Primary Care Archives - New York Health Foundation

Research Foundation for the State University of New York

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. Patients of color can face unique obstacles, including racism, bias, mistrust, and gaps in communication between patients and physicians. Engaging patients of color is an important step toward the development of a more equitable health system; however, few reliable metrics that capture patients’ perceptions of health equity exist.

The SUNY Downstate Health Sciences University (DHSU), in collaboration with partners One Brooklyn Health System and Arthur Ashe Institute for Urban Health, developed a patient-centered index to measure and address racial inequities in patient experience, grounded in the experiences of people living in Central Brooklyn, called the Brooklyn Health Equity Index (BKHI). BKHI is a 10-item health equity metric developed throughout a two-year community-engaged research project that amplifies patients’ voices and perceptions of inequities. 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 Research Foundation for the State University of New York (SUNY), on behalf of DHSU, a grant to participate in this initiative and scale the Brooklyn Health Equity Index to multiple health systems in Central Brooklyn.

Under this grant, DHSU and partners will implement BKHI in numerous clinics (including primary care) at University Hospital at Downstate and One Brooklyn Health System; use findings to drive patient experience improvement initiatives; and measure associations between BKHI scores and health care use and outcomes. BKHI findings will drive transformation at the patient-provider level by capturing information on patient experiences within the domains of trust, discrimination/disrespect, and provider acknowledgment of social determinants of health, and at the system level by providing an aggregate measure of health equity. The long-term goal is to evaluate the impact of routine health care system use of BKHI on patient experience; support health systems in making progress toward health equity; and spread BKHI use to health systems across New York State.

Health Care for All New York (fiscal sponsor: Hispanic Federation)

While New York has made great strides in increasing access to health coverage, disparities in health persist. Some of these disparities arise from unequal access to quality affordable care. Even insured patients struggle to find providers, schedule timely appointments, or afford out-of-pocket costs. In 2024, NYHealth awarded Health Care for All New York (HCFANY) a grant to develop and implement a new consumer advocacy agenda focused on primary care. In 2025, NYHealth awarded HCFANY a grant to continue to mobilize consumer advocates in New York to advance primary care policies.

Under this grant, HCFANY will deepen its advocacy on primary care investment and address other consumer-led priorities. It will continue to focus on three core policy areas: expanded coverage, enhanced affordability, and improved accessibility of primary care services. In its role representing consumers in these forums, HCFANY will elevate both primary care policies and consumer perspectives to primary care policy discussions. HCFANY member organizations will conduct policy research and analysis, communications, community outreach and education, and administrative policy advocacy to advance its efforts.

Community Health Care Association of New York State, Inc.

Community Health Centers (CHCs) face an increasingly complex federal health care landscape, marked by shifting funding priorities, regulatory changes, and evolving grant requirements. These challenges threaten access to care for vulnerable populations and CHCs’ ability to maintain their operations and service offerings. The Community Health Care Association of New York State, Inc (CHCANYS) supports 72 community health centers operating nearly 900 sites statewide. In 2023, CHCs served 2.4 million patients, with 88% living below the federal poverty level. In 2025, NYHealth awarded Community Health Care Association of New York State, Inc. (CHCANYS) a grant to help CHCs navigate federal changes, enhance their service models, and ensure continued access to high-quality primary care for the populations that need it most.

Under this grant, CHCANYS will provide training and technical assistance focusing on financial planning, compliance, and maintaining high-quality and mission-oriented care. CHCANYS will conduct outreach, analyze changes in relevant guidance and requirements, engage subject matter experts, and prioritize assistance for CHCs with limited resources and a high proportion of patients from underserved communities.

Code for America Labs

Nearly half New York State’s population—8.6 million people—rely on Medicaid, the Essential Plan, or subsidized marketplace plans, but recent federal changes put an estimated 4.5 million New Yorkers’ insurance at risk. With recent changes, Medicaid recipients who qualify under the Affordable Care Act’s expanded eligibility rules will be subject to new work requirements and more frequent eligibility checks, and the State will no longer be able to continuously cover children aged 0–6 on Medicaid. NYHealth has a long history of partnering with the New York State Department of Health (NYSDOH) to expand and protect insurance coverage. One of the most effective ways to ensure that New Yorkers maintain coverage is to use technology to automate wherever possible, reducing the need for enrollees to act. In 2025, NYHealth awarded Code for America Labs (CFA) a grant to partner with the New York State Department of Health to improve automated systems to handle more frequent renewals and reduce the number of consumers losing insurance coverage for administrative reasons.

Under this grant, CFA will partner with NYSDOH to design technology solutions that reduce consumers losing health insurance coverage for administrative reasons, like missed deadlines or missing documents. The work will focus on populations at highest risk, including adults subject to work requirements and biannual eligibility checks and young children who will lose continuous eligibility beginning in 2027. Through system assessment, design, testing, and implementation support, Code for America will help NYSDOH maximize automatic renewals, streamline eligibility processes, and enable tens of thousands of New Yorkers to maintain continuous health insurance coverage.

New York City Health and Hospitals Corporation

Policy changes, broader restrictions, and looming Medicaid cuts have deterred many New Yorkers from seeking essential care, increasing the likelihood that preventable conditions worsen. Primary care providers have reported a drop-off in patients seeking services. NYC Care, a citywide health care access program, expanded its outreach to ensure new and existing patients know about NYC Care as an affordable, safe option. However, persistent digital and logistical barriers continue to limit patient access to preventive and primary care. During the COVID-19 pandemic, NYHealth supported NYC H+H to launch a telehealth patient navigation program that provided one-on-one support before and after visits, improving participation and patient satisfaction. That initiative strengthened the health system’s capacity and laid out the groundwork for sustained equitable access to virtual care. In 2025, NYHealth awarded NYC H+H a grant to expand equitable access to in-person and virtual primary care for underserved New Yorkers.

Under this grant, NYC H+H will implement a culturally and linguistically responsive patient navigation initiative to help patients enroll in and engage with NYC Care. The initiative will be implemented across four NYC H+H sites, reaching an estimated 6,000 patients. Multilingual patient navigators will provide in-person and remote support to help patients enroll in NYC Care, prepare for and attend primary care visits, and engage in ongoing care through personalized education, reminders, and digital assistance. Through culturally responsive navigation before and after visits, NYC Care aims to strengthen patient engagement, reduce missed appointments, and use insights from navigator activities to improve retention and scale effective strategies over time.

New York University Grossman School of Medicine – Community Health Worker Research and Resource Center

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

As frontline public health workers, CHWs serve as a critical bridge between patients from marginalized communities and the health care system. In 2024, NYHealth awarded New York University (NYU) a grant to conduct focus groups with primary care providers and CHWs regarding CHW integration into care teams across New York State. That work identified immediately actionable steps, such as redesigning workflows, as well as broader themes needing further exploration. In 2025, NYHealth awarded NYU a grant to provide a comprehensive picture of CHWs’ and employers’ experiences with primary care service delivery, Medicare and Medicaid reimbursement, and more.

Under this grant, NYU will develop and field two complementary statewide surveys to engage CHWs and their employers. NYU will convene a stakeholder advisory committee to refine survey questions, identify survey respondents, and field the survey with CHW employers in various primary care settings. NYU will distribute a report of survey findings through its networks and conduct interviews with approximately 20 CHWs who complete the survey to inform stakeholders on CHW-driven advocacy and facilitating consensus-building.

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Funding Area: Primary Care