As state lawmakers and Gov. Kathy Hochul negotiate a new budget, health care executives say officials need to start thinking now of what the future of medical visits will look like. 

And after two years of the COVID-19 pandemic, health care has changed in New York — and those changes for patients and providers alike could be permanent. 

"I think it all starts with this budget," said Bea Grause, the president of the Healthcare Association of New York State, an industry group. "So the funding needs to be in place, the promise needs to be in place."

It's a future that will likely mean even more emphasis on telemedicine, allowing patients to meet virtually with their doctor or health care provider. And Grause wants legislators to focus on how the budget should be shaped around that.  

"It may mean investing in technologies such as telemedicine so people can perhaps get care in their home and it's really about figuring how to deliver alternative care in safe settings," Grause said. 

But the biggest change for many health care providers themselves has been finding new workers. Many have retired, left the job because of fatigue from the crisis or were fired following the implementation of vaccine mandates. 

The end of a staffed bed crunch during the wintertime surge brought on by the omicron variant of COVID-19 has only brought on something of a temporary reprieve for hospitals and health care facilities in the state. For much of the winter, state officials curtailed elective surgeries and procedures in order to alleviate the staffing issues at hospitals. 

Though over, the surge in cases exposed how fragile the health care system has become.  

"The workforce piece was accelerated by the pandemic and because health care is fundamentally people taking care of people, that drives everything," Grause said. 

Hochul has called earlier this year for funding that would expand the state's workforce in the coming years when she outlined her first agenda in the State of the State address in January. 

"A once in a life time pandemic demands a once in a life response," Hochul said. "That's why I'm setting the ambitious goal of growing our workforce by 20% over the next five years." 

And what all this change means for the state budget is lawmakers and Hochul diving into the complexities of the state's Medicaid program to make sure the funding can match up. 

"There are some things that will change permanently," Grause said. "But we still have to plan for the future, we still have an aging population, we still have underserved communities. So there's a lot of investment that needs to happen today in order to plan for tomorrow."

The budget is expected to be approved by the end of the month.