Nine organizations will receive a total of $500 million in awards over the next three years to create a new Social Care Network (SCN) program in New York State.
New York State, as part of its Medicaid Section 1115 Demonstration Waiver, is seeking to create a new model of care that will integrate healthcare and social care via networks with associated funding. The $500 million program is one component of a $7.5 billion three-year waiver with nearly $6 billion of federal funding.
The program will seek to address health disparities in low-income communities by leveraging federal funding to facilitate Medicaid members access to nutritional meals, housing supports, transportation and other social services. By integrating social care and health care, this program advances a key initiative under the New York Health Equity Reform (NYHER) waiver amendment.
The SCNs will be core to facilitating the delivery of health-related social needs, including nutrition, housing supports, transportation, and case management for eligible Medicaid members, with the goal of addressing health disparities and improving population health.
The state says that data shows that subsidizing health-related social needs can have significantly positive impacts on health outcomes for low-income New Yorkers.
For example, a program known as the Medicaid Redesign Team Supportive Housing Initiative is focused on providing permanent housing and tenancy support services to homeless New Yorkers with medical conditions. An analysis of the program showed that investing in housing supports led to better health outcomes such as:
• 40 percent reduction in inpatient days;
• 26 percent reduction in emergency department visits;
• 44 percent reduction in patients with inpatient substance use rehab admissions;
• 27 percent reduction in patients with inpatient psychiatric admissions;
• 15 percent reduction in overall Medicaid health expenditures.
Through strategic prioritization, the top decile of enrollees had average Medicaid savings of $45,600 per person per year.
The following organizations were selected and will be covering nine regions throughout the state:
• Care Compass Collaborative (Southern Tier)
• Finger Lakes IPA Inc. (Finger Lakes)
• Health and Welfare Council of Long Island (Long Island)
• Healthy Alliance Foundation Inc. (Capital Region, Central NY, North Country)
• Hudson Valley Care Coalition Inc. (Hudson Valley)
• Public Health Solutions (Manhattan, Queens, Brooklyn)
• Staten Island Performing Provider System (Staten Island)
• Somos Healthcare Providers Inc. (Bronx)
• Western New York Integrated Care Collaborative Inc. (Western New York)
“These Social Care Network awards will transform how healthcare and social care are delivered,” said Amir Bassiri, state Medicaid director, in a statement. “These networks are central to achieving the health equity goals of the NYHER waiver, and will complement our long-term strategy to incorporate social care benefits into the Medicaid Managed Care program.”
SCN Lead Entities will connect Medicaid members to support by contracting with social service providers to help Members navigate and access services. Each SCN Lead Entity will be a designated Medicaid provider and coordinate the delivery of services, including housing, transportation, nutrition, and care management, in their region. Medicaid members who need assistance with their unmet health related social needs will be connected to existing resources, such as housing, nutrition, transportation, and care management.
Unite Us, a company that provides the technology infrastructure to connect community-based organizations and healthcare entities, noted that it already partners with five of the nine SCN leads, which together represent 72% of Medicaid members across the state.
With Unite Us’ technology, SCNs will facilitate social care referrals, enabling reimbursements for CBOs providing services to members, and tracking outcomes. The company added that this delivers the comprehensive data needed for the state Department of Health and the Centers for Medicare and Medicaid Services (CMS) to evaluate the waiver's impact, which is a core component of the demonstration in order to determine the longevity of these services as a lasting benefit in managed care.
