NYSHealth Launches Insurance Coverage Consortium

December 12, 2007

With an estimated 2.2 million New Yorkers lacking health insurance—nearly 15% of the population—a number of organizations are seeking solutions to a problem that most experts agree represents a dire crisis. The New York State Health Foundation (NYSHealth) has sought to take a different route to success by bringing a group of leading institutions together in a "coverage consortium."

Funding a set of institutions across New York State, the consortium enables NYSHealth, key organizations, and decision-makers to work together on solutions and action steps necessary for expanding health care coverage.

The five consortium members—Columbia University’s Mailman School of Public Health, The Manhattan Institute, the United Hospital Fund (UHF), the Rockefeller Institute of Government, and Cornell University’s Department of Policy Analysis and Management—will work collaboratively to study the extent of the problems of health care coverage in New York State. Additionally, the consortium will assess coverage expansion proposals by convening a series of advisory groups and workgroups composed of health care experts, stakeholders, and analysts. Consortium members will gather and develop public-opinion data from New York State residents about the condition of health care coverage, providing important information about the awareness of problems with insurance coverage in the state and reactions to numerous options for reform.

Most important, consortium members will assess a set of possible actions to expand public and private coverage in New York State based on the comprehensive information gained from the advisory groups and workgroups, public opinion data, conferences, and research. These assessments will include projections on cost, coverage, and consequences of each of the options, providing an invaluable asset for policymakers.

James Knickman, NYSHealth President and Chief Executive Officer, noted that the consortium will offer a unique opportunity for a diverse group of experts to work together and find common ground and common solutions for the coverage problem.

“There is strength in numbers. With this consortium, we are bringing together some of the best minds in New York State to find real solutions to our health insurance coverage crisis.”

Knickman added that NYSHealth is in a unique and propitious position to organize these institutions in this effort. Because NYSHealth is a conversion foundation (established to receive the charitable funds resulting from the conversion of Empire Blue Cross Blue Shield from a nonprofit to a for-profit corporation), Knickman said its central role as a convener of institutions affords it flexibility and neutrality that many advocacy organizations cannot achieve.

Last December, the United Hospital Fund (UHF) joined with The Commonwealth Fund to publicize the Blueprint for Universal Health Insurance Coverage in New York, modeling a series of policy options for achieving near universal coverage, including projections of how many new persons would be insured, at what cost, and how that cost could be shared among individuals, employers, and government.

James Tallon, President of the United Hospital Fund of New York, plans to take advantage of the coverage consortium to continue the work of the Blueprint by analyzing a multi-staged “action plan” to promote the expansion of insurance in New York State. Tallon hopes to modify and refine the universal coverage scenarios presented in the original Blueprint as well as model alternative approaches.

“The Blueprint was a critical first step,” Tallon said. “The great thing about the consortium is that it will enable us to work with partners to build on its success.” Tallon said UHF would work with the Rockefeller Institute to develop an in-depth analysis of the individual and small group insurance market to identify opportunities for reform.

Peter Newell, former Executive Director of the New York State Assembly Committee on Insurance and now a Senior Health Policy Analyst with United Hospital Fund, says initiatives like NYSHealth’s coverage consortium are essential to the development of successful health policy.

“The key thing to remember about health care policy is that it requires at least a baker’s dozen of completely different groups—from doctors to hospitals to government to the insurance industry—all working together,” said Newell. “The idea that you could come to a solution without all of these groups working together is simply not realistic. And the great thing about this consortium is it will have some of the best minds in New York State, all with different backgrounds and experiences in health care, working together to try to find options for reform.”

Following the achievements of the Blueprint, Dr. Kosali Simon, a Professor at Cornell University’s Department of Policy Analysis and Management and a member of Cornell’s project team, says Cornell University plans to partner with Columbia University to develop alternative strategies for expanding coverage in the state and to identify the unique characteristics of New York’s health system that could affect the success of any given reform proposal.

“The idea will be to monitor public opinion on a variety of proposals for reform in order to gauge what is most popular with New Yorkers and, in turn, what is most realistic,” Simon said. “The focus groups that we convene in upstate New York, along with Columbia’s downstate groups, will provide invaluable information for policymakers about what New Yorkers want in their health care reform.”

Dr. Olveen Carrasquillo, a Professor of Health Policy and Management and of Medicine at Columbia University, said his team plans to draw heavily on the information gained from the focus groups, developing a comprehensive “menu” of reform options for policymakers to choose from and debate. In addition to the public opinion research, Carrasquillo said, his team plans a four-stage project that will develop coverage options, forecast cost and coverage implications, identify key New York State-specific concerns and, finally, host a conference based on the research gathered.

One of the key goals of the consortium will be to analyze the successes and failures of other states’ efforts in the coverage arena. The Rockefeller Institute of Government plans an extensive review of states’ experiences with coverage reform, especially in the area of small group reform.

“We’ll be able to learn enormously from the experiences of other states,” said Courtney Burke, Director, New York State Health Policy Research Center. “States have always proven to be priceless laboratories in legislative and administrative reform. With many states exploring small group insurance market reform as an option, our team will collect and synthesize information to inform policymakers here in New York about options in our State.”

As part of the consortium’s efforts, the Manhattan Institute will convene two conferences through the Institute’s Center for Medical Progress. In line with the other projects, the conferences will review who goes without insurance coverage in New York State and what regulatory and market changes might allow them to be served at a price they can afford. But Dr. Paul Howard, a Senior Fellow at the Center for Medical Progress, says the conferences will also enable widespread discussion among a variety of health care professionals, analysts, academics, and policymakers, involving them in the consortium’s activities.

“In many ways, the conferences we convene serve as a perfect microcosm for what the consortium will accomplish, bringing a variety of diverse and brilliant thinkers together to determine the best possible opportunities for reform,” said Howard.

Since December 2007, the Foundation has made 2 additional grants under the Consortium to New Yorkers For Accessible Healthcare and Community Service Society of New York.

To learn more about consortium projects, link to the abstracts below: