Independence Care System

Primary care is often a patient’s first and most regular point of contact with the health care system.

High-quality primary care provides ongoing, relationship-based care that meets the health needs and preferences of individuals, families, and communities, according to the National Academies of Sciences, Engineering, and Medicine. It is a rare “win-win” in health care that improves individual and community health, enhances health equity, and saves money. Despite the benefits, too little is invested in primary care and too many New Yorkers, especially New Yorkers of color, have difficulty getting care when and where they need it. In 2023, NYHealth issued a Request for Proposals (RFP), “Primary Care: Expanding Access and Advancing Racial Health Equity,” to test replicable models to improve the accessibility, quality, and equity of primary care in regions across the State. NYHealth awarded Independence Care System (ICS) a grant to participate in this initiative.

Under this grant, ICS will establish a Center of Excellence for primary care for people with disabilities at Woodhull Hospital, evaluate its impact, and support replication across the New York City Health + Hospitals (H+H) system and beyond. ICS will conduct focus groups in Brooklyn with 100 patients with physical disabilities to identify specific care needs and experiences with primary care providers. It will adjust care protocols based on patient feedback and evidence-based practices, and it will improve Electronic Medical Record documentation to better identify patients’ needs for accommodation. ICS will train primary care providers, clinical staff, and administrative staff and offer on-site consultation to support the delivery of more accessible and equitable care. In partnership with leading national researchers, ICS will analyze the model’s impact on enhancing uptake of screenings and preventive care, reducing hospitalization, and improving patient health outcomes. It will create resources to enable replication across H+H, including policies and procedures, disability competency training curriculum, and continuing education opportunities. It will also disseminate learnings through peer-reviewed publications and online patient and provider educational resources.

See a full list of grantees working to expand access to and advance racial health equity in primary care across New York State.

Manatt, Phelps & Phillips, LLC

The use of telehealth skyrocketed in New York State during the COVID-19 pandemic.

While telehealth has tapered off some, it is here to stay as an option for patients. Research shows that telehealth can expand access to care, lower no-show rates, increase patient satisfaction, and improve patient outcomes. However, uneven telehealth use during the pandemic has exacerbated—not reduced—disparities in health care access. Since the Public Health Emergency (PHE) expired in May 2023, the State and federal government have been reconsidering telehealth policies. In some cases, commercial and public payers are considering removing coverage for phone visits—a primary way that many patients of color and low-income patients access telehealth. The end of the PHE offers an opportunity for New York State to recalibrate telehealth policies to capitalize on successes and address pain points. Careful examination of telehealth policies is needed to ensure that all patients have equitable access to primary care. In 2023, NYHealth awarded a grant to Manatt, Phelps & Phillips to examine emerging telehealth policies, regulations, payments, best practices, and case studies to recommend changes that will preserve and expand equitable access to telehealth in New York State.

Under this grant, Manatt will produce a comprehensive and up-to-date analysis of telehealth in New York State. It will interview stakeholders, representing diverse perspectives and expertise, to generate a State-specific understanding of issues and opportunities in telehealth policy and identify case studies on high-impact telehealth service delivery models. Manatt will also analyze the telehealth policy landscape at the State and federal levels to find examples of effective policy solutions from other states, with a focus on promoting equitable access. It will delve into State-specific telehealth issues including coverage and reimbursement; virtual care modalities; regulations; originating site requirements; and policies affecting access to telehealth services. In addition, Manatt will present data on telehealth utilization to demonstrate uptake of telehealth across the State and highlight remaining gaps and disparities in access. Data will depict trends before, during, and after the PHE and be disaggregated by patient demographics, payer type, and care specialty, as available. Manatt will disseminate its findings to the media, policymakers, providers, consumers, advocates, and other health care-decision makers across New York State to inform timely policy conversations.

Community Health Care Association of New York State

High-quality primary care is best delivered by a diverse team of professionals who work together and combine skills to address the needs of patients and communities.

Members of this team include medical assistants (MAs), who are unlicensed personnel who perform various administrative and limited clinical tasks under the supervision of a physician. In New York State, the MA workforce of nearly 36,000 is expected to grow by 27% by 2030. With the fast growth of MAs and the shift to team-based care, MAs can take on enhanced roles in areas such as care coordination, patient navigation and education, and disease management. Because MAs are often members of the communities they serve, they are well-positioned to build relationships with patients—particularly patients of color and those from other historically marginalized groups—and earn their trust. But varying state regulations pose barriers to MAs taking on even greater responsibilities. More than 40 states formally define the scope of practice for medical assistants or empower clinicians to delegate tasks to unlicensed MAs, but New York lacks clear guidance. Health centers also struggle to use MAs because their education, training, skills, and experience vary considerably. In 2023, NYHealth awarded the Community Health Care Association of New York State (CHCANYS) a grant to expand the MA workforce in community health center settings through a statewide apprenticeship program and policy advocacy to expand the scope of practice for MAs in New York State.

Under this grant, CHCANYS will adopt a workforce development and policy strategy focused on MA advancement on the care team. It will launch a statewide MA apprenticeship program at 10 community health centers. This program will pair an MA apprentice with an experienced MA coach and a practice administrator champion to offer supervised practice and instructions. This curriculum has been recognized by the New York State Departments of Labor and Education and aligns with national accreditation competencies. CHCANYS will also lead skill-based trainings; provide technical assistance in hosting apprentices; offer peer-learning sessions; cover fees for accreditation exams; and perform site visits to help integrate MAs into care teams at participating health centers. Additionally, it will launch a statewide advocacy campaign to encourage stakeholders to define and expand the scope of practice for MAs.

2023 Grant Recipients for “Primary Care: Expanding Access and Advancing Racial Health Equity”

In 2023, NYHealth selected a cohort of organizations from across the State for grants totaling nearly $1,100,000 to expand access to and advance racial health equity in primary care.

Primary care is often a patient’s first and most regular point of contact with the health care system. High-quality primary care provides ongoing, relationship-based care that meets the health needs and preferences of individuals, families, and communities, according to the National Academies of Sciences, Engineering, and Medicine. It is a rare “win-win” in health care that improves individual and community health, enhances health equity, and saves money. Despite the benefits, too little is invested in primary care and too many New Yorkers, especially New Yorkers of color, have difficulty getting care when and where they need it.  

In New York’s primary care system, we see both glaring inequities and momentum for improvement—making now the right time to invest in and strengthen the system. Policy efforts are underway in New York and nationally to increase the proportion of overall health care spending directed toward primary care. At the practice level, primary care providers are implementing new models that place patients at the center of their care, use multidisciplinary care teams, and employ innovative uses of technology. 

In 2023, NYHealth issued an inaugural Request for Proposals (RFP), “Primary Care: Expanding Access and Advancing Racial Health Equity,” in our new Primary Care priority area to support two of our core strategies: (1) expand access to primary care, and (2) advance racial health equity through primary care. Expanding access to primary care is inextricably linked to advancing racial health equity, as shortage areas in New York State are often communities of color. Additionally, improving racial health equity through primary care is not only about increasing access to care, but also about improving the quality and experience of care for patients of color. 

Through this RFP, NYHealth is supporting the selected organizations to test replicable models to improve the accessibility, quality, and equity of primary care in regions across the State.  

Grant recipients are: 

EngageWell IPA

Primary care is often a patient’s first and most regular point of contact with the health care system.

High-quality primary care provides ongoing, relationship-based care that meets the health needs and preferences of individuals, families, and communities, according to the National Academies of Sciences, Engineering, and Medicine. It is a rare “win-win” in health care that improves individual and community health, enhances health equity, and saves money. Despite the benefits, too little is invested in primary care and too many New Yorkers, especially New Yorkers of color, have difficulty getting care when and where they need it. In 2023, NYHealth issued a Request for Proposals (RFP), “Primary Care: Expanding Access and Advancing Racial Health Equity,” to test replicable models to improve the accessibility, quality, and equity of primary care in regions across the State. NYHealth awarded EngageWell IPA a grant to participate in this initiative.  

Under this grant, EngageWell will connect residents living in emergency shelters and supportive housing across New York City to virtual medical and behavioral health services, aiming to reduce racial health disparities in primary care use and health management. EngageWell will facilitate a planning process with input from shelter and supportive housing residents to create a virtual, trauma-informed medical care experience that increases access to and trust in routine preventive care. EngageWell will seek to provide residents with 700 virtual primary care, urgent care, and mental health visits in home and congregate settings at up to 7 housing agencies. Residents will receive support and technology navigation from community health workers and referrals to follow-up care with EngageWell’s health care provider network. EngageWell will prioritize care to residents of color, residents with chronic conditions, residents who have not seen a primary care doctor in the past year, and residents who frequent the emergency department. EngageWell will evaluate the impact of this model on reducing emergency department use and share project findings through fact sheets, policy briefs, or conference presentations. It will disseminate best practices and lessons learned to stakeholders including national and statewide housing and health care provider networks; university partners; and digital health vendors.  

See a full list of grantees working to expand access to and advance racial health equity in primary care across New York State. 

Jewish Board of Family and Children’s Services

Primary care is often a patient’s first and most regular point of contact with the health care system.

High-quality primary care provides ongoing, relationship-based care that meets the health needs and preferences of individuals, families, and communities, according to the National Academies of Sciences, Engineering, and Medicine. It is a rare “win-win” in health care that improves individual and community health, enhances health equity, and saves money. Despite the benefits, too little is invested in primary care and too many New Yorkers, especially New Yorkers of color, have difficulty getting care when and where they need it. In 2023, NYHealth issued a Request for Proposals (RFP), “Primary Care: Expanding Access and Advancing Racial Health Equity,” to test replicable models to improve the accessibility, quality, and equity of primary care in regions across the State. NYHealth awarded the Jewish Board of Family and Children’s Services a grant to participate in this initiative.  

Under this grant, the Jewish Board will integrate primary care services into its Certified Community Behavioral Health Clinics (CCBHCs) in Brooklyn, the Bronx, Manhattan, and Staten Island to increase access to care and decrease care fragmentation for individuals with co-occurring primary care, mental health, and substance use disorder needs. It will embed primary care teams of clinicians and patient navigators to provide services like vaccinations and immunizations; diabetes, cardiovascular, hepatitis, and cancer screenings; medication management; health counseling; and family planning services. The Jewish Board will create and disseminate a framework on how to effectively and sustainably integrate primary care into CCBHCs to support other CCBHC agencies in meeting new regulations. It will also advocate for regulatory and funding changes to better enable primary care integration into CCBHCs.  

See a full list of grantees working to expand access to and advance racial health equity in primary care across New York State. 

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