MRT II Implementation Briefing: Private Home Care Exchange


  • Presentation is also available in Portable Document Format (PDF)
August 19, 2020

NY State of Health Private Pay Home Health Care Services Program

  • NY State of Health, New York´s Official Health Plan Marketplace, is one of the nation´s most successful state-based marketplaces and enrolls over 1 in 4 New Yorkers into health coverage
  • This new initiative would build on the "marketplace model" and allow New Yorkers to shop for home care services for themselves, their family members or friends from the same trusted source on a private pay basis
  • This program is working to launch on November 1, 2020, in time for NY State of Health Open Enrollment Period, on a pilot basis in Nassau, Suffolk, and Westchester counties, and then expand statewide later in 2021
  • Consumers or their family members will access the NY State of Health website and select the option for "private pay home health care services"
  • Then, search for personal care workers in their area and, based on user-generated criteria, including level of need, language preference, or other criteria, "match" with available workers
  • Once the personal care worker of their choice is selected, the consumer will schedule a free in-home or telehealth evaluation with the LHCSA
  • Then, the consumer will work directly with the LHCSA that employs the personal care worker to determine the consumer´s needs
  • Payment for services will be made directly by the consumer to the LHCSA

LHCSA Selection

  • On July 23, 2020, NY State of Health issued an invitation to LHCSAs to participate in the Pilot which outlines the requirements for participation
  • Proposals are due to NY State of Health on August 19, 2020
  • All LHCSAs licensed to serve in the pilot area and meet the invitation requirements will be approved and listed on the NY State of Health website
  • Approval of LHCSAs for participation will be made by September 9, 2020 and the program is scheduled to launch on November 1, 2020