New York State Health Foundation

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Grantee Efforts to Simplify and Streamline Medicaid

Making public programs work better is a fundamental strategy of NYSHealth’s program to expand coverage to the State’s uninsured population. In New York State, such programs are a cornerstone of the insurance system. Collectively, approximately 4.9 million New Yorkers are covered by Medicaid, Child Health Plus, and Family Health Plus. At least another 1 million New Yorkers are estimated to be eligible for public coverage but not enrolled.

NYSHealth grantees worked to ensure that all eligible people receive and retain their coverage and that the programs operate on a cost-effective and financially sustainable basis. Quick-strike, technical analyses provided program officials with practical, actionable information to enable wise programming and implementation decisions and policy changes.

  • Georgetown University developed options for collapsing and simplifying Medicaid’s multiple and overlapping eligibility categories; many of the recommendations were subsequently proposed in the Governor’s 2009-2010 budget and adopted into law.
  • Lake Research Partners conducted focus groups to understand why so many eligible people fail to renew their coverage. The results received broad attention and reinforced the State’s decision to implement telephone renewal procedures.
  • PMB Healthcare Consulting subsequently provided technical support to help build the phone renewal system.
  • Manatt Health Solutions recommended ways to streamline the Excess Income Program, which allows individuals with large or ongoing medical expenses access to Medicaid coverage even though their household incomes are too high to meet the regular Medicaid income eligibility standards.
  • New York University helped shape the $30 million Chronic Illness Demonstration Project, a major effort to manage and improve the care for some of the sickest and most expensive Medicaid patients.
  • The Rockefeller Institute of Government reviewed the prevalence of denials for Medicaid-funded nursing home care and found wide variation in reported denial rates across the State’s counties.
  • Finally, Spitfire Strategies designed and conducted focused enrollment drives for the State’s public health insurance programs and reached thousands of New Yorkers.