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The Nelson A. Rockefeller Institute of Government

Health Care: New York State Health Policy

New York State Health Policy

Expanding Public Health Insurance Under the Affordable Care Act:
What New York Might Learn from Connecticut, Massachusetts and Vermont

This lively, interactive public policy forum focused on how some states are expanding public health coverage in implementing the federal legislation that passed last year. The forum kicked off with presentations from speakers representing states neighboring New York. Brian Rosman of Health Care for All Massachusetts described the five-year-old Massachusetts law that is the model for federal reform law. Jill Zorn of the Universal Health Care Foundation of Connecticut discussed legislation to establish a public option — a state-run insurance plan that would compete with private insurers — when Connecticut implements federal health reform. Robin Lunge represented Vermont Governor Peter Shumlin, who is expected to sign legislation authorizing Vermont to set up a single-payer health plan, which would cover all state residents and be funded by taxpayers. New York State Senate Health Committee Chairman Kemp Hannon, Assembly Health Committee Chairman Richard Gottfried and Judy Arnold of the New York State Health Department spoke about past and current efforts aimed at expanding health coverage in New York. Also joining the forum were representatives of health insurance, hospital and insurance groups: Mary Clark of Citizen Action of New York, a consumer advocacy group; Jeffrey Gold of the Health Care Association of New York State, a group of hospitals and health care networks; and Paul Macielak of New York Health Plan Association, a trade group for managed care insurance plans.
May 19, 2011

Patient-Centered Medical Home Pilot Demonstrations in New York

Patient-centered medical homes (PCMH) are taking hold as a way to transform health care delivery. PCMHs are an approach to health care organized around the core relationship between patients and their primary care providers.This brief looks at efforts to pilot PCMH in eight regions of New York.
Courtney Burke and Wendy Weller, January 2011

Room for Interpretation: Causes of Variation in County Medicaid Asset Transfer Rates, Opportunities for Cost Reduction

New York State’s assumption of county Medicaid administration could reduce costs, but big savings will depend on improved administrative processes, according to this Institute report. The report examines differences in Medicaid nursing home eligibility denials among counties as an illustration of the challenges the state will face in taking over administration of Medicaid.
Courtney E. Burke, with Barbara Stubblebine and Kelly Stengel, August 2010

Thinking Ahead: Health Care Trends

This presentation for the Albany Medical Center Horizons Strategic Planning Committee provides an overview of the current health system and what will change under federal legislation, and suggests how the health system might change in the next five-10 years.
Courtney Burke, April 20, 2010

Health Care Reform: What You Need to Know and
How it Will Affect New York State

Courtney Burke, who directs the Institute's Health Policy Research Center, discussed federal health reform and its effect on New York State in presentations to the State Academy of Public Administration and the Schenectady Business and Women's Association. The presentation includes a look at similarities and differences in House and Senate bills, the effective dates of various provisions and their potential impacts on the state.
Courtney Burke, January 2010

Managing Risk in Health Insurance Markets: A Challenge for States in the Midst of Health Care Reform

States seeking to manage health-insurance risk while providing coverage to more residents should apply several strategies at once, say the Institute's Courtney Burke and Harvard University's Katherine Swartz in this report. Strategies include a requirement that individuals purchase insurance, creation of an insurance exchange, and merger of small group and individual markets.
Courtney Burke and Katherine Swartz, September 10, 2009

State Financing for Health Coverage Initiatives: Observations
and Options

New York faces steep financial challenges as it works toward universal health care coverage, according to a new report by the Institute's Health Policy Research Center. The report, funded by the New York State Health Foundation, analyzes potential sources of revenue and savings that the state could tap.
Courtney Burke and Kimberley Fox, June 3, 2009

Mitigating the Effects of High-Risk, High-Cost Populations in the Private Health Insurance Market

At this Institute Public Policy Forum, Katherine Swartz, professor of health policy and economics at the Harvard School of Public Health, provided an overview of the "Massachusetts experience" with ensuring universal health coverage, with a focus on the need to manage — and contain costs — for people with high medical expenses. In response, New York officials representing the departments of Health and Insurance — Troy Oechsner, Jay Laudato and Eileen Hayes — shared perspectives on New York's challenges in expanding care to more high-risk patients.
May 21, 2009

What the Berger Commission Has Meant for Acute Care in New York's
Capital Region

The New York State Commission on Health Care Facilities in the 21st Century — more commonly known as the Berger Commission — recommended a series of hospital and nursing home restructurings three years ago to reduce excess capacity, and ultimately costs, in the medical industry. At this May 1 Rockefeller Institute Publicy Policy Forum, James W. Connolly, president and chief executive of Ellis Hospital in Schenectady — a community he dubbed the commission's "Ground Zero" — discussed his oversight of a successful three-hospital consolidation there. James K. Reed, president and CEO of Northeast Health in Troy, where the commission made no such restructuring recommendations, talked about the voluntary consolidations that his organization is undergoing with two other area health systems. Both men said the industry needs to move forward itself with further restructuring.
May 1, 2009

Assessing Asset Transfer for Medicaid Eligibility in New York State

New Rockefeller Institute research examines the transfer of personal financial assets by New Yorkers seeking to have Medicaid pay for nursing home care. About 7 percent of such applications were rejected from 1998 to 2008 because applicants had transferred assets to family members or others within a few years of requesting Medicaid coverage, the study finds. Counties throughout the state varied widely in the percentage of applicants they rejected because of such asset transfers.
Rockefeller Institute of Government, March 2009
Read the news release

Medicaid and Long-Term Care: New York Compared to 18 Other States

New York’s Medicaid program spends more on long-term health care than any other state, but indicators of quality are only about average or slightly above average. This study compares New York to 18 other large or Northeastern states.
Rockefeller Institute of Government, February 2009
Read the news release

Ideas for Generating and Sustaining Finance for Health Coverage Initiatives in New York State

Seven experts from diverse backgrounds spoke at an Institute forum, discussing a variety of potential approaches to the expansion of health care coverage in New York State. They included David Sandman, senior vice president of the New York State Health Foundation; John Rodat, commissioner, Department of Management & Budget, Albany County; Elisabeth Benjamin, director, Healthcare Restructuring Initiatives, Community Service Society of New York; Raymond Sweeney, executive vice president, Healthcare Association of New York State; Sean Doolan, counsel, New York Conference of Blue Cross and Blue Shield Plans; Charles Brecher, research director, Citizens Budget Commission; and Paul Sorum, MD, chairman, Capital District Chapter, Physicians for a National Health Program.
December 5, 2008

Listen to the Audio (Full)
Speaker Highlights   [PDF]
Presentation by Elisabeth Benjamin   [PDF]
Presentation by Paul Sorum   [PDF]

Transforming Medicaid: The Key to Health Care Reform

A Public Policy Forum featuring New York State Health Commissioner Richard F. Daines, M.D., January 29, 2008

New York's Institution-Centered System for the Provision of Health Care

New York differs from other states in terms of where people receive health care and how much it costs. Compared to other states, New Yorkers, and particularly those enrolled in publicly funded health insurance programs like Medicaid, Child Health Plus, and Family Health Plus, receive more care more often in institutional settings.
Courtney Burke, May 2007

Medicaid and Long-Term Care: Where New York Stands

Presentation at the Ninth Binghamton Symposium on Health Care Management & Policy, Binghamton, NY.
Courtney Burke, May 10, 2007

Achieving Universal Health Care Coverage in New York: Lessons from Maine and Massachusetts

A Public Policy Forum with Celia Wcislo, Commonwealth Health Insurance Connector Board Member and Assistant Director, 1199 Massachusetts Division; Elizabeth Kilbreth, Associate Professor, Institute for Health Policy, University of Southern Maine, Muskie School of Public Service; Reactors: Deborah Bachrach, Deputy Commissioner, NYS Department of Health; Jane Preston, Chief of Staff to the Senate Health Committee; Bryan O’Malley, Legislative Assistant for Assembly Health Chair Richard N. Gottfried; and Moderator: James Knickman, President and CEO, New York State Health Foundation. Wednesday, November 14, 2007

Choices and Challenges in New York's Health Insurance Market: Views from Health Plan, Business, and Labor Leaders as Universal Coverage Discussions Begin

A Public Policy Forum with Jacqueline Martinez, Senior Program Director, New York State Health Foundation; David H. Klein, CEO, Excellus; William J. Cromie, MD, President/CEO, CDPHP; David J. Uba, Vice President, Strategic Planning, HealthNow New York, Inc.; Michael W. Cropp, President and CEO, Independent Health; Denise V. Gonick, Executive Vice President for Legal Affairs, MVP Healthcare; John A. D’Ambrosio, Ed.D., President, Orange County Chamber of Commerce; Steve A. McCormick, Plant Manager, Anheuser-Busch; Ted Potrikus, Vice President/Director of Government Relations, Retail Council of New York State; Mike Fishman, President, SEIU Building Service Local 32BJ; Troy Oechsner, Deputy Superintendent for Health, New York State Insurance Department; Kathleen Shure, Director, Division of Managed Care and Program Evaluation, New York State Department of Health; Jim Tallon, President, United Hospital Fund (moderator). September 28, 2007

Health Savings Accounts: Are They a Good Idea?

A Public Policy Forum with Peter D. Salins, Ph.D., Vice Chancellor for Academic Affairs and Provost, State University of New York, and James W. Fossett, Associate Professor of Public Administration and Public Health, Rockefeller College of Public Affairs and Policy, University at Albany. May 10, 2006

Administrative Responsiveness to the Disadvantaged: The Case of Children's Health Insurance

This study focuses on two means-tested programs in the context of American federalism, Medicaid, and the State Children's Health Insurance Program.
James Fossett and Frank J. Thompson, Journal of Public Administration Research and Theory, September 2005

Medicaid and State Budgets in FY 2004: Why Medicaid Is So Hard To Cut

This report assesses how Medicaid was treated in fiscal year 2004 in the budgets of ten states. Drawing on detailed analyses of state budgets, it examines state budget-balancing strategies, with particular attention to changes in Medicaid spending and eligibility compared to other government functions.
James W. Fossett and Courtney E. Burke, July 2004

A Divided Community: The Effects of State Fiscal Crises on Nonprofits Providing Health and Social Assistance

This paper examines the current state revenue crisis, demand for social services, the distribution of social assistance nonprofits, and both long-run and short-run changes in state expenditures to estimate the effects of state fiscal crises on the nonprofit sector associated with human service programs. This study finds divisions among nonprofits that affect the severity of these effects. These divisions are both functional and geographic.
Thomas Gais, Courtney Burke, and Rebecca Corso, The Aspen Institute, November 2003

CHIP and Medicaid Outreach: Strategies, Efforts, and Evaluation

This management brief presents an overview of the findings of case studies of Medicaid and CHIP administration in 18 states, in particular, the state efforts at Medicaid and CHIP communication and outreach, the correlation between these efforts and enrollment increases across states in recent years, and how these efforts compare with "best practices" standards.
Debra J. Ringold, Tricia M. Palmer Olson, and Laura Leete, July 2003

State-Local Relations and Their Effect on Policy Design and Implementation

The purpose of this brief is to report findings from an 18-state comparative study that shed light on state-local relations and their possible effects on Medicaid and CHIP enrollments of children and adults and Medicaid "take-up" rates.
Malcolm L. Goggin, May 2003

Children and the Take-Up Challenge: Renewal Processes in Medicaid and CHIP

This brief considers an array of practices related to the transaction costs of renewal. The first section focuses on the enrollment spans that states provide. A second section probes the degree to which states practice active inreach and have adopted other practices that reduce barriers to renewal. A third section examines the degree to which a seamless referral process exists between Medicaid and CHIP. The fourth section draws on the indicators that have been analyzed to suggest a tentative ranking of the states in terms of the client friendliness of their renewal processes. The final section looks to the future by asking whether those states facing the most acute take-up problems seem to be well-positioned in terms of their renewal practices to meet this challenge.
Frank J. Thompson, February 2003

Is Medicaid Retrenching? State Budgets and Medicaid Enrollment in 2002

This paper examines the sustainability of Medicaid and CHIP enrollment efforts in the large majority of the states where enrollment initiatives have been examined in earlier publications in this series. This paper will review recent trends in state revenues and Medicaid spending in these states, then examine state actions to balance their FY 2003 budgets, with particular attention to changes in Medicaid spending and activities affecting Medicaid and CHIP enrollment initiatives.
James W. Fossett and Courtney E. Burke, February 2003

The Complexity of Simplifying the Medicaid Application Process

This paper outlines some of the actions states took to simplify the Medicaid application process and whether simplification measures improved the degree to which Medicaid eligible individuals enrolled.
Courtney E. Burke, January 2003

Medicaid and Information Systems: Delays in Modifying Information Systems Contributed to the Decline in Medicaid Enrollment after Welfare Reform

This paper focuses on the role of information technology in the transition from pre- to post-welfare reform Medicaid program management and suggests that delays in addressing information systems’ issues contributed to the unexpected decline in Medicaid enrollment associated with welfare reform.
Mark Ragan, January 2003

Managing Medicaid Managed Care: Are States Becoming Prudent Purchasers?

This paper, published in Health Affairs, examines the extent to which five states are becoming “prudent purchasers” in their oversight of Medicaid managed care. Becoming a prudent purchaser appears to be a complex task for states that may prove difficult to achieve.
James W. Fossett, Malcolm Goggin, John S. Hall, Jocelyn Johnston, L. Christopher Plein, Richard Roper, and Carol Weissert, Health Affairs, Vol. 19, No. 4, 2000

Building Administrative Capacity for CHIP and Medicaid: Image, Outreach, and Organization

This management brief examines the coordination of CHIP and Medicaid administration at the state level through a comparative review of experiences of 18 states that have been the subject of ongoing research by the Rockefeller Institute of Government since 2000.
Christopher Plein, December 2002

Medicaid Enrollment Trends: 1995-2000

This paper examines trends in Medicaid enrollment among low-income adults and children between 1995, the last year before the passage of welfare reform, and 2000, the last year for which complete enrollment data are available. It also examines Medicaid “take-up,” or states’ success in enrolling those who are eligible for Medicaid.
Courtney E. Burke and Craig W. Abbey, August 2002