In April 2011, the New York City Human Resources Administration released Healthcare Reform at the Local Level:  Framework for a Navigator Program in New York City. 

Health care reform is ushering in significant changes that will likely affect how most uninsured residents, publicly insured individuals, and many small businesses access health insurance. 

Navigator Programs, which federal reform requires each Exchange to establish, will administer grants to eligible entities to provide culturally and linguistically appropriate education and enrollment assistance to residents and small businesses eligible for coverage in the Exchange.

Home to a large and diverse population of more than 8 million people, New York City has made significant investments to assure that its residents and business owners understand and have ready access to their health insurance options.  While health care reform has the potential to provide some benefits and new assistance for the uninsured, it is imperative that in the midst of these changes, current coverage gains are not lost. 

This issue brief looks at how best to implement a Navigator Program in New York City, outlining the need for a discrete Navigator Program in NYC and providing a framework for delivering efficient and effective, data-driven and accountable navigator services to meet the needs of the City’s large and diverse population.  In doing so, the brief highlights:

• Key City expertise and technology initiatives, such as HHS Connect, 311, ACCESS NYC, NYC Business Express, and NYC Health Insurance Link that should be leveraged by a locally administered Navigator Program to efficiently reach and serve residents and small businesses in the City. 
• The importance of data and its ongoing use to identify populations to be targeted by navigators (grantees) and the best mechanisms and entities for reaching them. 
• The imperatives for ongoing training and monitoring of grantees in the provision of education and enrollment assistance and use of referral tools to ensure a ‘no wrong door’ pathway for all residents who have coverage or care needs, including undocumented individuals and others left out of health care reform.
• The critical role that collaboratively developed and evolving outreach strategies play in responding to the changing needs of the uninsured over time.

The full report can be downloaded by clicking on the link below. You will need to have Adobe Acrobat Reader Version 5.1 or higher in order to open the document. For those who do not have Acrobat Reader, a link for Acrobat Reader Version 10.0.1 can also be downloaded from this page.

In May 2010, the Office of Citywide Health Insurance Access released Connecting New York City’s Uninsured to Coverage:  A Collaborative Approach to Reaching Residents Eligible for Public Health Insurance but Not Enrolled. 

This report summarizes the City and State programs and administrative policies that have served as a foundation for New York’s dramatic expansion in public health insurance enrollment.  It analyzes four common principles that have underpinned the successful and diverse outreach and enrollment strategies employed by OCHIA and its partners over the past decade. 

The report also provides a snapshot of how many New Yorkers had public health insurance in 2007, and how many did not, even though they were eligible for it.  Finally, the report examines how existing outreach strategies can evolve to meet the remaining challenges and emerging opportunities, such as access to web-based independent enrollment and recertification by individuals.

As the nation looks towards recently enacted health care reform in the hopes of covering more people than ever, this report sheds light on the successes and challenges borne from years of seeking to enroll everyone who is eligible for public health insurance.  We hope it is a useful reference for policymakers and practitioners working to increase access to coverage.

The full report can be downloaded by clicking on the link below. You will need to have Adobe Acrobat Reader Version 5.1 or higher in order to open the document. For those who do not have Acrobat Reader, a link for Acrobat Reader Version 10.0.1 can also be downloaded from this page.

This study demonstrates the value of using administrative data matches to identify public health insurance trends in schools and for individual students over time and across Medicaid and Child Health Plus. The utility of data matching further suggests that it is a potentially valuable tool for informing targeted outreach and streamlining enrollment and retention strategies.