New York State Health Foundation

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Helping Nonprofits Navigate Medicaid Redesign

  • By: NYSHealth
  • Date: August 2017
  • Priority Area: Special Projects Fund
  • Type: Grant Outcome Reports
  • Category: Grant Outcome Report
  • Grantee Name: Lawyers Alliance for New York

Overview

Quality and cost-efficiency is a primary focus of New York State’s health care delivery system. Under Medicaid Redesign, the State introduced the Delivery System Reform Incentive Payment (DSRIP) program in 2015 as a tool to reduce hospitalization rates while improving care quality for Medicaid beneficiaries. DSRIP involves all levels of the health care delivery system, including nonprofit health providers and other community-based organizations. Although redesign efforts have made significant improvements to the State’s health care delivery system, rapid changes left many smaller providers struggling to navigate and adjust to the new legal landscape. In addition, these resource-constrained providers were subjected to shifts in funding, generating ambiguity and concern for the future. In 2016, with co-funding from the New York Community Trust, NYSHealth awarded a grant to Lawyers Alliance for New York to provide legal support to health and human service nonprofit organizations navigating Medicaid Redesign and other health care reform efforts.

Grantee: Lawyers Alliance for New York (Lawyers Alliance)

Dates: May 2016 – April 2017

Grant Amount: $50,000

Grantee Website: http://www.lawyersalliance.org/

Grant ID: 15-03712


Outcomes and Lessons Learned:

  • Reached more than 300 nonprofit organizations through e-mail, follow-up phone calls, in-person meetings, and meetings with coalitions active in helping nonprofits;
  • Supported the long-term sustainability of under-resourced organizations by providing them with clarification on complex contractual changes and guidance in assessing future risk;
  • Provided direct legal services to 47 nonprofit organizations on 74 legal matters (surpassing the original target of 43 organizations on 65 legal matters) on issues such as managed care contracts, high-risk and undesirable terms, and compliance obligations;
  • Provided assistance to 9 nonprofits on 13 legal matters related to DSRIP contracts;
  • Educated more than 150 individuals on Medicaid Redesign (surpassing the initial goal of 100 individual) through webinars and workshops;
  • Organized 50 brief consultations with nonprofits (exceeding original aim of 40 brief consultations); and
  • Mitigated Health Insurance Portability and Accountability Act (HIPAA) risks for organizations by clarifying obligations under HIPAA, helping to draft internal HIPAA policies, and explaining how to implement the new provisions.

 

Co-Funding and Additional Funds Leveraged: Lawyers Alliance received a grant of $150,000 from the New York Community Trust to support this project.