New York Health Homes on the Way

Published December 14, 2011

Some New York Medicaid recipients are scheduled to begin receiving health care services through new “health homes” beginning January 1, 2012. The program is intended to provide better quality care while saving the state millions of dollars, but the state still hasn’t let counties know much about how the new system will work.

These health homes are part of a Medicaid overhaul passed by New York’s legislature earlier this year. Upon entering office in January, Gov. Andrew Cuomo (D) appointed a Medicaid Redesign Team (MRT) to suggest ways to overhaul the state’s expensive system. Parts of the MRT’s recommendations were approved by the legislature in early April.

New York’s Medicaid structure differs from those of most states in that counties are primarily responsible for delivering services and paying part of the cost.

The state took applications from providers to participate in its health homes system through October 3, but it has yet to let counties know which providers will be participating. With the program slated to begin operation on January 1, county officials and Medicaid providers worry they will not have enough time to deal with the numerous changes in Medicaid delivery these health homes will necessitate.

Changing Delivery Patterns

This will not be a problem, says New York Health Commissioner Nirav R. Shah.

“Health homes will provide comprehensive care to Medicaid enrollees who need multiple services, while reducing the number of avoidable hospitalizations and visits to emergency rooms to manage costs,” Shah said.

The homes are not physical structures but are instead a health care network to provide coordinated care for some of the hardest to serve Medicaid recipients. Not everyone on Medicaid will be eligible for these health homes. Only recipients with two chronic conditions or who have a serious mental health problem are eligible for enrollment.

Few Financial Specifics

Yet the real question is whether New York’s projections can be realized. Steven Berger, a member of the MRT, has criticized the lack of financial details about the new approaches.

“Most of what we voted on is first-rate stuff and terrific theory and good for people,” Berger said in an interview with WNYC radio. “If we want to make changes, we have a responsibility for showing how it can be paid for. Not doing that is irresponsible.”

The state estimates transitioning to health homes will save the state’s Medicaid program more than $33 million in the first year.