The New York State Health Innovation Plan

In December 2014, the New York State Department of Health was awarded a $99.9 million Round Two Model Test Award State Innovation Models (SIM) grant by the Centers for Medicare and Medicaid Innovation (CMMI) to implement the State Health Innovation Plan (hereafter "the Plan"). New York developed the Plan and the SIM grant application with the support of numerous stakeholders. The state's official project period of the grant began February 1, 2015 and will continue through January 31, 2020. New York was one of eleven states to receive a Round Two Model Test Award.

Additional Information:

Background of New York's Participation in the CMMI State Innovation Model Initiative

The CMMI Innovation Center created the State Innovation Models (SIM) initiative for states that are prepared for or committed to planning, designing, testing, and supporting evaluation of new payment and service delivery models in the context of larger health system transformation. The Innovation Center is interested in testing innovative payment and service delivery models that have the potential to lower costs for Medicare, Medicaid, and the Children's Health Insurance Program (CHIP), while maintaining or improving quality of care for program beneficiaries. The goal is to create multi-payer models with a broad mission to raise community health status and reduce long term health risks for beneficiaries of Medicare, Medicaid, and the Children's Health Insurance Program (CHIP).

More information about the Innovation Center and the State Innovation Models Initiative can be found at http://innovation.cms.gov.

In September 2012, New York State applied for a Model Testing Grant through CMMI. The application included the creation of a State Health Innovation Plan (SHIP) that included six models of care that would be tested in New York State. New York was initially awarded a Model Pre-Testing Assistance Award to further develop New York's Plan. New York conducted significant outreach and convened stakeholders to refine its approach to transforming health care in the state in preparation for implementing the goals of the SHIP.

On May 22, 2014, CMMI released a Funding Opportunity Announcement (FOA) to support the implementation of the State Health Innovation Plan through "State Innovation Models: Round Two Funding for Design and Test Assistance." New York submitted an application for Round Two Model Test funding on July 18, 2014. On December 16, 2014, New York received notification that it had received a Round Two Model Test award from CMMI. The performance period under the Round Two Testing awards runs from February 1, 2015 through January 31, 2020.

Goals of the Plan and SIM

The intent and goal of the Plan is to identify and stimulate the spread of promising innovations in health care delivery and finance that result in optimal health outcomes for all New Yorkers. Multi-payer support of these initiatives is key to long-term success, as is the input and recommendations of key stakeholders throughout the state.

The Plan will pave the way for the state to support innovations in health care delivery, to implement strategies to spread those innovations more broadly throughout New York. The Plan was the basis for an application for funding from CMMI that provided approximately $99.9 million in support of proposed initiatives through SIM.

SIM Drivers

SIM is comprised of five drivers which will collectively transform New York's health care system from a reactive, volume-based care delivery system to a proactive, prevention-focused, value-oriented system that is both patient-centered and broadly accessible. These five drivers and associated programs are listed below.

Timely, appropriate access is the cornerstone of quality health care and foundational to achieving the SHIP goals. New York has a proud history of providing access to care, with one of the lowest proportions of uninsured populations across the country. The SHIP builds on this history to ensure access without disparity, inclusive of all populations across NYS of any means, circumstance, background, or geography. The SHIP's ambition is to improve access and continue to be a leader in providing timely access to health care for all.

Projects under this driver include:

  • Consumer Engagement
  • Project ECHO

The SHIP aims to increase the number of people receiving integrated care. Under SHIP, all New Yorkers should have access to a new care model, NYS PCMH, which builds on the principles embodied by the NCQA-certified medical home. The ultimate goal of the Integrated Care Pillar is that that 80% of the population receives health care services through an integrated care-delivery model, such as NYS PCMH, by 2020.

Projects under this driver include:

The near and long-term success of the SHIP rests squarely on the extent to which HIT can effectively evolve and be integrated into New York’s health care system. Through SHIP, New York committed to plans that continue its commitment to providing best-in-class HIT functionality to support patient care coordination and to advance population level improvements in the quality of care delivery, systemic cost-control, and health outcomes.

Under the SHIP, consumers, providers, and payers will experience unprecedented levels of health data transparency. Health data transparency empowers consumers, providers, and payers, to make increasingly informed decisions about the quality and costs of the care they seek and provide. The SHIP proposed to create and improve statewide transparency of core quality, utilization and cost metrics at a facility and practice level. The SHIP also included plans for a consumer-targeted website to provide this information in a user-friendly format to enable consumer action and shared decision-making. Improving transparency across the health care system and engaging New York’s consumers in their own health care is critical to achieving the Triple Aim.

Projects under this driver include:

The SHIP recognizes that health and health care outcomes are influenced, if not determined, by factors outside the health care delivery system. SHIP uses the State Health Department’s Prevention Agenda 2013–2018 as a guide for building healthy communities and citizens and targets specific opportunities to enact and meet the goals and objectives of the Agenda. Specifically, SHIP works to strengthen links between primary care, hospitals, long-term care providers, local health departments, and a variety of community stakeholders to ensure a truly integrated approach to identifying and addressing local health challenges. The ultimate goal of the SHIP’s population health driver is to: (1) connect 90% of primary care practices to community-based organizations working to support population health through high-quality registries of community health-focused organizations, and (2) promote regional health planning.

Projects under this driver include:

SHIP encourages a NYS health workforce that supports and assures comprehensive, coordinated, and timely access to care that promotes health and well-being for all New Yorkers.

Projects under this driver include: