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ABSTRACT New York City Health + Hospitals is the largest safety-net health care delivery system in the United States. Before the coronavirus disease 2019 (COVID-19) pandemic, NYC Health + Hospitals served more than one million patients annually, including the most vulnerable New Yorkers, while billing fewer than five hundred telehealth visits monthly. Once the pandemic struck, we established a strategy to allow us to continue to serve our existing patients while treating the surge of new patients. Starting in March 2020, we were able to transform the system using virtual care platforms through which we conducted almost eighty-three thousand billable televisits in one month, as well as more than thirty thousand behavioral health encounters via telephone and video. Telehealth also enabled us to support patient-family communication, postdischarge follow-up, and palliative care for patients with COVID-19. Expanded Medicaid coverage and insurance reimbursement for telehealth played a pivotal role in this transformation. As we move to a new blend of virtual and in-person care, it is vital that the major regulatory and insurance changes undergirding our COVID-19 telehealth response be sustained to protect access for our most vulnerable patients.
New York City Health + Hospitals is the largest safety-net health care delivery system in the US, serving more than one million New Yorkers across eleven hospitals and more than sixty community health centers. More than 70 percent of NYC Health + Hospitals' adult population is insured by Medicaid or has no insurance. This population is one of the most ethnically diverse in the country. Furthermore, NYC Health + Hospitals is the leading provider to many of New York's most vulnerable populations, including homeless patients (more than sixty thousand shelter residents), justice-involved
patients (more than forty thousand hospital admissions annually), and people living in NYC public housing (more than four hundred thousand residents). The tsunami of coronavirus disease 2019 (COVID-19) cases revealed that our vulnerable patients disproportionately bore the burden of the devastating health and economic impacts of the pandemic. As our health system faced an overwhelming volume of inpatient admissions, as well as the need to temporarily close some of our clinics, we turned to telehealth solutions to help maintain existing operations while responding to the new demands associated with COVID-19.
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