Primary Care Archives - New York Health Foundation

Primary Care for All Americans (Fiscal sponsor: Global Impact) 

New York State’s primary care advocacy efforts are primarily led by provider organizations working to advance policy and practice changes. Consumer advocacy groups are increasingly engaging on primary care issues with a focus on patients’ needs. Yet a key voice remains underrepresented: grassroots, community-level movements that directly involve primary care providers, community leaders, and patients in local advocacy and solutions development. Community-led models are emerging, but remain limited; many communities still lack the leadership and resources to create these types of initiatives. In 2024, NYHealth awarded Primary Care for All Americans (PC4AA) a grant to expand New York’s primary care advocacy network.

Under this grant, PC4AA will build relationships with community members, health care providers, and other stakeholders to understand community needs and develop culturally aligned strategies to address primary care access challenges in Queens. It will establish a grassroots network of primary care advocates with a targeted plan to improve primary care access locally. Over time, this grassroots model will complement efforts to increase primary care access and equity statewide.

Center for Health Care Strategies

As frontline public health workers who are predominantly people of color, Community Health Workers (CHWs) serve as a critical bridge between patients from marginalized communities and the health care system. Recent policy changes have increased opportunities for CHW integration. Medicare now reimburses CHW services for older adults with health-related social needs nationwide, and New York State has joined 23 other states in initiating Medicaid reimbursement for CHW services for pregnant and postpartum women, children, adults with health-related social needs, and other high-risk populations. However, this potential remains largely untapped. In 2024, NYHealth awarded the Center for Health Care Strategies (CHCS) a grant to equip providers and policymakers with the tools to integrate CHWs into primary care and maximize Medicare and Medicaid reimbursements.

Under this grant, CHCS will launch and facilitate a learning collaborative with six clinical and community-based providers seeking to bill Medicare and Medicaid for CHW services. Participating organizations will identify barriers to reimbursement and design solutions to overcome them. CHCS will provide tailored technical assistance, host educational workshops, and support shared learning. It will develop and widely disseminate a toolkit to help New York providers navigate and braid Medicare and Medicaid reimbursement. Finally, it will make policy recommendations to improve Medicare and Medicaid CHW benefits or better coordinate their implementation.

New York University, Robert F. Wagner Graduate School of Public Service

Nationally and in New York State, we spend only about five cents of every health care dollar on primary care. Underinvestment runs counter to what we know: national research demonstrates that primary care has a high return on investment. But New York State lacks specific evidence demonstrating the effects of primary care investment in its unique health care market. There is a clear need for rigorous, objective, and New York-specific analysis to showcase the potential savings and value of primary care investment based on actual health insurance claims data. In 2024, NYHealth awarded The Robert F. Wagner Graduate School of Public Service at New York University (NYU Wagner) a grant to analyze the relationship between primary care investment and associated outcomes in health, quality, and cost savings for Medicaid health insurance claims in New York State.

Under this grant, NYU Wagner will develop analytic frameworks and methodologies to understand the relationship between primary care investment and health outcomes. In partnership with Dartmouth researchers, NYU Wagner will conduct analyses that describe the association between primary care investment and health outcomes and expenditures, as well as assess how Medicaid health plans’ spending on primary care affects enrollees’ health care utilization and expenditures. NYU Wagner will share the findings to inform advocacy efforts and policy improvements.

Envision Community Health Worker Training and Technical Assistance Center (fiscal sponsor: University of South Carolina)

A core strategy of NYHealth’s Primary Care program is to enhance the role of New York State’s CHWs and integrate them into primary care teams to improve patient access, reduce clinician strain, and support equitable career advancement for Community Health Workers (CHWs). New York State is one of eight states without a statewide CHW association or coalition. In 2024, NYHealth awarded Envision a grant to provide technical assistance and enable Community Health Workers, primary care providers, and other CHW employers and supporters across the State to organize and strengthen the CHW profession.

Under this grant, Envision, a technical assistance provider with a track record of establishing statewide CHW coalitions, will bring its model to New York. It will equip CHWs and partners with the skills needed for statewide organizing, create a policy advocacy platform, establish channels to share priorities with policymakers, and support stakeholders in determining how to sustain their collective advocacy efforts.

Mullan Institute for Health Workforce Equity at George Washington University

High-quality primary care is best delivered by a diverse team of professionals—including unlicensed professionals such as Medical Assistants, or MAs—who collaborate and combine skills to address the needs of patients and communities. But New York State lags other states in using MAs effectively; for example, unlike 49 other states, New York prohibits MAs from administering vaccinations. Because New York State does not license or define a scope of practice for MAs, primary care practices vary widely in how they use MAs and face barriers to using them in enhanced ways. With a 2023 NYHealth grant, the New York Alliance for Careers in Healthcare (NYACH) and the Mullan Institute for Health Workforce Equity at George Washington University (GW) worked together to develop a research plan focused on variations in MA roles, barriers to expanding MA responsibilities, and MA recruitment and retention. NYACH and GW are now ready to implement the research plan. In 2024, NYHealth awarded GW a grant to assess how Medical Assistants (MAs) are used, trained, and retained within primary care teams across New York State.

Under this grant, GW will use surveys with primary care practice administrators, key informant interviews, and focus groups with MAs to yield practical ideas to inform primary care delivery and policymaking. These may include innovative models of team-based care; on-the-ground insights about policy solutions to expand MA responsibilities; gaps in training and opportunities for standardization; effective uses of State funding; and feedback on apprenticeship models and other professional development programs.

New York University Grossman School of Medicine

A core strategy of NYHealth’s Primary Care priority area is to elevate the non-clinical workforce—specifically, Medical Assistants (MAs) and CHWs—and integrate them into primary care teams to improve patient health outcomes, reduce clinician strain, and support equitable career advancement.

Previously, NYHealth supported the New York Alliance for Careers in Healthcare to design a statewide scan of the current functions and desired roles of MAs on care teams. Similarly, an understanding of on-the-ground experience is needed to effectively scale models of CHWs’ integration. In 2024, NYHealth awarded New York University (NYU) a grant to conduct focus groups with primary care providers and community health workers regarding CHW integration into care teams across New York State.

Under this grant, NYU will conduct a series of focus groups both upstate and downstate to elicit experiences and information from both CHWs and the clinical and community-based providers that employ and partner with them (e.g., academic medical centers, community hospitals, community health centers, physician practices). NYU will distill the findings into a research brief that summarizes themes and offers recommendations, share related materials with researchers and CHWs in other states, and promote its work through webinars and publications.

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Funding Area: Primary Care