1115 Waiver Demonstration: Conceptual Framework – A Federal-State Partnership to Address Health Disparities Exacerbated by the COVID-19 Pandemic



Authors: New York State Department of Health: Office of Health Insurance Programs
Year: 2021
State: NatDoc: National Document
Website link: https://www.health.ny.gov/health_care/medicaid/redesign/2021/docs/2021-08_1115_waiver_concept_paper.pdf
Publicly Available: Yes
Billing and Reimbursement:
Certification:
Evidence Generation:
Policy:
Sustainable Financing: Engaging state partners in general, General other, How to engage and work with Medicaid, MCO or bundled payment reimbursement models, Evidence-based interventions, ROI and bundled payment successes/challenges
Workforce Development: Data sharing between social services and clinical teams, General other (including mention of “employment practices”)

To achieve the overall goal of fully integrating social care and health care into the fabric of the NYS Medicaid program, while recognizing the complexity of addressing varying levels of social care needs impacting the Medicaid population, this waiver proposal is structured around four subsidiary goals:

  1. Building a more resilient, flexible and integrated delivery system that reduces racial disparities, promotes health equity, and supports the delivery of social care;
  2. Developing supportive housing and alternatives to institutions for the long-term care population;
  3. Redesigning and strengthening health and behavioral health system capabilities to provide optimal response to future pandemics and natural disasters; and
  4. Creating statewide digital health and telehealth infrastructure


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