Month: May 2016

Reimbursing important conversations

Having conversations with your doctor can help them understand how your life outside of her office impacts your health.  Doctors’ time is often limited and the types of questions they ask might not only depend on what is most important, but what they can bill for.

End of life discussions are thought to be essential by most doctors, but they rarely have them, for a variety of reasons. In January, Medicare began reimbursing providers for end of life discussions in the hope that this type of planning would become more common place.

Growing evidence suggests that screening for poverty and connecting patients to community resources can have positive impacts on health.  Would doctors be more likely to screen for these risk factors if they were getting paid? We think so!  In a poll, 75% of doctors said Medicare’s new policy makes it more likely that they will engage patients in these conversations.

Reimbursing is a great first step to encourage providers to start having these types of discussions with patients. However, more training, engagement with community based organizations, and clinical infrastructure are likely needed to integrate this type of screening into regular practice.

Bill Would Expand Insurance Coverage for NYers

Thanks to the Affordable Care Act (ACA) and the opening of the New York State of Health Marketplace, 2.8 million New Yorkers have enrolled into quality, affordable health coverage. Among the provisions of the ACA is the basic health program, which allows states to provide low-cost coverage to eligible individuals who have incomes up to 200 percent of the federal poverty level (roughly $23,700 for a single person).

Since the Essential Plan became available in 2015, nearly 400,000 New Yorkers have enrolled. They now have access to quality healthcare with no deductible and premiums of $20 or less.

Yet New York residents who are Permanently Residing under the Color of Law (PRUCOL) are not eligible for the Essential Plan. Many of those affected are young adults who grew up in the U.S. and are beneficiaries of the Deferred Action for Childhood Arrivals (DACA) policy. Ironically, these individuals are already covered by Medicaid if their income is below the threshold. Once their incomes increase and they are no longer eligible for Medicaid, they face a “coverage cliff” and often must choose between work and access to health insurance.

The New York State Assembly is working to expand Essential Plan eligibility to include immigrants who are PRUCOL. The Assembly included $10.3 million in its 2016-17 budget to provide this coverage.  Unfortunately, the funding was ultimately cut during budget negotiations. Assembly members Richard Gottfried and Marcos Crespo have since introduced legislation that would expand Essential Plan eligibility to include immigrants who are PRUCOL. Bill A10054 was successfully voted out of the Assembly Health Committee on May 17 and is now awaiting a vote by the Ways and Means Committee.

Health Care for All New York has drafted a Letter of Support for A10054. Please feel free to adapt this letter for your organization. Submit completed letters to Assembly Member Gottfried (

Hungry Long Islanders don’t always qualify for help

Food insecurity exists in every county and congressional district in the country. But not everyone struggling with hunger qualifies for federal nutrition programs.

On Long Island 42% and 35% of food insecure people in Nassau and Suffolk County respectively, are not eligible for the Supplemental Nutrition Assistance Program (SNAP) or other Nutrition Programs. This means 69,533 Long Islanders struggle to put food on the table for their families. This includes 43,944 children.  Almost half of food insecure children on Long Island are not eligible for help accessing food.

The House Child Nutrition Reauthorization bill (H.R. 5003) that was voted out of committee on May 18th would further put children’s food security at risk.  The bill adds a NEW block grant provision that was added just before markup and remained intact despite efforts by Democrats to strike the provision.  It also weakens community eligibility by raising the percentage of identified student threshold from 40 to 60 percent.  This includes 5 Long Island schools that would lose Community Eligibility and about 72 schools that are currently eligible that would never get the chance to implement CEP if the bill is approved on the House floor.

However, on the State level, there has been an effort to address the gap between food insecure people and the percentage of those who are eligible for food assistance.  As part of the 2016 State-of-the State, Governor Cuomo announced that New York State will raise the income level from 130% to 150% of the federal poverty level for the SNAP program.  Raising the income guidelines is estimated to bring in $688.5 million in additional federal SNAP benefits to New Yorkers each year, with an estimated annual economic impact of $1.27 billion.  The new FPL guidelines will go into effect on July 1, 2016.

Take Action!

Contact Members of the House Education and Workforce Committee letting them know your outrage and opposition to the committee passed bill (H.R.5003)

Find out more about food insecurity in Nassau and Suffolk County using Feeding America’s Map the Meal Gap project

It’s Hurricane Preparedness Week (May 15-21)

The Northern Atlantic hurricane season, which spans from June 1 to November 30, is right around the corner, and the 2016 hurricane season is expected to be the most active since 2012 – the year that Superstorm Sandy hit Long Island.

The National Oceanic and Atmospheric Administration (NOAA) states that “it only takes one storm to change your life and community”, and so this week – Hurricane Preparedness Week – NOAA offers daily tips focusing on specific preparedness measures everyone should take.

Sunday, May 15: Determine your risk
Monday, May 16: Develop an evacuation plan
Tuesday, May 17: Secure an insurance check-up
Wednesday, May 18: Assemble disaster supplies
Thursday, May 19: Strengthen your home
Friday, May 20: Identify your trusted source of information for a hurricane event
Saturday, May 21: Complete your written hurricane plan

NOAA also offers pre-written text as well as images that you can share on your social media platforms. View them by clicking here. An example of their shareable content, “5 Things to Know About Hurricane Hazard Risks” is embedded below.

Additionally, PSEG Long Island’s Storm Center website provides additional information on how to prepare your home and family, how to prepare your business, severe weather tips, and more, which you can read by clicking here.


States that Spend More Money on Social Services are Healthier

This week a study from the Yale School of Public Health found that States that spend more money on social services and public health programs relative to medical care have much healthier residents.  As researchers increasing identify links between social determinants of health, poor health outcomes and rising health care costs, the Obama Administration is preparing to fund additional research through the Accountable Health Communities Model which will examine the idea that improving social services can improve health and lower health care costs.

The new study was the first to compare state spending on social services to spending on Medicare and Medicaid and to residents’ health.   New York was among those with the lowest ratios of social services to medical spending, averaging $2.30 on social services for every medical dollar spent.  Compared with states like Colorado and Nevada that average $5 for every dollar of medical treatment and have much healthier residents, with lower rates of heart attacks, lung cancer, mental illness and obesity.

Many health care providers and Public Health experts agree that improved services for patients such as housing, transportation, job training, and nutritional security will save money down the road.   Spending on social service programs are generally less expensive than medical costs.  The authors of the study found that a 20% change in the median ratio of social to health spending would result in there being 85,000 fewer obese adults in the state within a year, saving an average of $2,700 in average annual health care expenses per person.

Elizabeth Bradley, lead author on the study, urges for more efficient rather than more government spending.  “It’s not just that it’s moral or immoral, it’s just smart” she says.  By failing to provide people services they need it can increase what we all pay in taxes on health care.



HHS Issues New Medicaid Rules

On April 25, 2016, the Department of Health and Human Services (HHS) issued a final rule on managed care in Medicaid and the Children’s Health Insurance Program (CHIP). The rule, which is the first overhaul of Medicaid and CHIP managed care regulations in more than a decade, advances the Administration’s efforts to modernize the health care system to deliver better care, smarter spending, and healthier people.

The final rule has four key goals:

(1) Supporting states’ efforts to advance delivery system reform and improvements in quality of care for Medicaid and CHIP beneficiaries

The rules clarify states’ authority to enter into contracts that pay plans for quality or encourage participation in alternative payment models and other delivery system reform efforts.

(2) More consumer-friendly Medicaid health plan information

The rules require states to provide information such as the Medicaid handbook, plan provider directories, and other important enrollment information on one central website. It also supports providing enrollment assistance and counseling.

(3) New quality rating system

The rules would implement a quality star rating system for Medicaid Managed Care plans similar to the system currently used for Marketplace health insurance plans. This system will enable consumers to make choices based on plan quality. States and plans have 3 years to implement this provision.

(4) Steps to improving adequate health plan provider networks

States will be required to set time and distance standards for key provider types. Currently, whether to set such standards is completely up to the states. Requires plans to regularly update directories of doctors and hospitals. A 2014 investigation by the Department of Health and Human Services’ inspector general found that half the doctors listed in official insurer directories weren’t taking new Medicaid patients.

The provisions of the rule will be implemented in phases over the next three years, starting on July 1, 2017.