around Westchester and further north in the Hudson Valley. Open Door provides a vital service to the county, offering a range of medical, dental, and behavioral health services each year to more than 60,000 patients, most of whom live at or below the federal poverty level. According to Lindsay Farrell, president and chief executive officer of Open Door, “Our midwives deliver over 350 babies a year through our midwife program with Phelps.”
While the health commissioner of Westchester County was not available for comment, Jan Fisher, executive director of Nonprofit Westchester, which includes many health care organizations among its more than 300 members, says, “Westchester has seen a growing focus on patient-centered care, which, in many ways, has resulted in the expansion of responsive facilities and the acquisition of top talent. In addition, county residents no longer need to travel to New York City to receive the highest level of health care.”
The Corporatization of Health Care Is Rampant in Westchester
Hospitals, medical practices, and community health centers have grown enormously in Westchester in the past decade, and yet, they certainly have faced their share of struggles due to an aging population with rising demand for health care services — as well as a shortage of clinicians and support staff. However, nothing epitomizes the corporatization of health care in Westchester more than Optum’s acquisition in 2022 of CareMount Medical, headquartered in Mount Kisco. According to sources on lohud.com, when the group of 2,100 CareMount providers, serving 1.6 million patients throughout the Hudson Valley and New York City, joined Optum, they became part of one of the largest owners of medical providers in the country, with 53,000 physicians nationally.
On top of that, Optum is owned by UnitedHealth Group, one of the largest companies in the world. It should be noted that UnitedHealth Group owns UnitedHealthcare, the company’s insurance arm.
In a multipart series in The Examiner News critiquing Optum, publisher Adam Stone commented on a variety of complaints against Optum, including patients’ frustration with billing errors; difficulty in accessing timely medical care (including problems getting through on the phone to get appointments and longer wait times to see doctors); dismissals of patients for cases involving severe medical conditions or billing disputes; and high-profile departures and layoffs, including the exodus of between 10% and 15% of Optum’s primary-care physicians.
A female Briarcliff Manor patient who wanted to remain anonymous says, “I am a Medicare patient, and I saw that my ‘wellness visit’ to my primary-care physician had been billed at $225; it should be covered at no cost. When I called the billing department at Optum, I was told that my Medicare did not cover this bill as it was coded. When I asked to speak to a supervisor I was told, ‘There’s no supervisor here, plus everyone here will tell you the same thing.’”
The patient drove to her doctor’s office with her bill to get it sorted out. The receptionist there gave her the phone number of someone at Optum who worked with former CareMount patients (that person is no longer there for comment, and the company would not supply any information about a replacement), who was quickly able to access her bill and discovered that, while her doctor had correctly billed it as a “wellness visit,” Optum had miscoded it as an “annual exam.”
Another Optum patient, also a woman from Briarcliff Manor, complained about major delays in seeing her doctors. “I’ve been going to the same internist for several years. The last time I saw her, she told me she was leaving the practice and becoming a concierge doctor [more on that later]. It was too far for me to go to see her, so I asked the nurse to recommend another doctor. [The nurse] answered, ‘There are several doctors that would be good for you, based on your age, sex, and existing conditions, but they are all booked for over a year in advance.’”
And it’s not just large medical practices that are being acquired. Small practices are being purchased left and right…
This patient ended up seeing several physician assistants, and finally, was able get an appointment with a new internist. She says, “I was actually very pleased with the results.” However, as an anonymous retired Mount Kisco doctor warns, “Many patients cannot get in to see a doctor, so they will set up an appointment with a nurse practitioner or physician assistant. But, by seeing a midlevel practitioner, they risk that something rare or unusual could be missed.” He says, “I really call this the dumbing down of medicine.”
When asked for a response to criticisms about its clinical care and billing, Optum issued a statement from Dr. Jon Nasser, president and chief medical officer at Optum Medical Care, New York and New Jersey, that read: “Supporting our patients with compassionate and quality care is our highest priority. We appreciate the feedback we receive from our patients and care teams. The recent changes we have made to upgrade our telephone system and increase appointment availability have been well received and we remain committed to further enhancing our services to meet the evolving health care needs of the communities we serve.”
In addition, in a letter sent to Optum patients from Dr. Nasser, the recipients were told, “since 2023 we have hired more than 120 new clinicians in over 20 specialties” and “our teams have been focused on creating additional time slots both in person and virtually.” The company would not confirm how many of those clinicians were doctors and how many were nurse practitioners or physician assistants.
Optum also answered questions about billing issues by asking patients to call the number on their bill if they have any concerns. When asked about how patients could escalate a bill they did not agree with, the company shared that the best way to do so would be to send an email via the contact page on its website: east.optum.com/contact-us.
This is not the only case of this type of health care corporatization in the county. What was formerly WestMed Medical Group, with nearly 500 physicians and 1,500 clinical employees at sites across Westchester and Connecticut, joined Summit Health in 2022 — a medical network with more than 15,000 workers across five states.
And it’s not just large medical practices that are being acquired. Small practices are being purchased left and right in the county. For example, Hudson Valley Eye Associates (HVEA) in Hawthorne was bought out in 2023 by OCLI, one of the leading ophthalmology practices in the U.S. OCLI in turn, is supported by Spectrum Vision Partners (SVP), a management services organization that supports more than 50 ophthalmology practices, more than 130 doctors and surgeons, and five ambulatory surgery centers across five states.
When contacted for an interview on the acquisition, Greg Wappett, chief development officer for SVP, declined to comment, instead directing all inquiries to the OCLI online press release announcing the acquisition. The press release notes: “Hudson Valley Eye Associates is Spectrum’s 24th affiliation since 2017,” thus becoming part of “a multi-practice ophthalmology group with locations in New York, New Jersey, Connecticut, Pennsylvania, and West Virginia.”
While the press release quotes an HVEA doctor who is “excited to be joining the OCLI Vision team,” many patients are not as happy. One anonymous Ossining patient says in an August 7 email (provided by the patient): “Since I saw you [the eye doctor] on June 25, I have been trying to speak to someone in your office who can help me. Two employees assured me that they would find out and call me back. Since that last call I called four more times and left messages but no one ever answered.”
She goes on to explain the problem: “My new prescription is quite different than my existing script that I have been wearing, not just a bit of reading improvement like you indicated. I was not confident in the staff member who did my eye test. It was so fast, the fastest I ever had. I need to understand if this script is correct in order to get new glasses.” As of the date this article was submitted, the patient had not heard back from the office.
Concierge Care to the Rescue, for Those Who Can Afford It
Some doctors who are frustrated with case overloads and the “profits over patients” mentality at large corporate medical practices have left to go into concierge medicine. Concierge medicine is a membership-based health care service that pairs exclusive, personalized care with accessibility and convenience.
For a flat monthly fee with a concierge doctor, you get unlimited office and telehealth (phone, text, and videoconferencing) visits that last as long as you need, as well as direct care from a doctor. You also gain access to your doctors’ direct phone line for medical questions and simple diagnostic and blood tests in their office. And, if you have a major health problem, your doctor coordinates specialist referrals and hospital care as needed.
According to partnermd.com, “The average cost of concierge medicine is usually between $2,000-$5,000 annually. In major markets, you will find more expensive memberships. For instance, [a practice with] offices in New York, the Hamptons, Los Angeles, San Francisco, and South Florida has membership costs ranging from $3,500 per year to $10,000 per year.” With a membership fee, concierge doctors don’t have to see dozens of patients per day to make sure they get enough revenue from health insurance reimbursements for their practice to be sustainable. There usually is limited insurance cooperation and likely some out-of-pocket costs.
For a flat monthly fee with a concierge doctor, you get unlimited office and telehealth visits that last as long as you need…
Dr. Lori Solomon, who has operated a solo concierge practice in Dobbs Ferry for six years, says, “I practice family medicine, and I see all ages. I do preventative care, acute care, management of chronic conditions, and mental health services.”
Patients come to the office or have telehealth visits with Dr. Solomon, and she also makes house calls when needed. “I did a lot of COVID tests in people’s backyards during the pandemic, and I’ve also visited patients after they’ve come home from the hospital,” she says.
“The main thing for me is that I can level the number of patients I’m taking care of so that my patients have better access. If you’re taking care of 5,000 patients, then they might have to wait six to nine months for an appointment. If you have only 500, there isn’t much of a wait at all,” says Dr. Solomon. “In addition, there is no limit on the number of visits or how long the visit lasts.”
And So It Goes
As reported by the attorney general’s offices in Connecticut and New York, a proposed merger between the nonprofits Northwell Health and Nuvance Health was given the green light at the time this article was submitted. When all approvals are finalized, this merger will create one of the nation’s largest health systems, bringing together 28 hospitals and hundreds of other medical facilities serving New York and Connecticut.
Laura Joseph Mogil is a Briarcliff Manor resident and a frequent contributor to Westchester Magazine. She will probably be looking for new doctors in the near future.
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