Academy Awarded Contract to Support New York State Roadmap to Achieve the “Triple Aim”: Improved Health, Better Health Care and Lower Costs

The New York Academy of Medicine will evaluate New York’s $100 million State Innovation Model initiative

New York, N. Y., October 19, 2016 – In recognition of the Academy’s extensive expertise in health reform and experience in large-scale evaluations, the organization, along with its partner on the project, FAIR Health, Inc., has been selected to evaluate the New York State Department of Health’s ambitious State Innovation Model (SIM) initiative to improve health care across the state, which has as its heart the transformation of primary care to a comprehensive, coordinated model.

In December 2014, New York was awarded a four-year $100 million State Innovations Model Testing grant from the Centers for Medicare and Medicaid Innovation as one of 11 states developing and testing new ways of achieving health care reform’s “triple aim”—better care, lower costs and better patient outcomes.

“As long-time supporters of health care innovation in New York State, the Academy is proud to have been selected as the evaluator for the SIM initiative. The effort is critical to moving the state’s health care system into the future, ensuring access to high quality care for every resident and working toward improved health for all,” said Jo Ivey Boufford, MD, President of the Academy.

FAIR Health President Robin Gelburd stated, “FAIR Health is excited to partner with the New York Academy of Medicine on this important New York State initiative. We bring to the partnership our unique role in the marketplace, as stewards and analysts of an independent data repository of over 21 billion private healthcare claims nationwide and as a CMS-certified Qualified Entity given access to all of Medicare Parts A, B and D data.”

The SIM initiative, which began in February, 2015, and lasts through January, 2019, is designed to accomplish the “triple aim” through an ambitious, multifaceted range of activities, including the coordination of primary care services with long-term care, behavioral health care, specialty care and supportive community services (called advanced primary care), as well as testing valued-based payment models and expanding the state’s health care workforce.

Finding out What Works

The Academy’s interdisciplinary approach to evaluating the SIM initiative’s many components will draw on the combined expertise of the organization’s Center for Evaluation and Applied Research, Center for Health Innovation and Center for Health Policy & Programs. Uniquely positioned to have extensive knowledge and a broad perspective on health and health care throughout New York State, Academy experts will use data analytics, as well as in-person interviews and focus groups with policymakers, providers, community based organizations and health care consumers, to assess the SIM initiative’s challenges and successes.

“Our goal is to use multiple data sources—ranging from insurance claims to analyze the use of health services and associated costs to information collected through interviews and site visits—to understand the impact of the SIM initiative and improve it over time,” said Jose Pagan, PhD, Director of the Academy’s Center for Health Innovation.

“Our comprehensive approach to evaluation will allow us to identify not only what works, but how it works and for whom. We expect that our findings will be useful to the state and its partners as the SIM initiative’s activities are implemented - and to those more broadly involved in health reform efforts nationwide,” added Linda Weiss, PhD, Director of the Academy’s Center for Evaluation and Applied Research.

By revealing the lessons learned from reforming New York’s vast health care system in real time, the Academy will create a base of knowledge that may be used to inform future health system reform efforts in NYS and around the country.

Center for Health Policy and Programs

Through our Center for Health Policy and Programs, we provide evidence-based guidance to public and private sector leaders to help shape policies and programs that promote long, active, healthy lives and communities. Whether through evidence from research, expert testimony, convening of multiple stakeholders, technical assistance or through our work leading coalitions, we are actively helping to align and shape the actions of communities, government and industry to transform the places where we live, work, play and learn into environments that promote health.

Center for Evaluation and Applied Research (CEAR)

CEAR works with a broad range of not-for-profit and governmental organizations to investigate, design and assess initiatives that seek to improve the health and well-being of populations in New York City, New York State and around the world. With expertise in both qualitative and quantitative research methods, CEAR conducts needs assessment, process evaluation and outcome evaluation.

Center for Health Innovation

The Center for Health Innovation develops and implements innovative and data-driven solutions to improve the health care system, with increased attention on vulnerable populations. With the triple aim of reducing costs, increasing quality, and improving population health, the center designs, tests and evaluates financially sustainable improvements in health care delivery systems that recognize the social and economic determinants of health.

About the Academy

The New York Academy of Medicine advances solutions that promote the health and well-being of people in cities worldwide.

Established in 1847, The New York Academy of Medicine continues to address the health challenges facing New York City and the world’s rapidly growing urban populations. We accomplish this through our Institute for Urban Health, home of interdisciplinary research, evaluation, policy and program initiatives; our world class historical medical library and its public programming in history, the humanities, and the arts; and our Fellows program, a network of more than 2,000 experts elected by their peers from across the professions affecting health. Our current priorities are healthy aging, disease prevention and eliminating health disparities.

About FAIR Health

FAIR Health is a national, independent, nonprofit organization dedicated to bringing transparency to healthcare costs and health insurance information through data products, consumer resources and health systems research support. FAIR Health uses its database of billions of privately billed medical and dental claims to power an award-winning free consumer website and to create data products serving all healthcare stakeholders, including government officials, researchers, consumers, providers, insurers and other businesses. FAIR Health has been certified by the Centers for Medicare & Medicaid Services (CMS) as a Qualified Entity, eligible to receive all Medicare claims data for use in nationwide transparency efforts. In addition, FAIR Health’s data have been designated as the official data source for a variety of state health programs, including workers’ compensation and Personal Injury Protection (PIP) programs, as well as state consumer protection laws governing surprise out-of-network bills and emergency services. For more information, visit www.fairhealth.org.