The New York Department of Health began accepting applications from provider organizations on August 1 for participation in its Medicaid health homes program for individuals with chronic medical and behavioral health conditions. This program is authorized by section 2703 of the Affordable Care Act (ACA) and New York legislation enacted in April 2011 based on recommendations of Governor Cuomo’s Medicaid redesign team. Health homes will provide comprehensive care management, care coordination and health promotion services, transitional care and follow-up to help individuals discharged from inpatient care, patient and family supports, referral to community and social support services, and health information technology to effectively link all of the patient’s care team members together. New York expects that the program will be fully operational by October 1 and that it can achieve savings of $33.2 million in its first year by improving care and reducing unnecessary hospital readmissions that can occur when individuals with high cost chronic conditions such as congestive heart failure and diabetes do not receive the services that this program offers. New York has submitted an approvable state plan amendment to the Centers for Medicare and Medicaid Services (CMS) under which the State can obtain 90 percent federal financial participation for these services for two years under section 2703 of the ACA.   

The New York Department of Health also announced on August 5 that it will be awarded $325 million over a three-year period for its Hospital-Medical Home demonstration project and $20 million over a three year period for its Potentially Preventable Readmissions project under section 1115 waiver authority. The first project will provide incentives to hospital teaching programs to participate in evidence-based quality and patient safety improvement initiatives and to achieve certification as patient-centered medical homes by the National Committee for Quality Assurance (NCQA). The second project will provide competitive grants to provider organizations to devise and implement additional strategies to reduce unnecessary hospital readmissions.