New York State Health Department Announces Package of Innovative State Regulatory Initiatives That Will Improve Access to Health Care and Reduce Overall Costs

Bold Regulatory Modernization Initiative will update existing regulations and policies to better leverage advances in technology and New York's evolving health care needs

New regulatory measures will increase quality, reduce costs and improve the health of New Yorkers

ALBANY, N.Y. (February 20, 2018) - The New York State Health Department today announced a series of sweeping recommendations that will improve the delivery of health care in New York State. Major recommendations include measures to integrate primary care, behavioral care and substance abuse treatment in a single setting; and deliver telehealth to patients at any location, including their homes.

The recommendations announced today are the result of the first phase of the State Department of Health's Regulatory Modernization Initiative (RMI) and can be found in thereport, entitled "Spurring Health Care Innovation Through Regulatory Modernization: Putting Patients First".

Regulatory reforms will include:

  • Integrating primary and behavioral health services. A growing body of evidence confirms that the integration of primary and behavioral health services can improve the quality of care and lower costs. And yet, while many patients face both physical and behavioral health care needs, care is often provided in silos—impacting patients, providers, and payers alike. New York State will propose regulations to allow for an innovative new licensure category in order to allow providers to more readily offer integrated services—with a streamlined licensure application and approval process, and standard requirements across all relevant State agencies.
  • Allowing patients to access care more conveniently by expanding the use of telehealth services. The ability of telehealth to remotely connect patients and healthcare providers can be an important tool in ensuring access to health care, improving care and patient outcomes, enhancing patient satisfaction, and reducing health care costs through improved population health. Yet, health care providers and systems in New York State have identified a number of challenges to the adoption and delivery of telehealth services, including financial, statutory and regulatory barriers. New York State will take a landmark step forward to expand access to telehealth services through a series of measures, including expanding the list of eligible originating sites so that patients can receive telehealth services in any setting, including their own homes.
  • Putting patients at the center of a coordinated, cohesive health care system by easing care transitions. Health care stakeholders have long agreed on the importance of supporting the delivery of services across an integrated system of care; for post-acute care in particular, achieving care coordination is critical to reducing readmissions and improving patient outcomes, while slowing the growth in costs.To allow for the delivery of new, innovative models that allow for more seamless care transitions, and improve access to high-quality post-acute care that keeps New Yorkers healthy and well, New York State will take a series of steps to reform the post-acute regulatory landscape. That includes proposing legislation to expand the scope of practice of certified Emergency Management Technicians in order to expand access to care.

Department of Health Commissioner Dr. Howard Zucker said, "Updating our regulations and policies is a major step forward in building a health care system that puts the patient at the center. I want to commend the members of the RMI workgroups who worked so hard to produce this report. The end result will be a health care system that better meets patient needs."

The RMI was launched by NYSDOH in 2017 to overhaul the policies and regulations that govern the licensure and oversight of health care facilities. Six workgroups comprised of subject matter experts solicited ideas from health care providers, consumers, and payers on ways to streamline and improve policies, regulations and statute. The workgroups were: Integrated Primary Care and Behavioral Health; Telehealth; Post-Acute Care Management Models; Cardiac Services; Off-Campus Emergency Departments; and Long-Term Care Need Methodologies and Innovative Models. The Long-Term Care workgroup is continuing to meet and will submit its recommendations at a later date.

Each workgroup also included staff from NYSDOH, Office of Mental Health, Office of Alcoholism and Substance Abuse Services and Office of People with Developmental Disabilities. Members of the Public Health and Health Planning Council also joined many of the RMI workgroups.

OASAS Commissioner Arlene Gonzalez-Sanchez said, "For people struggling with substance use disorder, receiving addiction treatment in conjunction with care for any additional conditions is central to their recovery.Governor Cuomo's Regulatory Modernization Initiative is moving New York State toward a system where integrated care is more common and easier to access, which will result in better outcomes and increased efficiency."

OMH Commissioner Anne Marie Sullivan said, "Increasing access to behavioral healthcare is essential to our goal of helping people recover from mental illness. By integrating primary and behavioral health services and better utilizing technology, we can help more people receive the healthcare they need more quickly and efficiently.These regulatory changes will have a very positive impact on the lives of New Yorkers."

Acting OPWDD Commissioner Kerry Delaney said, "The regulatory changes resulting from this collaboration across multiple agencies will enable us to provide increased flexibility, improved access and, most importantly, choice of providers to the people we support. Expanding the use of secure telehealth services is incredibly important for thousands of people who have difficulty accessing specialists or who live in remote areas where simply accessing routine health care services can be difficult. We look forward to the improved access to quality care that these changes will provide to people with developmental disabilities."

NYSOFA Director Greg Olsen said, "These are incredibly important regulatory changes that place people at the center of care and further brings systems together to assure that the diverse needs of people can be addressed in one place. I applaud members of the RMI for recommending these common-sense reforms that will improve lives as well as outcomes."

Greater New York Hospital Association President and CEO Kenneth E. Raske said, "I applaud the state's commitment to modernizing the health care regulatory landscape. The landmark steps announced today will move us towards a more innovative health care system that delivers the highest quality care for patients. Thanks to the Governor, New York State's health care delivery system is at the forefront. We look forward to working with the RMI workgroups on additional topics and recommendations in the future."

Hospital Association of New York State President Bea Grause said, "We were very pleased to work with the Governor on this critical initiative. The proposals outlined today will help hospital and health systems across the state to deliver coordinated, valued-based care. We applaud this important first step and look forward to a continued partnership with the state to improve healthcare for all New Yorkers."

Community Health Care Association of the State of New York President & CEO Rose Duhan said, "At the Governor's direction, the Regulatory Modernization Initiative set the New York State Department of Health on an important path to modernize and harmonize health care regulations across State agencies. The proposals outlined in today's report will allow community health centers across the State to better serve the millions of New Yorkers who depend on them today. We applaud Governor Cuomo's commitment to moving the health care delivery system to one that delivers high quality care, at lower costs, for all New Yorkers."

Iroquois Healthcare Alliance President and CEO Gary Fitzgerald said, "Today's announcement is an important step in our continued work to deliver high quality, coordinated care for New Yorkers, especially those in our Upstate communities. Iroquois Healthcare Alliance applauds Governor Cuomo's commitment to meeting the unique needs of our rural and Upstate urban communities."

NYS Council for Community Behavioral Healthcare Executive Director Lauri Cole said, "Governor Cuomo is committed to making reforms that better enable the health care system to deliver on its promises for the millions of New Yorkers that rely on it every day. These proposals are an important step as we work to ensure that every New Yorker has access to integrated primary care and behavioral health services."

The RMI is the latest in a series of initiatives designed to transform health care in New York. The process began in 2011 when just days after his inauguration, Governor Cuomo created the Medicaid Redesign Team (MRT). Changes to Medicaid generated by the MRT led to significant savings and the creation of the Delivery System Reform Incentive Payment (DSRIP) Program. DSRIP, now in its fourth year, relies on networks of providers known as Performing Provider Systems that work collaboratively in communities, with the goal ofreducing avoidable hospital use by 25 percent over five years. A separate initiative known as the New York State Health Innovation Plan (SHIP) serves as the roadmap to achieving the Triple Aim -- improved health, better health care quality and lower costs – and centers on an advanced primary care model.Taken together, these initiatives are breaking down service silos and fostering collaborations among health care sectors.