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  • Mount Sinai School of Medicine, Center to Advance Palliative Care Providing Technical Assistance to Expand Palliative Care in New York State Hospitals Priority Area: Expanding Health Care Coverage $500,000

    Persons with serious, advanced illness and those at the end of life often confront a health care system that does not know how to meet their needs, which include the provision of expert symptom and pain management, well-communicated information, and improved quality of care. Palliative care can help transition patients to more effective care, reducing their length of stay and providing a more appropriate setting for their health needs. Despite the opportunities for savings and improvements in care, less than 60% of New York State hospitals reported that they provided palliative care services. In 2009, NYSHealth funded the Center to Advance Palliative Care (CAPC) to address this problem by working with the remaining 40% of New York State hospitals to establish a palliative care program at their hospitals. In addition, CAPC worked to enhance the long-term sustainability and quality of established palliative care programs.

  • Public Health Solutions Applying Technology to Increase Health Insurance Enrollment Priority Area: Expanding Health Care Coverage $75,000

    Approximately one million New Yorkers are estimated to be eligible for public health insurance but are not enrolled. To help reach these people, New York State designates a network of “facilitated enrollers” (FEs) to identify and assist eligible individuals with signing up for public health insurance programs such as Medicaid, Child Health Plus, and Family Health Plus. Public Health Solutions (PHS) has been an FE since 2001 and is active in Kings County, New York County, and Queens County. Until recently, FEs had to rely on an entirely paper-based process that is time-consuming, error-prone, and redundant. For this grant, PHS was able to fully implement an electronic application process. As a result, the number of daily applications completed per FE increased from 4.8 to 5.9—a 24% increase.

  • The Lewin Group Bending the Cost Curve in New York Priority Area: Expanding Health Care Coverage $399,981

    Rising health care costs and the containment of their growth have been national and State-specific issues for decades. Recognizing the need for a national roadmap to control the unsustainable growth in health care costs, the 2007 Commonwealth Fund report, “Bending the Curve: Options for Achieving Savings and Improving Value in U.S. Health Spending,” identified 15 federal policy options and estimated the impact they could have on lowering health care spending relative to projected trends. Modeled by The Lewin Group (Lewin), the study concluded that these options could generate 10-year savings ranging from $9 billion to more than $300 billion. The report became a major resource for policymakers tackling the issue of health care costs. In 2009, the New York State Health Foundation (NYSHealth) awarded a grant to Lewin to leverage the model, data collection, and methods developed under the national study to create a State-specific roadmap for New York.

  • Smith House Health Care Center Creating Primary Care Access in Dannemora Priority Area: Special Projects Fund Priority Area: Advancing Primary Care $50,000

    Residents of Dannemora and nine other neighboring towns in the remote Adirondack mountain region of New York typically must travel long distances to receive primary care. Long travel times and frequent inclement weather conditions create significant deterrents for residents in need of medical care, especially for senior citizens and those with disabilities. In order to address the gap in medical services in this remote region, the Smith House Health Care Center (Smith House) proposed the creation of a satellite community health center (CHC) in Dannemora. In 2009, the New York State Health Foundation (NYSHealth) awarded Smith House a grant to support the formation of this CHC.

  • Community Health Center of Buffalo Increasing Access to Primary Care in Niagara Falls Priority Area: Special Projects Fund $204,624

    Low-income and uninsured patients in Niagara Falls, New York had to rely on the emergency department of Niagara Falls Medical Center for primary and chronic care needs. With the help of NYSHealth, a satellite community health center was established next to the medical center through a partnership with the Community Health Center of Buffalo (CHCB) to provide primary care to 7,500 patients per year.

  • National Opinion Research Center (NORC) Survey of Employer Health Benefits in New York, 2009 Priority Area: Expanding Health Care Coverage $200,000

    Private, employer-sponsored health insurance is the main pillar of the health coverage system in New York State, as it is in the rest of the nation. In both New York and the United States, nearly 60% of the nonelderly population relies on employer-sponsored insurance. However, national data reveal steady erosion in this foundation over the last decade. Fewer firms are offering insurance to their employees. With NYSHealth’s support, in 2009 the National Opinion Research Center (NORC) at the University of Chicago examined job-based insurance and uninsured New Yorkers under the age of 65. This data enabled NYSHealth to report a deeper understanding on various trends associated with cost and coverage of employer health benefits, and also provided policymakers with reasons behind these trends.

  • Our Lady of Lourdes Memorial Hospital, Inc. The Hope Dispensary of the Southern Tier Priority Area: Special Projects Fund $198,326

    Prescription medications are particularly costly and sometimes simply unaffordable for uninsured individuals, especially during difficult economic climates. Yet these medications are necessary for all individuals—particularly those with chronic diseases—to manage their medical conditions and avoid costly emergency department care or hospital admissions. The Dispensary of Hope, a nonprofit that collects unused sample medications from physicians’ offices across the United States, was created to directly address this issue. Sample medications are then distributed to clinics and pharmacies that serve low-income and uninsured individuals throughout the United States and abroad. A community planning committee and coalition formed in the Southern Tier region of New York State developed plans for a pharmacy using the Dispensary of Hope’s model. The committee approached the New York State Health Foundation (NYSHealth) to request start-up funds to continue the formation and implementation of “The Hope Dispensary of the Southern Tier,” which they planned to administer through Our Lady of Lourdes Memorial Hospital, Inc. in Binghamton, New York.

  • Bridges to Excellence From Potentially Avoidable Complications to Potentially Achievable Savings: A Payment Reform Initiative for New York State Priority Area: Expanding Health Care Coverage $123,899

    The rising cost of health care has imposed economic burdens on families, employers, and governments at every level. While there is no simple formula for lowering the growth in health care costs, stakeholders and policymakers are making efforts to reduce the cost of care without compromising quality. In 2009, NYSHealth awarded Bridges to Excellence—a program of the Health Care Incentives Improvement Institute—a grant to launch two payment reform pilot programs that offered incentives for physicians and hospitals to collaborate, improve the quality of care, and reduce costs.

  • Excellus Health Plan Evaluating a Patient-Centered Medical Home Pilot Project Priority Area: Advancing Primary Care $300,000

    Numerous studies have demonstrated that comprehensive and integrated primary care is a cost-effective means to reduce health care fragmentation and its associated costs. The patient-centered medical home (PCMH) is a promising model in which highly connected, coordinated, and inclusive patient care is overseen by a team of care providers, including physicians, nurses, pharmacists, social workers, and other care coordinators. Excellus BlueCross BlueShield (Excellus), MVP Health Care, and physicians in upstate New York partnered to create the Rochester Medical Home Initiative (RMHI) to test the viability of the PCHM model. Excellus and MVP Health Care provided $8 million to fully fund the demonstration. Excellus also compensated participating primary care physicians for providing additional case management and trained them to implement PCMH principles into their practices. In 2009, NYSHealth awarded Excellus a grant to support an independent research evaluation of RMHI’s demonstration of the PCMH model.

  • Bellevue Hospital Center Improving Care and Reducing Hospital Admissions and Costs for Patients at High Risk of Frequent Hospital Admissions Priority Area: Expanding Health Care Coverage $500,000

    Patients with frequent hospital admissions comprise a small number of overall patients, but account for a disproportionate share of hospital visits and costs. Twenty percent of Medicaid patients account for almost 80% of Medicaid expenditures in New York State. In order to reduce the cost of health care in New York State, the Medicaid system needs programs that better address patients’ needs and deliver more cost-effective care.

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