Engaging Consumers Through Network Accessibility and Performance
Empowering Health Care Consumers
November 15, 2016
Outside New York State
Too often the health care system puts patients last, when they should come first. Consumers and patients are frequently marginalized, rather than placed at the center of the health care system and treated as its most important customers.
The interests of providers, payers, and other organized stakeholders take precedence over the patient in many cases. NYSHealth seeks to amplify the voice of the health care consumer and increase the information and tools available so that patients have more influence over their health and health care. To change the current dynamic and increase health care consumers’ choice, control, and convenience, NYSHealth issued a request for proposals, Empowering Health Care Consumers in New York State. Through this initiative, NYSHealth is funding ambitious, large-scale projects and studies to increase consumers’ access to their own health information; provide new tools and resources that will inform consumer health care decision-making; and identify strategies that meaningfully engage consumers in determining the types of health care services available in their local communities. NYSHealth awarded Cynosure Health a grant to participate in this initiative.
Under this grant, Cynosure Health conducted a comprehensive analysis of New York provider network adequacy, specifically those networks’ composition, performance, and accessibility. Since implementation of the Affordable Care Act, concerns have surfaced about the adequacy of provider networks and that these networks restrict patient choice on physician and hospital providers. Although narrow networks could be a means to control costs and lower premiums, this phenomenon raises questions about adequate access and quality. Based on its analysis, Cynosure Health produced a report outlining specific recommendations for policymakers, health plans, and other relevant stakeholders on how to improve New Yorkers’ provider networks. It worked with consumer health advocates led by Center for Independence of the Disabled New York to ensure that the project and its recommendations were informed by consumers.