January 9, 2024 marked a significant stride toward a stronger, healthier New York as the Centers for Medicare & Medicaid Services (CMS) approved a monumental amendment to the 1115(a) Medicaid Waiver. This groundbreaking approval marks an additional investment of $7.5 billion into the state’s healthcare framework, with a significant investment for a strong data infrastructure.
The core goals behind the waiver is to increase health equity among all New Yorkers and build on the healthcare gaps uncovered during the pandemic. Central to handling the waiver goals is the establishment of Social Care Networks (SCNs) tasked with screening, referring, and coordinating Health Related Social Needs (HRSN) services to eligible Medicaid beneficiaries. These SCNs will cultivate crucial partnerships with Community-Based Organizations (CBOs), ensuring comprehensive service delivery. The Statewide Health Equity Regional Organization (HERO) will guide this initiative, providing support through crucial data analysis, regional needs planning, and program analyses.
The waiver brings forth crucial initiatives and commitments, each playing a pivotal role in shaping a more integrated healthcare system for New York:
As part of the 1115 Waiver, SCNs will benefit from infrastructure funding for technology, business and operational practices development, workforce development, and outreach. Furthermore, SCNs will be reimbursed for delivering HRSN services on a fee-for-service basis, per the State-published fee schedule. They are responsible for screening, referring and determining Medicaid beneficiaries’ eligibility for new waiver services, which include navigation and linkage to existing State and Federal Social Services (Level 1) and enhanced HRSN services like case management, nutrition support, housing support, and limited transportation (Level 2).
Another key component of the waiver is to track outcome data from service delivery to ultimately transition target populations from a fee-for-service basis to be included in risk bearing value based payments (VBP) arrangements. The state will be using critical service data to design these arrangements.
The release of the waiver opens the opportunity for organizations to become Social Care Networks. There will be nine (9) SCNs selected to represent the communities in New York and organizations will need a strong data partner with experience to put themselves in the best position to be awarded the SCN. Foothold has both the experience and expertise to partner with organizations from the application process through service delivery.
Why Foothold Technology?
Through the complexities of the 1115 Medicaid Waiver, Foothold Technology isn’t just a software provider — we’re your strategic partner. Ready to empower your organization to thrive in the changing healthcare landscape, our commitment is to ensure that your Social Care Network is well-equipped to deliver effective and equitable care to those in need.