Guarantee high-quality, affordable, and accessible health care for all New Yorkers
Access to health care is a critical component of New York City’s approach to advancing health equity. Currently an estimated 600,000 New Yorkers are without health insurance, despite half of that number being eligible for coverage.
In January 2019, the City announced guaranteed care for all New Yorkers, a landmark initiative to 1) enroll New Yorkers in health insurance, including New York City’s public health insurance option, MetroPlus; and 2) guarantee anyone ineligible for insurance — including undocumented New Yorkers — direct access to Health + Hospitals (H+H) primary and specialty care physicians, pharmacies, and mental health and substance abuse services through a new program called NYC Care.
- Boost enrollment
The City will accelerate efforts to enroll eligible New Yorkers in insurance, particularly MetroPlus. MetroPlus provides free or affordable health insurance that connects insurance-eligible New Yorkers to a network of providers, and serves as an affordable, quality option for all New Yorkers, including those on Medicaid and Medicare, and those purchasing insurance from New York State of Health (New York’s health insurance marketplace). The City will connect more independent workers, City vendors, and City workers to MetroPlus, while also improving the quality of the MetroPlus customer experience through improved access to clinical care, mental health services, and wellness rewards for healthy behavior.
- Launch NYC Care to connect New Yorkers to health services
NYC Care, launching in summer 2019, will connect thousands of New Yorkers who are ineligible for health insurance — including undocumented New Yorkers and those who cannot afford insurance — to reliable care. Once the new program is fully implemented in 2021, those enrolled will be able to access the clinical services, coordinated care, and the customer service that people with health insurance are accustomed to experiencing. NYC Care is open to anyone who does not have an affordable insurance option, and will be priced on a sliding scale to ensure affordability. NYC Care will provide a primary care doctor and access to specialty care, prescription drugs, mental health services, hospitalization, and more.
New York City is revitalizing how H+H, the nation’s largest public hospital system, can improve the quality of care for patients and streamline communication among providers. As we focus on strengthening place-based outpatient health care, we will leverage new technology to expand access to specialty doctors, and modernize our health records and billing infrastructure.
- Expand primary care to better address community health needs
H+H is transforming the health system’s vast ambulatory care operations and improving access to primary care. In 2018, the system released a five-point strategy that will be adopted across more than 70 place-based health centers, including 11 hospital-based outpatient operations, which together provide more than five million outpatient visits to children and adults every year. We will open three new full-service ambulatory care sites by the end of 2021.
- Improve access to specialty care through eConsult
H+H will ensure patients can get the right care at the right time in the right place. To do so, the City is expanding its eConsult system to all H+H facilities by the end of 2020. The use of eConsult expands access to ambulatory specialty care by enhancing communication among primary care providers and specialists. Today, eConsult is live in more than 100 clinics across 11 facilities, including adult medical and surgical subspecialties, behavioral health, and pediatric subspecialties.
- Implement an electronic health record and financial system across all NYC H+H facilities
To support expanded access to care and services, H+H is moving to a modern IT and financial infrastructure that features a single electronic health record and billing system. This will help to more accurately document health care delivery and correctly bill insurers. Most importantly, it will improve patient care by strengthening communication across more than 70 patient care sites. This timely access to patients’ complete medical records will enhance our clinicians’ ability to make better care decisions, and will allow them to spend less time managing paper records and more time caring for patients.
How eConsult works for patients
Over 28,000 eConsults completed since 2016
eConsult can allow primary care providers to give their patients access to the advice of specialty care providers before the patient visits a specialty clinic. For example, one Bronx resident – we’ll call him Jose – saw his primary care doctor and complained of ringing in his ears. The primary care doctor believed Jose was experiencing tinnitus, a condition that would normally be treated by a specialty care provider. However, before the primary care doctor sent Jose to an Ear, Nose and Throat (ENT) specialist, she sent an eConsult to a specialist in the ENT department. The specialist reviewed the chart and recommended he see an audiologist before coming to the ENT department. The specialist also gave Jose’s primary care doctor instructions for the tests he needed, and an appointment for a visit to the audiologist was scheduled. When Jose finally went to the ENT, the diagnosis was already determined, and Jose and his healthcare provider were able to immediately focus on a plan of action for Jose’s care. As a result of eConsult, Jose was able to see the appropriate specialists in the right order all while saving time by avoiding unnecessary specialist appointments.