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NYC Care: A Large Health Care Access Program for Uninsured New York City Residents
Jonathan Jiménez1, Marielle Kress, Ted Long
1NYC Health + Hospitals, Duke University School of Medicine, Durham, North Carolina (Dr Jiménez); NYC Health + Hospitals, New York (Ms Kress and Dr Katz); and Health + Hospitals, NYU Grossman School of Medicine, New York (Dr Long).
Context:
Millions of people living in the United States are excluded from health insurance due to income or immigration status. These 2 groups are more likely to lack access to health care or a regular source of care.
Program:
NYC Health + Hospitals is addressing this need with NYC Care, a health care access program. The program is designed to be the single point of access for uninsured care citywide and includes a membership card, a 24-hour customer service line, and direct access to primary care medical homes. Health care is coordinated across NYC Health + Hospitals using integrated electronic referrals and a medical record system.
Implementation:
The program uses a single enrollment process across safety net health care resources of NYC Health + Hospitals. A 24-hour call center was established to answer questions, make primary care appointments, and make warm handoffs to enrollment staff. Once eligibility is confirmed and patients are enrolled, they are mailed a membership card, a member handbook, and offered a primary care appointment. A multipronged public awareness campaign including citywide, multilingual marketing and outreach via community-based organizations was essential to build trust.
Outcomes:
NYC Care had 119 203 members at the end of June 2023. Fifty-eight percent had not seen a primary care doctor in the NYC Health + Hospitals system in the prior 36 months. In total, 76 439 had completed 1 or more primary care visits; 53.1% of enrollees with diabetes had improved hemoglobin A 1c , and 73.4% of enrollees with hypertension had improved blood pressure control after 6 months of enrollment.
Discussion:
NYC Care demonstrates that municipalities can improve access to care for the uninsured by simplifying steps to affordable health care services, connecting patients directly to patient-centered medical homes, and improving the patient experience. A comprehensive public awareness campaign is also crucial.
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