New York State Approved it’s 1115 Waiver!
Dear Friends, Customers, and Partners,
We hope this letter finds you in good health and high spirits. We are pleased to share exciting news regarding the recent approval of the New York State 1115 Waiver by the NYS Department of Health, a significant milestone in promoting health equity, reducing disparities, and strengthening our workforce.
We are excited by the potential the waiver will have to impact the health and social care ecosystems across the Empire State. As always, we remain dedicated to providing you with the highest quality of advisory services and supports. If you have any questions about the 1115 Waiver or would like more information about how you can prepare, please do not hesitate to reach out.
Vanessa Guzman, ME, MS CEO,
SmartRise Health
1115 Waiver | 5 THINGS YOU SHOULD KNOW
Medicaid will pay for social services. Through Health-Related Social Needs (HRSN) Initiative, Managed Care plans will pay for services such as screening, case management, housing, nutrition, and transportation through the Social Care Networks (SCNs).
Statewide and regional governance. Social Care Networks (SCN) will organize HRSN programming amongst local providers, while the statewide Health Equity Regional Organization (HERO) will collect data and drive statewide strategy reducing health disparities and advancing health equity.
Global budgets. New York joins Maryland, Vermont, and Pennsylvania with Global Budgets. Select hospitals, specifically those who are financially distressed, will have the opportunity to be rewarded for value rather than volume of care provided.
Alignment with CMS’ models. The waiver is aligned with CMMI’s Making Care Primary and AHEAD Model, which hopefully reduces some redundancies in reporting and compliance.
Investing in our healthcare workforce. With 1 in 3 healthcare workers planning to leave their job (Rev Cycle Intelligence), New York State is preparing Student Loan Repayment for specific provider types and training programs focused on alleviating staffing shortages and increasing access to culturally and linguistically appropriate services (CLAS).
At SmartRise Health, we focus on empowering and mobilizing healthcare and community organizations to innovate and maximize value. We do this through designing and launching strategies, systems, and trainings to achieve measurable change on health, equity, and social factors. Here are some things you should be thinking about as New York State begins its 1115 Waiver Implementation journey.
Take inventory. Conduct an organization-wide assessment about your process for collecting quality and equity data, including Social Determinants of Health and Z Code data. If you participate in any ACO or CMMI program, think of what services you select and make sure it aligns with the waiver.
Conduct due diligence. Identify which types programs your organization is eligible for, including global budgeting, HRSN services, workforce training.
Consider People, Process, and Technology. Ask questions like…
How can we further integrate behavioral health into primary care?
What is our process for SDoH screening and community referrals? Do we have the right data capture/aggregation and referral platforms in place?
Does our organizational governance structure lend itself to cross-departmental collaboration?
Does this initiative dovetail with existing accreditation programs, such as Joint Commission and National Committee for Quality Assurance?
Please reach out to us at support@smartrisehealth.com to learn how our team at SmartRise can support you through your 1115 Waiver readiness efforts.