Columbia University – Mailman School of Public Health

Approximately 2.5 million New Yorkers lacked health insurance in 2007, according to estimates from the United Hospital Fund, a New York health policy center.

Proposals for increasing coverage had been offered, but needed to be analyzed for their responsiveness to New York’s health care system, their costs and consequences, and their acceptance by the public. The staff at Columbia University’s Mailman School of Public Health examined the unique features of health care delivery in New York State and developed alternative strategies for expanding coverage–drawing heavily on public input–so that lawmakers can choose from a comprehensive menu of choices.

This project was part of a larger NYHealth Coverage Consortium that funded 10 grants to seven universities, policy institutes, and community agencies across the State, supporting projects that could inform State health reform efforts, offer ways to streamline enrollment in public programs, significantly reduce costs and improve quality, and test ideas for expanding coverage among small employers, sole proprietors, and self-employed people.

Read an NYHealth special report that contains a summary of findings from this consortium.

Columbia University will guide New York State in a systematic exploration of different approaches to achieve expanded coverage by engaging in an in-depth examination of a range of reform options.

The United Hospital Fund (UHF) and Commonwealth Fund developed a “Blueprint” proposal to expand coverage in New York State. Additionally, New York State Assembly Representative Richard Gottfried plans to examine various approaches to universal coverage in New York State. The Columbia University project intends to complement these two developments in health reform by examining the unique features of health care delivery in New York State and incorporating models that reflect the characteristics of the State.

The Columbia University project team will partner with Cornell University to develop alternative strategies for expanding coverage in New York State, drawing heavily on public input, so that lawmakers can choose from a comprehensive menu of choices. The Columbia University project team will also examine the specific characteristics of New York State health policy and assess how these would affect the success of proposals, as well as examining the microsimulation forecast models used to assess them. An important component of this project involves convening an advisory committee to identify a set of feasible, appropriate reform models.

In the first phase of this project, Dr. Olveen Carrasquillo and Dr. Sherry Glied will develop coverage options for New York State. The second phase will consist of using a rudimentary forecast model to get a sense of the cost and coverage implications of these proposals. The third phase will identify key New York State-specific issues that are not addressed in standard models and commission a series of papers that explore these issues. In the fourth and final phase, Dr. Carrasquillo and Dr. Glied will host a conference among micro-simulation modelers. Additional analysis will include more policy-relevant micro-simulation analysis incorporating the New York State-specific factors identified at the conference and provide results of interest to key New York State stakeholders.

This project is part of the NYS Health Coverage Consortium