Albany Med's plans in Greene and Columbia counties warrant scrutiny

To the editor:

As a former member of the Board of Trustees at Columbia Memorial Health, former member of its executive team, and a resident of Greene County, I have been following Albany Med's recent actions in Greene and Columbia counties with growing concern. Three actions in particular, in sum, warrant serious scrutiny from the communities they affect, and from state and federal regulators.

The Ambulatory Surgery Center

Albany Med is investing several million dollars to build an ambulatory surgery center at Greene Medical Arts in Catskill. While additional outpatient surgical capacity may offer some added convenience for local patients, it is worth asking whether this is the most pressing need facing Columbia and Greene counties. Emergency room capacity and inpatient hospital beds remain a greater priority for most rural communities. The more likely driver of this investment is market share; specifically, Albany Med's interest in capturing more ambulatory surgery volume from the Mid-Hudson Valley. That is a legitimate business objective, but it should be understood as such.

Behavioral Health Expansion

Albany Med has also announced plans to double the number of inpatient behavioral health beds at its CMH Hudson campus. At a time when many hospitals across New York State have been closing their behavioral health units, expanding that capacity is a worthy goal that I supported as a member the CMH team. However, there is growing reason to believe the primary motivation here is operational rather than community driven. By expanding behavioral health capacity in Hudson, Albany Med may be positioning itself to convert existing beds at its other locations to higher revenue medical-surgical use. So, while there may be some limited community benefit to the expansion at CMH, it may be secondary to Albany Med's broader strategic interests.

Critical Access Hospital Conversion

The most consequential and concerning proposal is the plan to convert the hospital to Critical Access Hospital status, which would require a significant reduction in inpatient beds. The intent behind Critical Access designation—supporting essential services in rural areas—can be sound policy. But the practical effect of this conversion deserves careful examination.

Albany Med's main campus is already operating under considerable strain. Its emergency department is experiencing extremely high volumes, and inpatient capacity is routinely stretched. Reducing inpatient beds in Columbia and Greene counties would direct more patients into that stressed system in Albany, potentially lengthening wait times and placing additional pressure on an infrastructure that is not well-positioned to absorb it.

Additionally, this conversion exacerbates the potential for significant patient shuffle. More Greene and Columbia locals will have to be transported to Albany for inpatient care, and more Capital Region patients will have to travel to Hudson for behavioral health care, impacting not just the patients but their families as well.

Residents of Greene and Columbia counties, and the broader Capital Region, deserve a full, transparent explanation of how the cumulative impact these actions improve, rather than diminish, local access to timely care. That rationale may exist. If so, it needs to be clarified and underscored. I can state with certainty that a primary goal of CMH’s affiliation with Albany Med was to improve local access to care; I was part of the CMH team that made that pledge.

These are not abstract policy questions. Given the confluence of these three actions, there is reason to question whether Albany Med views Greene and Columbia counties primarily as a community to be served, or as a resource to be leveraged in pursuit of its system-wide goals. Regulators must move very carefully, if at all.

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Bill Van Slyke

Catskill, NY

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The views expressed in letters to the editor are those of the author and do not necessarily reflect the official policy or position of Porcupine Soup.

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