Health Reform: Opportunities for New York’s Behavioral Health Providers James R. Knickman April 27, 2011 NYAPRS 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 1,100,000110,000 – 440,000660,000 – 1,000,000 Newly eligible for Medicaid 90,00050,000 – 70,00020,000 – 40,000 Access to Exchange Eligible for Subsidies 700,000570,000130,000 Access to Exchange Ineligible for Medicaid or Subsidies 340,00080,000260,000 Affordability Exemption Takers 200,000 Penalty Payers60,000 Undocumented Immigrants 390,0000 Total2,620,000810,000 – 1,160,0001,460,000 – 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

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