ABSTRACT
The passage of the New York Prospective Hospital Reimbursement Methodology (NYPHRM) in 1982 was a milestone for New York State as it attempted to address several pressing problems related to the provision of hospital services. To deal with these issues, NYPHRM established a series of eight regional pools in New York State. The purpose of the regional pools was to limit the political liability of shifting money from upstate New York to New York City where most of the uncompensated care was provided. By the mid- to late 1980s, the Health and Hospitals Corporation (HHC) began to confront its identity as a provider of care to the poor. The HHC began to plot a strategy to provide improved primary care services to its patient population. This entailed the development of new primary care centers, the conversion of older, disease-specific clinics to primary care centers, and the reorganization of outpatient departments into primary care units.
