Expanding Health Care Coverage

Project Title

Increasing Health Care Policy Research and Analysis Capability in New York State

Grant Amount


Priority Area

Expanding Health Care Coverage

Date Awarded

July 1, 2007


Capital Region





Medicaid is the single largest funding source for long-term care, paying for half of all nursing home and community based long-term care in the nation. Given the disproportionate use of Medicaid as a funding source for long-term care, the New York State Department of Health’s Office of Health Insurance Programs was looking for potential policy improvements to better target Medicaid spending and services.

In addition, many states are looking for ways to reduce asset transfers as a means for reducing long-term care costs. Under this grant, New York State Health Policy Research Center at the Rockefeller Institute of Government (Rockefeller) undertook two studies. The first study compared New York State to other states on a range of long-term care issues. The second study reviewed the prevalence of denials for Medicaid-funded nursing home care and found wide variation in reported denial rates across the State’s counties. Both reports resulted in widespread press coverage across the State.

This project was part of a larger NYHealth authorization that funded a series of quick-strike analyses to help the New York State Department of Health’s (NYSDOH’s) Office of Health Insurance Programs find ways to streamline and expand its public health insurance programs.

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

Read Medicaid and Long-Term Care: New York Compared to 18 Other States, a Rockefeller-produced report about how New York compares with other states on a range of long-term care issues, such as demographics, spending, and quality.

Read Assessing Asset Transfer for Medicaid Eligibility in New York State, a Rockefeller-produced report about the incidence of asset transfers for Medicaid-funded long-term care.

Read additional analyses NYHealth funded Rockefeller to conduct based on its findings on rates of asset transfers.

One important lesson emerged from this project regarding data extractions. Although the data necessary for this project were collected for administrative purposes, they were difficult to use for research. One way to address this shortcoming is to fund upfront work to see if the desired analysis is possible and whether the limitations present too much of a barrier to make a larger study worthwhile. Read about how this issue has come up on another NYHealth grant to date.

New York spends more public money on health care per capita than any other state. Yet, despite this investment, the State faces challenges to improve patient outcomes, modernize health care delivery, reduce costs, and increase access and coverage. Rockefeller Institute will support the New York State Department of Health in studying options for Medicaid reform.

Rockefeller Institute will undertake two key activities to support the State Department of Health. Institute staff will provide assistance in shaping the administrative studies that outside experts will conduct. Staff also will solicit proposals from experts, coordinate the review of the proposals, and manage the grantees funded under this initiative. The second category of activities involves undertaking “quick turnaround” data analyses for the State Department of Health related to its efforts to expand enrollments in public insurance programs.

To undertake this project and to stimulate other work related to state health policy, the Rockefeller Institute, the public policy research arm of the State University of New York, will create the New York State Health Policy Research Center. The institute will seek to mine in-state expertise, employ national expertise, and conduct thorough analyses of health care in New York State.

The State has many organizations and experts working on health care—including staff in the legislature and the governor’s office, trade organizations, staff at the New York State Department of Health (DOH) and other state agencies, and nonprofit organizations, such as the United Hospital Fund, the Manhattan Institute, New York University, Columbia University’s School of Public Health, and the Rockefeller Institute. These efforts, however, are not sufficiently connected. Unlike other states (e.g., Massachusetts, California, and New Jersey), New York does not have a single or predominant networking entity for health care policy research.

Known for its expertise in the conduct and dissemination of public policy research, the Rockefeller Institute’s efforts will take advantage of its in-house talent to pursue short- and long-term research projects on health care challenges in New York State. At the same time, the Institute will also seek out some of New York and the nation’s top scholars and health care experts to write research papers and perform research projects focused on New York’s health care system. The end result of this endeavor will be the creation of a clearinghouse for New York’s health care experts that will work in collaboration with the NYHealth Coverage Consortium to address New York’s health insurance coverage crisis.

This project is funded under the NYHealth authorization: Medicaid Reform in New York State: Supporting Analyses to Expand, Simplify and Reform the System.