Highly anticipated changes aimed at advancing health equity and improving care for 7.3 million New York Medicaid recipients are ready to be rolled out over the next few months, New York State Medicaid Director Amir Bassiri announced at United Hospital Fund’s annual Medicaid Conference on July 31.
Mr. Bassiri, speaking to more than 870 in-person and virtual attendees, said key entities that will help carry out the goals of the recently approved New York Health Equity Reform 1115 Waiver will be revealed in August and start work in October. Among these are a group of nine Social Care Networks that will facilitate access to health-related social needs (HRSN) services and a newly renamed Statewide Health Equity Regional Organization (SHERO) tasked with advancing the health equity and service delivery goals.
“Our goal is to achieve a more equitable and integrated delivery system—it starts with social care integration,” Mr. Bassiri said. “It is going to require innovation, partnership, and collaboration.”
Enhanced HRSN services covered under the 1115 waiver include housing support, nutrition services, transportation, and case management and will be targeted toward members with high health risks, such as substance use disorder, serious mental illness, or toward children with chronic conditions.
Other core components of the waiver focused on improving population health and strengthening the health care workforce are also in the pipeline for the next few months, Mr. Bassiri said. These include a Career Pathway Training Program that will begin in August, a student loan repayment plan slated for 2025, and a provision that will keep eligible children ages 0 to 6 continuously enrolled in Medicaid starting January 1.
Mr. Bassiri also laid out a timeline for a voluntary state-based alternative payment and service delivery model known as AHEAD. New York is applying for its downstate region to participate in the model this August and expects to receive federal approval in October, Mr. Bassiri said.
In line with the conference’s theme, “Shaping the Future of Care Integration,” the second keynote speaker of the day was Emma Sandoe, PhD, MPH, Medicaid director of the Oregon State Health Authority. Dr. Sandoe shared lessons Oregon has learned implementing its own 1115 waiver and her experience with a social care integration pilot project in North Carolina.
Oregon offered climate-related services to eligible members starting in March and plans to launch housing support in November and nutrition services in 2025, Dr. Sandoe said.
“It’s not a light switch,” she said. “You learn from an iterative process what the barriers are.”
Medicaid Conference attendees also learned how care coordination can help a specific population during a morning panel focused on perinatal and child health. Moderated by New York State Chair and National Board Member of the American Academy of Pediatrics Jeff Kaczorowski, MD, FAAP, the panel included Janice Krystal Ascencio, MD, MBA, FACOG, acting chair of Jamaica Hospital Medical Center’s Department of Obstetrics and Gynecology; Maja Castillo, MD, MHA, assistant vice president and pediatric medical director at HealthFirst; Madeleine Dorval-Moller, MSW, MPA, executive director of the Northern Manhattan Perinatal Partnership; and Katherine Piwnica-Worms, MD, MHS, assistant vice president of pediatrics at NYC Health + Hospitals.
Panelists noted that the 1115 waiver will provide a more sustainable way to integrate health and social care for pregnant people and children given that most current programs offering these services operate on temporary grant funding. Under the waiver, enhanced HRSN services are available for at-risk children under the age of 6, children with chronic conditions, foster care youth, juvenile justice-involved youth, those under kinship care, and pregnant people, including those up to 12 months postpartum.
“This waiver will save lives,” Ms. Dorval-Moller said, adding that capacity for these services will be a challenge. “I’m very grateful we are making the first step, but we need to work more to ensure health equity.”
In the afternoon, conference attendees heard about health start-up Cityblock Health’s coordinated care model, which offers primary health, behavioral health, and social care in seven states. The value-based care model has shown promising outcomes: a 20 to 30 percent decrease in avoidable emergency department utilization, a 20 percent decrease in behavioral health admissions, and improved patient trust and satisfaction scores, Cityblock Chief Health Officer Kameron Matthews, MD, JD, FAAFP, said.
“Social care is the beginning, the middle, and the end of our model,” Dr. Matthews shared in a fireside chat with UHF’s Senior Vice President for Policy and Program Chad Shearer. “The whole health model is focused on the priorities from the members’ lens, not our own.”
United Hospital Fund’s Medicaid Conference is made possible with the support of our sponsors: The Commonwealth Fund, Unite Us, Affinity by Molina Healthcare, Acentra Health, IBM Consulting, Equifax/Carahsoft, and New York State Technology Enterprise Corporation (NYSTEC).
“There is tremendous value in convenings like this one that bring together such a diverse group of stakeholders–state and local government, health care delivery systems, providers, community-based organizations, academics, policy experts, and Medicaid members,” said UHF President and CEO Oxiris Barbot, MD. “The opportunity to learn, ask questions, provide feedback, and foster innovation furthers our collective goal of strengthening and improving New York’s Medicaid program.”
See below for a video of the Medicaid Conference, and for slides from presentations at the event.