Health Reform: Opportunities for New York’s Behavioral Health Providers

James R. KnickmanApril 27, 2011NYAPRS Executive Seminar on Systems Transformation

About NYSHealth

• Private, not-for-profit grantmaking foundation focused on health

• Work in all regions of New York State, in three primary areas– Health care coverage and cost

– Diabetes

– Integrated outpatient services for mental health and substance use disorders

Key Aspects of Health Reform

• Coverage expansion

• Delivery system reform

Insurance Reform: 1.2 Million New Yorkers Could Gain Coverage

Source: Manatt Health Solutions and NYSHealth analysis

Currently Uninsured

Newly Insured Post-Reform Range

Remaining Uninsured Post- Reform Range

Eligible for Medicaid but Unenrolled

1,100,000 110,000 – 440,000 660,000 – 1,000,000

Newly eligible for Medicaid

90,000 50,000 – 70,000 20,000 – 40,000

Access to Exchange Eligible for Subsidies

700,000 570,000 130,000

Access to Exchange Ineligible for Medicaid or Subsidies

340,000 80,000 260,000

Affordability Exemption Takers

200,000

Penalty Payers 60,000

Undocumented Immigrants

390,000 0 390,000

Total 2,620,000 810,000 – 1,160,000 1,460,000 – 1,820,000

Key Aspects of Health Reform

• Coverage expansion

• Delivery system reform– Improve quality

– Reduce costs

Quick Poll

How should we reduce costs?

• Cut benefits

• Cut rates

• Revamp the delivery system

Delivery System Reform: ACOs

• Providers banding together

• Emphasize primary care

• Focus on coordinated, efficient care

• Shared risk, shared savings

• Savings for New York State could approach $50 billion in 10 years

The Big Goal

Integrated patient care

Key Question for Mental Health Providers

Will mental health providers be team

members or at times team leaders?

The Promise of Health IT

• Information-sharing

• Patient engagement

• Data analysis/quality improvement

New York State Health Foundation1385 Broadway, 23rd Floor

New York, NY 10018phone: 212.664.7656

www.nyshealthfoundation.org