Empowering Health Care Consumers

Grantee Name

Community Catalyst 

Funding Area

Empowering Health Care Consumers

Publication Date

June 2024

Grant Amount


Grant Date:

July 2021 – January 2023

Across New York State and the country, acute care hospitals have closed or downsized, while others have merged into large regional health systems.

Consolidation in New York’s health care delivery system is raising concerns about reduced competition and consumer choice, exacerbated barriers to care and other inequities, and higher prices. Despite the stakes involved with provider consolidation, affected patients and communities have little say in New York State’s regulation of health facilities, including the Certificate of Need (CON) process, which governs the establishment, construction, and renovation of health care facilities. In 2021, NYHealth awarded the Hospital Equity and Accountability Project (HEAP) of Community Catalyst a grant to develop models for consumer engagement in the State’s CON process, building upon earlier grants to Community Catalyst in  2016,  2017, and 2020. Under this grant, HEAP worked with a team of New York State consumer health advocates to empower affected patients and community members to make their voices heard during hospital consolidation decision-making.

Outcomes and Lessons Learned

  • Provided technical assistance and peer learning opportunities to local coalitions across New York State, including in the Bronx, Lower Manhattan, Mount Vernon, and Schenectady. 
  • Supported coalitions of patients, community members, faith leaders, and clinicians to engage the community through rallies, town halls, and conversations with hospital executives and State regulators; lead community health needs assessments; and submit analyses to the New York State Department of Health.  
  • Garnered media attention in print, radio, and television outlets (including Crain’s New York, Politico, and Spectrum NY1), shining a light on consolidation proposals and patient and community concerns.
  • Fielded and analyzed community surveys to assess merger implications for patient access, equity, and care quality. For example:
    • In the Bronx, trusted community-based organizations and faith leaders surveyed residents about their satisfaction with the care they received after a local health system’s clinic consolidation. 
    • In Schenectady, a survey of more than 400 residents revealed differences between the health care experiences of people in marginalized communities (including people of color and those with low income) and those in less marginalized communities. 
  • Had a tangible impact on hospital merger deliberations:
    • Testimony from local coalition members in Lower Manhattan described limited community engagement and potential adverse effects of a proposed merger on people with disabilities. This testimony led the State oversight body, the Public Health and Health Planning Council (PHHPC), to vote against the merger.  
    • In response to community concerns of reproductive health service discontinuation in Schenectady, hospital executives changed plans from a full merger to a shared management agreement that proposed to maintain the majority of services.
  • Created a toolkit for other communities to replicate this organizing and advocacy. This resource includes practical steps and templates to form community coalitions, organize community forums, assess community health needs, engage the media, and raise concerns with government regulators. 
  • In partnership with the Community Voices for Health System Accountability (CVHSA) coalition, successfully advocated for and informed implementation of a requirement for hospitals submitting merger proposals through CON applications to include independent health equity assessments. 
  • Also in partnership with CVHSA, helped secure a second consumer representative on the PHHPC, ensuring that more consumers are at the table as consolidation decisions are being considered in New York State.  

In 2024, amid high-profile, controversial proposals to close hospital sites including SUNY Downstate, Beth Israel, and St. Catherine of Siena Hospital, both houses of the New York State legislature passed a bill that would require public notice and public engagement when a general hospital seeks to either close entirely or close a unit that provides maternity, mental health, or substance use services.  

Co-Funding and Additional Funds Leveraged: N/A