Reports, Newsletters, and Presentations

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Defining Essential Health Benefits: Federal Guidance and New York Options

Publication Date: 05.31.2012
Author: Peter Newell

Fifth in a series of reports on the Accountable Care Act, this report explores options for New York policymakers in determining what essential health benefits will be required for all individual and small group policies beginning in 2014.

Implementing Long-Term Care Reform in New York's Medicaid Program

Publication Date: 02.27.2012
Author: Sarah Samis, Andrew Detty, and Michael Birnbaum

One of two jointly released Medicaid Institute reports examining implementation of Medicaid policy changes in New York, this report explains and considers potential strategies and options for improving the management of long-term care services for elderly and disabled Medicaid beneficiaries, and addresses the issues of balancing residential and community-based long-term care, refining reimbursement for long-term care services, and providing effective care management.

Implementing Behavioral Health Care Reform in New York's Medicaid Program

Publication Date: 02.27.2012
Author: Elizabeth M. Patchias and Michael Birnbaum

One of two jointly released Medicaid Institute reports examining implementation of Medicaid policy changes in New York, this report explains the roles and responsibilities of newly authorized regional behavioral health organizations; discusses the long-term challenges of integrating behavioral and physical health care delivery; and considers how the State might measure effectiveness of care.

Passive/Active: Defining the Role for a Health Benefit Exchange in the Interests of New Yorkers

Publication Date: 12.19.2011
Author: Peter Newell and Robert L. Carey
A new Fund report carefully examines the roles New York’s health benefit exchange should play, ranging from a passive marketplace with the free market alone determining the quantity and scope of offerings, to an active purchaser. Fourth in a series of reports on the health benefit exchange.

New Directions

Publication Date: 12.06.2011

New directions. Innovation. Fundamental change. Those imperatives are an essential part of the Fund's work, as highlighted in the 2011 annual report.

Measuring Quality for Complex Medicaid Beneficiaries in New York

Publication Date: 12.05.2011
Author: Alice Lind, RN, MPH

This Medicaid Institute report points to the importance of quality measurement for Medicaid beneficiaries with complex needs — specifically those with multiple chronic conditions, behavioral health conditions, and long-term care needs — as a means of improving care but also as a tool to advance the state’s strategies of reimbursement reform and service delivery redesign for vulnerable and high-cost populations.

Antimicrobial Stewardship Toolkit

Publication Date: 09.30.2011
Author: Greater New York Hospital Association/United Hospital Fund

This toolkit is intended to provide a basic framework for developing and implementing an antimicrobial stewardship program at a hospital or long term care facility. 

Two into One: Merging Markets and Exchanges under the Affordable Care Act

Publication Date: 09.14.2011
Author: Peter Newell and Bela Gorman
This Fund report focuses on two discretionary decisions New York faces under the Affordable Care Act: first, merging the health benefit exchanges for individuals and small businesses, and second, merging the individual and Small Group markets. Through analysis of different scenarios, the report presents estimates of the premium change that would result from setting rates for these populations based on the combined experience of individuals and groups.

Health Insurance Coverage in New York, 2009

Publication Date: 09.09.2011
Author: Juliana Macri, Emily Lawton, Christine Coyer, Victoria Lynch, Genevieve M. Kenney, Peter Newell, and Andrew Detty

This edition of the annual chartbook quantifies differences in insurance coverage and uninsurance around New York State and within New York City. Data are broken down into 14 separate regions across the state, including the five boroughs of New York City. Within the city itself, estimates are provided for 55 separate neighborhoods.

Medicaid Prescription Drugs: Purchasing and Management

Publication Date: 07.05.2011
Author: Shawna Kittridge, J. Carmelina Rivera, Kristin Coyle, and Michael Zucarelli

This report explores the technical and policy decisions states can make when purchasing and managing prescription drugs in today’s Medicaid environment. It identifies best practices from around the nation and examines New York’s Medicaid prescription drug program in particular. The report also lays out how federal health reform affects the Medicaid drug benefit.

Implementing Health Care Reform: External Review of Health Plan Decisions

Publication Date: 05.20.2011
Author: Mark Scherzer, Esq.

This issue brief recommends changes for New York's highly regarded External Review program, which allows consumers to appeal health plan benefit denials before impartial medical panels.

Coordinating Medicaid and the Exchange in New York

Publication Date: 05.16.2011
Author: Danielle Holahan
Second in a series focused on New York's health exchange, this report describes the steps necessary to integrating New York's Medicaid program and health insurance exchange.

The Big Picture III: Private and Public Health Insurance Markets in New York, 2009

Publication Date: 04.13.2011
Author: Peter Newell and Allan Baumgarten

The Big Picture is the Fund’s series of yearly reports that highlight enrollment and financial results in New York’s public and private insurance markets. According to this installment, total premiums paid by government, individuals, and businesses for public and private insurance coverage approached $50 billion in 2009, a 7.5 percent increase over the previous year. The report examines factors contributing to increased profitability and considers the state’s forthcoming challenges related to structuring a health insurance exchange.

The Adirondack Medical Home Demonstration: A Case Study

Publication Date: 03.10.2011
Author: Gregory Burke and Sean Cavanaugh

This report describes the development and early successes of the Adirondack Medical Home Demonstration, and draws lessons that may be useful to other regions of the state and the entire nation.

New York Medicaid Beneficiaries with Mental Health and Substance Abuse Conditions

Publication Date: 02.15.2011
Author: Teresa A. Coughlin and Baoping Shang

This report paints a detailed picture of New York's Medicaid beneficiaries receiving care for mental health and substance abuse conditions—who they are, what kind of services they regularly seek, and how they differ from or resemble other Medicaid beneficiaries not receiving the same kinds of care.

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