Medicaid Redesign Team Votes Yes To End Segregated Care

November 09, 2011

One of the proposals adopted by the MRT was recommended by Dr. Neil Calman, President and CEO of the Institute for Family Health, and a member of the MRT Health Disparities Work Group. Dr. Calman’s proposed recommendation would ensure that existing standards of care are enforced in teaching hospitals and training clinics. As a result, the care provided to persons who are uninsured or covered by Medicaid would be equivalent to those services provided by the faculty practices to privately-insured patients in the same institutions.

“Teaching hospitals in New York State operate a two-tiered system where Medicaid patients are seen in specialty outpatient clinics and privately insured patients are seen in faculty practices. These two systems provide substantially different care in terms of quality, with clinic patients receiving poorer continuity of care, longer wait times, and poor patient access to physicians after- hours,” said Dr. Calman. “This proposal requires a single level of care for all patients, regardless of insurance status. By ensuring that all New Yorkers are entitled to the same quality of care, we will end the practice of providing inferior care to Medicaid beneficiaries in teaching hospitals and promote equity in the healthcare system. In addition to this being an equity and disparities issue, not providing continuity of care, after hours call coverage and communication to referring providers results in unnecessary ER visits, hospitalizations, and other excess costs. Our patients and the State deserve better than that.”

Other recommendations adopted by the MRT include proposals to:
• improve data collection on race, ethnicity, gender, sexual orientation, disability and housing status by health providers, consistent with federal health reform;
• provide reimbursement to hospitals, clinics and community health centers that make language assistance services available to their limited English proficient patients (LEP);
• ensure that prescription drug labels are easier to understand for patients with low health literacy, seniors and LEP communities, among others;
• reform the state’s distribution of charity care funding to hospitals to ensure that safety net providers who serve the uninsured are appropriately and equitably compensated.

“By recommending this package of proposals to the Governor, the MRT has shown that New York State is willing to be a leader on ensuring equality and fairness for all people of our state,” said Nisha Agarwal, Director of the Health Justice Program at New York Lawyers for the Public Interest, a longtime partner of Bronx Health REACH, and a member of the MRT Health Disparities Work Group. “Disparities on the basis of race, ethnicity, disability and other such factors are an unacceptable and persistent scourge on the healthcare system. New York is finally saying enough is enough.”

The Medicaid Redesign Team was formed by the Governor via executive order in January 2011. It has been the primary vehicle through which the Medicaid budget has been managed this year, and it is the mechanism through which long-term reforms to the New York state healthcare delivery system is being carried out.