How leaders would use an extra $100M in clinical work

If you were handed $100 million earmarked for clinical work, where would you invest it first?

This is the question Becker’s posed to two hospital leaders. Their responses come down to what kind of investment matters most to their community and their system.

Editor’s note: Responses have been lightly edited for clarity and length.

Chinyere Anyaogu, MD. Deputy Chief Medical Officer at NYC Health + Hospitals (New York City): With $100 million allocated specifically for clinical work to improve health care in New York City, the most effective approach would focus on scalable, high-impact interventions targeting underserved populations, reducing preventable diseases and strengthening care coordination. The top-level goal would be to create a replicable, data-driven clinical model that improves outcomes, reduces cost and addresses health disparities in New York City as a scalable pilot for the U.S. Here is the breakdown:

1. Establish a network of care to address persons who are high utilizers and who have fragmented, expensive care (approximately $40 million). This would include hiring interdisciplinary clinical teams, integrating behavioral health into primary care settings, upping language and cultural appropriate services and launching more mobile health units.

2. Implement a citywide digital platform that integrates with EHRs and Medicaid data (approximately $20 million). This includes a platform that can identify high-risk patients, coordinate care across hospitals, clinics and community organizations and offers AI-enabled care navigation assistance for patients and clinicians.

3. Launch a preventive care accelerator program (approximately $15 million) that features food-as-medicine clinicals, maternal health navigation for Black and Latina women, smoking cessation and mental health integrations through community organizations and partnerships.

4. Train and deploy 500 community health workers (approximately $10 million).

5. Fund an independent public health evaluation team with about $10 million that would track outcomes of the above programs, measure cost savings and equity improvements and develop a national replication playbook.

6. Use the remaining funds to build safe, affordable housing and employment opportunities.

Bill Bryant, BSN, RN. COO Whitman Hospital & Medical Clinics (Colfax, Wash.): Having worked for several organizations across the United States, the No. 1 identified community need in every location is mental health resources and particularly inpatient resources. The challenge with this as we consider the term “investment,” is that reimbursements for mental health care do not offset the cost of services. If utilized in this manner, the investment would be short term and limited to those that could be served until the resources ran out.

If considering the funds for “investment,” the more natural use would be to invest in imaging services or surgical services. Investing here would generate more revenue and allow the funds to be truly utilized as an investment that would sustain growth of services, staff jobs, community resources, etc. The challenge with this is it addresses an area that is already being addressed and where resources currently exist, but it would allow the funds to be utilized in a manner to create long term good.

The true answer to the question of utilizing earmarked funds lies in the term “investment.” If we are investing in the greatest need, the funds should be utilized for mental health services, which impact physical health and community health. If we are investing in the long-term good, investing in resource-generating areas like surgery or imaging will allow for more long-term use of the resources and will sustain more jobs, and provide more services. The short answer is the funds would need to be distributed proportionally to achieve all objectives to the extent possible. As with most healthcare questions, there is rarely a simple answer and often the answer can be as complex as the question itself.

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