Coalition of New York State Public Health Plans (Affinity Health Plan, Inc.)

Effective implementation of health reform requires a seamless system that will allow individuals to easily transition between different types of coverage and remain insured as their incomes and circumstances fluctuate.

Many people are expected to move back and forth between Medicaid and private polices available in the exchange. As low-income families shift between different insurance programs, there is a risk that they could experience breaks in coverage or other disruptions that undermine their continuity of care. The Coalition of New York State Public Health Plans (the Coalition) applied operational knowledge to directly inform how New York State achieves seamless transitions across several coverage programs in the exchange.

Specifically, the Coalition: 1) estimated the number of New Yorkers likely to experience income volatility and changes in insurance eligibility; 2) identified barriers to continuity of coverage and care, including misalignments of coverage program rules, health plan participation, provider networks and benefits; and 3) recommended solutions and developed detailed action plans to implement them.

Read the report associated with this grant, “Achieving Continuity of Insurance Coverage for Lower-Income New Yorkers in 2014.”