## Overview NYC Health + Hospitals (NYC H+H) is the largest municipal health care system in the United States, serving as a vital safety net for more than one million New Yorkers annually across all five boroughs of New York City[1][3]. The organization operates a comprehensive network that includes 11 acute care hospitals, five long-term care facilities, six diagnostic and treatment centers, over 70 community-based Federally Qualified Health Centers (Gotham Health), a certified home health agency, correctional health services, and the MetroPlus Health Plan—a managed care option for low- and no-cost coverage[2][4][6]. With a workforce of roughly 45,000, NYC H+H is committed to providing high-quality, culturally responsive, and equitable care to all, regardless of ability to pay, immigration status, or gender identity[1][3]. ## History Founded in 1969 by the New York State Legislature as a public benefit corporation, NYC H+H was created to operate and improve the city’s public hospitals, which had faced significant challenges in funding and quality in the preceding decades[1][5][6]. Its oldest facility, Bellevue Hospital, dates back to 1736 and has been a pioneer in medical education, psychiatric care, and trauma services[1]. Over the 20th century, the system expanded to meet the growing and diverse needs of New York City’s population, especially after the introduction of Medicare and Medicaid in 1965, which initially strained but later helped stabilize public hospital finances[1]. ## Key Achievements NYC H+H has earned national recognition for its commitment to health equity, ranking #2 nationally in health equity and #3 in pay equity[6]. Its hospitals are repeatedly recognized for trauma care, behavioral health, maternity services, and culturally competent care, including designations as LGBTQ+ Healthcare Equity Leaders and Baby-Friendly hospitals[2]. The system’s Gotham Health network focuses