Online Program

Evaluation of the implementation of Medicaid health homes in New York City: The affordable care act in action

Tuesday, November 5, 2013

Jessica Fear, MA, LMFT, Community Mental Health Services, Visiting Nurse Service of New York, New York, NY
Neil Pessin, PhD, Community Mental Health Services, Visiting Nurse Service of NY, New York, NY
In 2011, New York State Department of Health (NYS DOH) redesigned the Medicaid service delivery program to implement a provision of the Affordable Care Act; the option for building person-centered systems of coordinated care. Entitled Health Homes, this model offers a comprehensive integration of medical and behavioral health care management to serve New York's most vulnerable and disenfranchised populations.

Three overarching goals guide Health Home implementation: Improve coordination of care and patient outcomes for 976,000 targeted NYS Medicaid beneficiaries, 42% with mental health and substance use issues; Reduce expenditures by decreasing avoidable hospital and ER usage; Utilize Health Information Technology (HIT) to create connectivity between each patient's interdisciplinary team of providers; sharing care plans and patient information in real time.

Implementation began in spring 2012, with several critical lessons learned, falling into six key areas: Becoming Operational; Enrolling Eligible Beneficiaries; Effective Financial Modeling; Establishing Relationships and Defining Roles; Developing Health Information Exchange; and Defining and Measuring Quality.

The Visiting Nurse Service of New York (VNSNY) was designated as a lead Health Home in the Bronx and Manhattan, in partnership with seven other medical and behavioral health providers. Our health home will, at full capacity, provide coordinated care to approximately 30,000 of the highest need Medicaid recipients; those with Serious Mental Illness, substance abuse issues, HIV/AIDS and multiple chronic medical illnesses, many with co-occurring diagnoses.

This presentation will outline the details behind each key implementation area, focusing on challenges, lessons learned and process measures/quality outcomes tracked and reported.

Learning Areas:

Chronic disease management and prevention
Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs
Program planning
Social and behavioral sciences

Learning Objectives:
Analyze impact of unanticipated implementation challenges Discuss critical lessons learned in the first year Define key steps for establishing interdisciplinary partnerships Identify the stakeholders required to gain buy-in for optimal success

Keyword(s): Health Reform, Medicaid

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the Director of the VNSNY Health Home, one of the people in charge of implementing this new Medicaid health home initiative for VNSNY in NY City.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.