Preparing for the New Normal


If there's one thread that runs through all of UHF's work, it's the knowledge that health care is in an extended period of flux. Our efforts must be more anticipatory, and responsive, than ever.

It's a “new normal” of ongoing change. Every aspect of our health care system is under review. Policy shifts are driving efforts to address longstanding challenges—paying for care coordination for the most complex patients, or lowering barriers between mental health and physical health care, or phasing out payment strategies that encourage more intensive interventions rather than prevention, to name just a few. These efforts have positive and ambitious goals, but implementation is a serious hurdle in a complex health care system. We are engaged in a constant search for strategies that can bring promising innovations quickly to scale.

In this rapidly changing environment, UHF remains focused on both trees and forest—the specific policies, populations, initiatives, programs, and innovators that drive change in specific areas of health care, and the complicated system that serves as their backdrop. We analyze, track, catalyze, and promote changes that will create a more integrated, patient-centered, and effective health care system, with program initiatives focused on three broad areas:

COVERAGE THAT PROMOTES ACCESS TO EFFECTIVE CARE
Our extensive work on health insurance coverage over the last decade has been reshaped to address the new realities of coverage subsidies and streamlined enrollment made possible by the Affordable Care Act. We are identifying the “who” and “why” of the remaining uninsured and focusing on easing the challenges to accessing health care still faced by immigrants, young adults, and others. We are looking at the future of coverage for children, and suggesting new alternatives as federal funding for the Child Health Plus program heads toward a sunset date. And we continue to examine Medicaid, the backbone of coverage for the poor and underserved in New York, for opportunities to modernize services and enhance the health outcomes achieved for the $60 billion that New York spends on the program each year.

QUALITY IN ALL HEALTH CARE SETTINGS
We continue to enhance our work to promote quality health care for New Yorkers. Our longstanding efforts to build quality improvement capacity in the “micro systems” of hospitals and clinics where patients are served are now complemented by a developing agenda, and a new Quality Institute, focused on the factors shaping the “macro system”—the policy environment, data systems, and payment approaches. Collaborating with providers and other stakeholders will be critical to ensuring that New Yorkers are engaged partners in their health care and get the right care when they need it, even as policy, payment, and delivery system configurations are changing around them.

SERVICES AND SYSTEMS THAT WORK BETTER FOR EVERY NEW YORKER
If our guiding vision is to shape positive change in health care for New Yorkers, direct opportunities for improvement are found in scaling and spreading promising innovations in services that are delivered across New York every day. Whether we are promoting “advanced primary care” that better manages chronic illness, integrates behavioral and physical care, and improves the patient experience, or developing and disseminating high-quality training materials for family caregivers, or working with community-based organizations to enhance their role in health and health care, our goal is to objectively assess the literature and lived experience, and to support the new approaches that make a difference for people.