Important Publications

This set of guidelines, developed by the Center for Health Care Strategies for NYSHealth, is designed to help grant applicants think about and formulate a program evaluation as part of an NYSHealth grant proposal.

This Community Service Society report, supported by NYSHealth, outlines the coverage benefits for individuals and the cost savings for the State of establishing a state-run Basic Health Plan (BHP). In addition to providing more affordable coverage to nearly half a million New Yorkers, a BHP could also help some 100,000 uninsured residents gain access to insurance.

This NYSHealth-funded report by Health Care for All New York and the Community Service Society details the personal stories of families, small business entrepreneurs, senior citizens, and students across New York who have benefited from the Affordable Care Act.

This United Hospital Fund (UHF) report, supported by NYSHealth, examines the roles New York’s health benefit exchange should play, ranging from a passive market organizer model that relies on the free market alone to determine the quantity and scope of offerings, to an active purchaser model that would use leverage to get the best prices through a competitive procurement.

This Families USA report examines what effect the passage of the Affordable Care Act (ACA) will have on families in New York State.

This Taconic Health Information Network and Community (THINC) report, supported by NYSHealth, looks at the concerns and opportunities for health providers and commercial health plans to collaborate in implementing value-based payment models such as accountable care organizations (ACOs). Providers and health plans are being motivated by a growing sense that costs and budgetary constraints will inevitably require significant movement away from the fee-for-service model.

This NYSHealth report, developed by Empire Justice Center and the Community Service Society, untangles some of the key issues related to the Navigators and Consumer Assistance Programs designed to help individuals and small business enroll in and maintain health insurance coverage.

This United Hospital Fund (UHF) report, supported by NYSHealth, focuses on two discretionary decisions for New York involving the State’s new health benefit exchange: first, merging the exchanges for individuals and small businesses, and second, merging the individual and small group markets.

This NYSHealth report uses hospital discharge data to calculate hospital readmissions rates across all payers in New York State and explores quality improvement and payment reform strategies to improve care and bring costs down.

This Consumers Union report, supported by NYSHealth and the Missouri Foundation for Health, reviews findings based on consumer interviews and testing of a new health insurance disclosure form that will make it easier for consumers to understand their health plan options and associated costs.

This NYSHealth-supported toolkit is designed to get both grantees and funders to consider sustainability from the onset of their grant projects. It provides resources and tools to help integrate sustainability strategies and practices into all stages of the grant process.

This NYSHealth special report, Expanding Health Insurance Coverage for Sole Proprietors And Employees of Small Business: A Planning Process, contains a summary of findings from the 2008 NYSHealth request for proposals (RFP), “Expanding Coverage Options in the Small Group and Individual Market in New York State.” The report assesses a group of early Foundation investments that supported projects and policy analyses aimed at restructuring or strengthening the individual and small-group insurance market.

A new NYSHealth report, “Considerations for the Development of Accountable Care Organizations in New York State,” provides a framework for State officials and health care industry stakeholders to consider the policy issues raised by the development of Accountable Care Organizations in New York.

This NYSHealth special report, Improving Health Care Options in New York: the Experience of the Coverage Consortium, contains a summary of findings from an NYSHealth Coverage Consortium initiative that funded a set of institutions across New York State to work on solutions and action steps necessary for expanding health care coverage.

This United Hospital Fund report, supported by NYSHealth, examines the organizational improvements necessary to successfully integrate the State’s Medicaid program into the health insurance exchange.

This Urban Institute issue brief examines the challenges of health coverage enrollment and provides tactics for Federal policymakers to increase participation in health insurance programs created or expanded by the Affordable Care Act (ACA).

This report by Social Interest Solutions, conducted for NYSHealth, identifies the assets and deficits in New York State’s Information Technology (IT) readiness to implement health reform.

This NYSHealth-supported brief by Public Health Solutions examines how moving from a paper-based system to electronic applications can simplify the health insurance enrollment process for uninsured low-income individuals and families.

This Maxwell School of Syracuse University report, conducted for NYSHealth, examines variations within New York State for two expensive conditions: acute myocardial infarction and congestive heart failure.

This Manhattan Institute analysis, conducted with NYSHealth support, provides a vision of a market-based exchange in New York State, arguing that the exchange should function as a clearinghouse for all qualified health plans. Its recommendations include greater flexibility in insurance design, an expansion of age-banding to allow lower cost plans for younger and healthier enrollees, and a defined contribution mechanism for small businesses.

This NYSHealth special report, An Assessment of New York State Health Foundation 2007 Health Insurance Coverage Grants, summarizes enrollment results, project deliverables, and overall project outcomes of a grant initiative that sought organizations across the State to develop interventions that would improve the State’s enrollment and reenrollment processes, and that would help increase health care coverage for vulnerable populations. This initiative also aimed to expand private insurance coverage for the 1.6 million uninsured New Yorkers, at the time, who were not eligible for public coverage.

This NYSHealth special report, Making Public Health Insurance Programs Work Better: Partnering with The New York State Department of Health To Reform Medicaid, is part of an NYSHealth authorization that funded a series of quick-strike analyses to help the New York State Department of Health’s (NYSDOH’s) Office of Health Insurance Programs find ways to streamline and expand its public health insurance programs.

This NYSHealth-funded report by the Medicare Rights Center looks at the process for determining continued eligibility for Medicare Savings Programs (MSPs) in New York State. Medicare Rights Center worked with the New York Medicare Savings Coalition and others to assess the State’s MSP recertification processes and develop reform recommendations.

This NYSHealth-supported report by the Manhattan Institute examines retail clinics in New York State. According to this new report, retail clinics could help expand access to health care services, reduce inappropriate emergency room use, and lower health care costs.

This Medicare Rights Center report examines New York State’s efforts to help people with limited incomes who are eligible for—but cannot afford—Medicare to enroll in the program through the State’s Part A buy-in benefit.

This Rockefeller Institute brief reviews eight patient-centered medical homes (PCMH) underway in New York State. PCMHs have emerged as a team-based, primary care model that focuses on continuous and coordinated care. Core elements of this model include an ongoing relationship with the primary care doctor, increased access to care and services, and a value-based payment system. PCMHs are expected to result in comprehensive care and improved health outcomes for the patient, while reducing care costs.

Health insurance exchanges are the centerpiece of the public and private insurance reforms included in the Federal health reform law. This NYSHealth-supported report from the United Hospital Fund examines the critical, complex choices that New York State faces in establishing a successful exchange.

This United Hospital Fund report analyzes rates of service use and levels of spending per recipient across New York State, documenting variation by region and by county. To explain regional variation, it examines four interrelated factors—demographics, reimbursement policies, availability of service, and local administration.

This United Hospital Fund report examines elderly dual Medicare-Medicaid beneficiaries in New York City who are recipients of personal care, a type of Medicaid long-term care service which includes assistance with eating, bathing, and dressing, as well as activities associated with independent living such as shopping and meal preparation. The report provides a brief examination of those who received care during December 2008, and also profiles a cohort of beneficiaries first receiving the service in 2003 and follows them through 2008.

This report from the New York State Department of Health describes the current administration of New York Medicaid and provides short- and long-term recommendations for the State to develop and implement a plan for State administration of Medicaid in the next five years. This is the first step required by legislation enacted in June 2010 to transfer Medicaid administrative responsibilities from local counties to the State government, which will result in administrative efficiencies.

This Citizens Budget Commission (CBC) report conducted by The Lewin Group reveals New York State’s excessive spending for Medicaid, one of the largest items in the State budget—costing $50 billion annually—and a significant burden on local governments. The report identifies enrollment, provider payment rates, and utilization as the three factors driving Medicaid costs, and that all three should be addressed in cost-containment proposals. The report further recommends that a multi-year plan that focuses on restructuring the system to provide better health, better outcomes, and lower costs should be developed.

This NYSHealth-supported survey of more than 800 public and private employers, conducted by NORC at the University of Chicago between late 2009 and early 2010, reveals trends in New York State over time and compares New York State employers to employers nationwide. The analysis finds that the proportion of workers in New York State with employer-sponsored heath insurance has fallen dramatically over the last decade, to 58% from 69% in 2001, and now lags the national average (65%).

This United Hospital Fund-Medicaid Institute issue brief, Enrolling Childless Adults in Medicaid: Lessons from the New York Experience and Opportunities in Health Reform, provides information about the key characteristics and coverage patterns of childless adults in New York, shares lessons from a recent study of uninsured childless adults who are eligible for Medicaid, and provides policy considerations for increasing this group’s participation in Medicaid. While New York has been a leader in extending Medicaid eligibility to childless adults, its experience demonstrates that this is one of the hardest groups to enroll.

This NYSHealth-funded study, “Bending the Health Care Cost Curve in New York State: Options for Saving Money and Improving Care,” with technical appendix, conducted by The Lewin Group shows that New York State can curb health care costs by billions of dollars on its own over the next decade. With the support of the Federal government and the private sector, even greater savings could be realized.

These NYSHealth-funded materials, created by the Health Care of All New York (HCFANY), are one-page consumer education briefs highlighting how the new health reform law, known as the Affordable Care Act (ACA), affects small business owners, seniors, children, young adults, and women.

This NYSHealth-funded report, prepared by the New York State Health Policy Research Center analyzes Medicaid administration at the county level, in particular, determination of eligibility for Medicaid coverage of nursing home care. Legislation enacted as part of the 2010-11 New York State budget requires the State to assume control of Medicaid administration and costs from counties. Administrative costs for Medicaid are estimated at $1.1 billion annually. The report highlights steps the State could take to begin the process of centralization, as well as other ways to reduce costs both through administrative and policy changes.

New York State's nonprofit health centers as a whole are in financial distress, according to this report, “Health Center Financial Check-Up: Prescriptions for Strengthening New York’s Diagnostic and Treatment Centers,” supported by NYSHealth. The report, prepared by the Primary Care Development Corporation, analyzed seven years of financial data from 95 nonprofit diagnostic and treatment centers, and found that 43% lost money in all or most years, and margins fell from 2.28% in 2001 to 0.56% in 2007. On average, the health centers, which serve some 1.5 million mostly low-income New York State residents, were only one payroll away from full-scale financial distress.

This NYSHealth-funded report, prepared by Manatt Health Solutions and NYSHealth Visiting Fellow Deborah Bachrach, analyzes the key provisions of the Federal reform law, known as the Affordable Care Act (ACA). It finds that Federal health reform could expand health care coverage for an estimated 1.2 million people in New York State who are currently uninsured. It also projects the unique implications that each provision of the law holds for New York, and identifies the tasks and hurdles that State government and other stakeholders must confront when implementing reform.

This National Health Policy Forum report presents findings from an April 2010 site visit to New York City (NYC) that examined health care delivery for Medicaid beneficiaries and the uninsured in New York City’s hospital-dominated market. Site visit participants met with heath care experts to explore a range of topics, including the use of health information technology to improve care delivery and outcomes, community-oriented care and cultural competence, payment incentives and funding, and the effect of health reform legislation on care delivery for safety net providers and the patients they serve.

This New York City Office of Citywide Health Insurance Access (OCHIA) report summarizes the City and State programs, and administrative policies that have served as the groundwork for New York’s expansion in public health insurance (PHI) enrollment.

The Medicare Rights Center has released the report, Local Promise: Maximizing Enrollment into Low-Income Medicare Programs through State-Based Consumer Advocacy, which evaluates collaborative advocacy efforts to increase enrollment in Medicare Savings Programs (MSPs) in New York, Maine, Kansas, and Florida. MSPs are programs administered by each state’s Medicaid office that help people with low incomes pay their Medicare costs.

The Family Health Plus Employer Buy-In (EBI) program enables employers and union benefit funds to “buy-in” to New York’s popular Family Health Plus program, which has a comprehensive benefit package. The Community Service Society of New York has produced a policy brief, Three Steps to Affordable Health Coverage for New York’s Employers, which describes how restructuring the EBI program can provide affordable, comprehensive health coverage to employees of small businesses, other employers, unions, and sole proprietors in New York State.

Sustaining the insurance coverage expansion made possible by Federal health care reform will require containing health care costs. While philanthropy alone cannot resolve this issue, it has an obligation to take on seemingly intractable problems. On July 7, 2010, Health Affairs published an article coauthored by NYSHealth Senior Vice President David Sandman, “A Philanthropy Tackles Growth in Health Costs at the State Level.”

This United Hospital Fund report is a qualitative study of uninsured New Yorkers who are eligible for public coverage, but not enrolled. The study, which involved focus groups and interviews with professionals who work closely with this population, suggests ways to lessen obstacles in obtaining health insurance, including raising awareness about the importance and availability of health insurance, and simplifying the eligibility determination process.

This New York Primary Care Coalition report examines health care expenditures in New York State, and recommends investing in primary care to improve health outcomes and reduce costs. High rates of hospital use, emergency department use, and readmission contribute to the mounting health care costs, which are in excess of $160 billion each year and continue to rise. The report suggests that New York State could save at least $10 billion by investing in primary care.

This NYSHealth-funded, United Hospital Fund report, “The Big Picture Updated,” provides an analysis of more recent activity in New York’s private markets and public health insurance programs. It follows up on a report released by the United Hospital Fund in October 2009, “The Big Picture: Private and Public Health Insurance Markets in New York,” which provided a comprehensive review of New York’s commercial, Medicare, Medicaid, and self-funded insurance markets.

This Robert Wood Johnson Foundation report reviews the National Academy for State Health Policy’s initiative to assess the systems, policies, and processes for enrolling and retaining children in health coverage programs in New York State. With support from the Robert Wood Johnson Foundation, eight states—including New York—were selected to participate in this effort to increase enrollment and retention of eligible children in Medicaid and CHIP. These assessments reviewed each state’s reports and policies, and conducted onsite interviews with stakeholders and administrators in the children’s health insurance programs.

This United Hospital Fund report outlines the intricacy of cost-sharing devices applied in New York’s insurance market. As the cost of health coverage has increased, cost sharing has become a tool health plans commonly use to reduce annual premium increases but it also raises out-of-pocket costs.

Data show that while immigrants comprise 22% of New York State’s population (nearly 4.2 million immigrants) and 37% of New York City’s population, they are approximately three times more likely than citizens to be uninsured. A significant number of these immigrants are currently eligible for existing public health insurance programs; yet, they remain uninsured. This United Hospital Fund report seeks to uncover the barriers this population faces to maintain health insurance, the factors influencing their choices, and policy blueprints that help in increasing insurance enrollment among eligible immigrants.

This United Hospital Fund report describes trends in employer-sponsored and public coverage for New York City, New York State, and the U.S. Between 2007 and 2008, 15% (roughly 2.5 million) of New Yorkers were uninsured, and this data remained unchanged from the previous coverage assessment period (2006-2007). The uninsured rate among children declined to its lowest level in the decade, however, likely because of increases in public coverage. The uninsured remain disproportionately low-income, nonelderly working adults, 41% of whom are eligible, but not enrolled in public coverage plans.

Federal reform has the potential to extend health insurance coverage to many New Yorkers, but it largely leaves out noncitizens who are already less likely to be insured than citizens. This NYSHealth-funded study conducted by New Yorkers for Accessible Health Coverage and the New York Immigration Coalition, examines several factors contributing to high rates of uninsurance and outlines provisions to help fill the gaps that would be left by Federal health reform.

This United Hospital Fund report finds that while academic medical centers (AMCs) have the best financial performance of any category of hospitals in New York City, they have significantly lower operating margins than AMCs in other states. The report also found that New York City AMCs tend to have proportionately longer lengths of hospital stays, serve more Medicaid patients, provide fewer surgical admissions than their peers in other states, and operate in a more competitive marketplace.

This NYSHealth-funded report by the United Hospital Fund examines the impact that Federal health care reform and the issues it raises—including, funding for Medicaid, insurance market reforms, subsidies to ensure affordability, and a range of mechanisms to bring the nation closer to universal coverage—would have on New York State.

In 2008, the New York State Health Foundation supported the New York Immigration Coalition’s (NYIC) Health Collaborative, which provides education, communication and outreach skills to diverse immigrant-focused community based organizations (CBOs) that help immigrants access health care. The Collaborative included two legal services organizations and nine CBOs, representing the Latino, South Asian, Russian, Balkan, Korean, Haitian, and Filipino communities in New York City and Long Island. In this NYSHealth-funded report, the New York Academy of Medicine evaluated the activities undertaken by the Collaborative, their outcomes, and likelihood of sustainability after grant funding ends.

This NYSHealth-funded report by the Health Policy Research Center at the Rockefeller Institute of Government indicates that standardizing health insurance options is key to helping consumers compare plans and make informed choices. 

This United Hospital Fund report explores the use of third-party data matching as a strategy to simplify the enrollment and retention of eligible people in Medicaid and the Children’s Health Insurance Program (CHIP).

This NYSHealth-funded United Hospital Fund report combines a detailed analysis of health plan enrollment and financial results with a comprehensive review of how New York’s health insurance markets actually work and are governed by key statutes and regulations.

This report, issued by the Manhattan Institute, estimates the effect various market-based health insurance reforms would have on the number of uninsured in New York.

A new NYSHealth-funded report issued by the Health Policy Research Center at the Rockefeller Institute of Government and Harvard University reviews strategies New York State and other states could use to manage risk in the small-group and individual insurance markets, ultimately making health insurance more affordable and accessible. Using Massachusetts and potential Federal reform options as a guide, the report discusses considerations that would need to be addressed to implement such risk management strategies as insurance exchanges and insurance mandates.

This report, by the United Hospital Fund, shows that noncitizens represent a large and disproportionate share of New York’s uninsured population. Nearly 30% of the state’s 2.3 million uninsured people are noncitizens and noncitizens are three times more likely to be uninsured than citizens

This new analysis by New Yorkers for Accessible Health Coverage (NYFAHC) and funded by NYSHealth contrasts the approaches of New York's major commercial insurers to enrolling immigrant communities and finds that community credibility makes a difference. The most successful strategies integrated linguistically and culturally appropriate services with the marketing of coverage to immigrants. The report also suggests developing intermediaries between insurers and enrollees, or "connectors," that can establish group buying power and help consumers navigate coverage options.

This tool kit, prepared by the Research Foundation of SUNY, was designed to help refugees in the Buffalo, New York area enroll in health insurance. It includes guides to health insurance in six languages: Arabic, Burmese, English, Karen, Vietnamese, and Somali. Each guide contains information on the eligibility and documentation criteria of various programs, as well as contact information for where refugees and immigrants can enroll. This project is supported by a NYSHealth grant.

A new report released by the Small Business Majority compares the impacts of three health care reform scenarios on small businesses by applying the Gruber Microsimulation Model (GMSIM). Small businesses are struggling under the current health care system, and the report concludes that the reform options being debated in Washington will likely save small businesses money, protect wages and jobs, and encourage small business owners to reinvest in and grow our economy.

A new report issued by the Health Policy Research Center at the Rockefeller Institute of Government and funded by the New York State Health Foundation (NYSHealth) evaluates revenue and saving strategies the State could consider to confront the challenges of implementing universal health care coverage.

A new report issued by the Community Service Society of New York (CSS) and funded by the New York State Health Foundation (NYSHealth) finds that African Americans are more likely to be disenrolled from Medicaid.  More than 40% of all enrollees in New York’s public health insurance programs lose their coverage each year although many remain eligible. The analysis of Medicaid health plan data reveals that among racial/ethnic groups, African-Americans have the lowest annual retention rates (59%) while Asian/Pacific Islanders have the highest retention rates (65%).

A new report issued by the Community Service Society of New York (CSS) and funded by the New York State Health Foundation (NYSHealth) urges New York State to promote health equity more effectively through its popular public insurance programs. These programs—Child Health Plus, Family Health Plus and Medicaid Managed Care—serve nearly 3 million New Yorkers, approximately 30% of whom are African American, and another 37% are Latino.

New York State's Medicaid Excess Income Program (EIP) is bogged down by complicated processing requirements that lead to high costs and delays in much-needed coverage and care for patients, according to this NYSHealth-funded study conducted by Manatt Health Solutions.

This NYSHealth-funded survey conducted by PHI (formerly the Paraprofessional Healthcare Institute) finds that only 25% of home care workers employed by Upstate agencies have employer-sponsored health insurance.

In this NYSHealth-funded report, PHI advances recommendations to increase the number of home care workers enrolled in health insurance. The report recommends that New York State strengthen existing public health insurance options, including the Family Health Plus Buy-In option. It also recommends creating a new multi-employer benefit fund that would pool risks and contributions for home care workers across the State.

This Special Edition of the Medicaid Update highlights the reform measures advanced in this year’s Budget.

This NYSHealth-funded report was created by the Rockefeller Institute of Government. It analyzes the role of asset transfers in New York county officials’ decisions to deny Medicaid coverage for nursing home care.

In response to the growing number of New Yorkers who risk losing health
insurance coverage in the current troubled economy, the United Hospital Fund prepared this guide with support from the New York State Health Foundation.

Financial distress among health centers is grave and growing, according to initial findings unveiled in this NYSHealth-produced issue brief by the Primary Care Development Corporation.

This NYSHealth-funded issue brief by the Children’s Defense Fund – New York (CDF-NY) reviews public health insurance policies implemented in 2007 and 2008 that may have collectively influenced child and adult enrollment in 2008.

Approximately one-third of enrollees in New York State's public health insurance programs-Medicaid, Child Heath Plus, and Family Health Plus-fail to complete the annual recertification process and lose coverage despite remaining eligible, according to this NYSHealth-funded study conducted by Lake Research Partners. Some former beneficiaries manage to reenroll months later, resulting in a high churn rate that undermines efforts to provide continuous and stable health insurance to low-income New Yorkers.

New Yorkers for Accessible Health Coverage and the New York Immigration Coalition have produced an analysis of the potential impact of the nine leading proposals for health reform on immigrants. The NYSHealth-funded report is part of a broad analysis of how health coverage among immigrants can be increased.

A new study conducted by the Nelson A. Rockefeller Institute of Government, with funding from NYSHealth, compares New York State to 18 other large states on various aspects of long term care. Long-term care includes nursing facilities, care for the mentally retarded and mentally ill, and home and personal care. Comparison states include California, Texas, Florida, Massachusetts, New Jersey, Pennsylvania, and Ohio.

CHCANYS teamed up with the Empire Justice Center, the statewide legal services organization, to develop this handbook detailing health care coverage for immigrants.

This Columbia University report, funded by NYSHealth, models five plans to reduce the number of uninsured in New York State. The analysis indicates that the plans differ vastly in both their potential impact on the problem and costs. This is the first model to compare proposals on the basis of the number of people who would gain coverage; drop private coverage in favor of public options; and how each plan would increase statewide health care spending, including the cost to State government to finance expansions.

This Cornell University report, funded by NYSHealth, explores the opinions of New Yorkers on health care reform and summarizes the findings of a statewide survey of 475 employers and 1,200 residents.

This United Hospital Fund Report, funded by NYSHealth, models the effects of merging three segments of New York State’s commercial health insurance market: Direct Pay, Healthy New York, and Small Group. This research hopes to contribute to the creation of a viable market in which individuals in New York State can purchase affordable, comprehensive health insurance policies.

This Rockefeller Institute of Government report, made possible by an NYSHealth grant, looks at statewide strategies for improving private health insurance coverage to small groups. It examines rating policies, group purchasing arrangements, premium subsidies, refundable credits, and reinsurance as strategies for increasing access to private health insurance.

This NYSHealth-funded report was created by the Rockefeller Institute of Government. It provides an overview of the strategies all 50 states have used to increase insurance coverage in the small-group market including what is known about the effectiveness of these strategies.

This transcript from the Manhattan Institute’s 2008 Medical Progress Conference (an NYSHealth-funded event) brings together a variety of perspectives about affordable health care for the uninsured in New York.

Continuing its reporting on health insurance issues affecting New Yorkers, the United Hospital Fund (UHF) has released a data update on Offer, Eligibility, and Take-up Rates of Employer-Sponsored Coverage in New York, 2005.

This report is the initial product of Columbia University's Mailman School of Public Health's project whose overarching purpose is to analyze both qualitatively and quantitatively, meaningful and lasting options to expand health insurance coverage in New York State.

This is a transcript of the first of two panels hosted by the Manhattan Institute and funded by NYSHealth to explore options to increase health insurance coverage.

The United Hospital Fund has released a new report on the 900,000 New Yorkers who are eligible for public insurance but not enrolled in any of the available programs.