Report Indicates Managed Care Key to State Medicaid Reform

New York's Public Health Plans Generate Strong Outcomes and Savings

ALBANY, NY (02/10/2011)(readMedia)-- A new report finds that New York's public health plans surpass state and national Medicaid benchmarks in quality care measures while driving down costs. New York's success in providing high quality, cost-effective health care through managed care provides a solid foundation for Medicaid reform.

The 2010 Medicaid Managed Care & Family Health Plus Quality Update also finds that the Coalition of New York State Public Health Plans has "successfully closed the gap in care quality that traditionally separated Medicaid from commercial plans." Coalition plans rival commercial insurance plans, despite the unique challenges of providing care to individuals who often have more complex health needs and face significant barriers to health care.

Members of the Coalition of New York State Public Health Plans - which provide health care through Medicaid Managed Care, Family Health Plus and Child Health Plus - exceeded national Medicaid standards on 74% of quality care measures. Their innovative approach to primary care resulted in outstanding outcomes in preventive measures including childhood immunization, breast cancer screening and sexually transmitted disease testing.

Coalition health plans provide high quality health care to more than 2.5 million children and adults using comprehensive networks of providers and services that work together to ensure a coordinated continuum of care. Medicaid reform provides opportunities to cover uninsured New Yorkers while cutting costs by promoting care management.

"New York's public health plans use innovative approaches to improve health outcomes and reduce Medicaid costs," said Maura Bluestone, chair of the Coalition of New York State Public Health Plans. "The 2010 Quality Report shows that our networks produce strong outcomes that can be replicated as the State seeks to reform our health care delivery systems."

The Coalition of New York State Public Health Plans includes nine plans serving two-thirds of children and adults enrolled New York's public health insurance programs. The 2010 Quality Update shows:

• 83% of children in Coalition plans received preventative immunizations, well above the state HMO rate of 75% and national HMO benchmark of 78%.

• 70% of women in Coalition plans received recommended breast cancer screening, far exceeding the national Medicaid benchmark of 52%.

• 82% of patients in Coalition plans received ambulatory follow-up care within the critical 30-day window after being hospitalized for mental illness, surpassing the national Medicaid benchmark of 60%.

• 90 percent of patients enrolled in Coalition plans say they would recommend their health plan to others.

"Publicly-sponsored health coverage using managed care in New York is really excellent coverage," said Assembly Health Committee Chair Richard N. Gottfried. "Medicaid managed care, Family Health Plus and Child Health Plus have been a successful model for controlling cost, improving quality and effectiveness and expanding access to care. This model will help in the Medicaid redesign effort."

###

Members of the Coalition of New York State Public Health Plans offer decades of experience in delivering high quality services to populations that often experience significant barriers to health care. Coalition plans are sponsored by or affiliated with public and not-for-profit hospitals, community health centers and physicians. Coalition members include:

Affinity Health Plan (New York City and Nassau, Orange, Suffolk, Rockland and Westchester Counties)

Fidelis Care New York (New York City and 41 counties)

Healthfirst (New York City and Nassau and Suffolk Counties)

Health Plus (New York City and Nassau County)

Hudson Health Plan (Dutchess, Orange, Rockland, Sullivan, Ulster and Westchester Counties)

MetroPlus Health Plan (Bronx, Kings, New York and Queens Counties)

Monroe Plan for Medical Care (Broome, Chemung, Chenango, Livingston, Monroe, Ontario, Orleans, Schuyler, Seneca, Steuben, Tioga, Wayne and Yates Counties)

Neighborhood Health Providers (New York City and Suffolk County)

Total Care (Cortland, Onondaga, Oswego and Tompkins Counties)