The New York State Care Coordination Organization/Health Homes (CCO/ HHs) were designed by NYS Office for People With Developmental Disabilities (OPWDD) and NYS Department of Health (DOH) to replace the Medicaid Service Coordination (MSC) model to enable a more comprehensive, integrated, and holistic service coordination to better support people, with complex health care needs.
The goal and focus of CCO/HHs and their Care Managers are to improve care and health outcomes, lower Medicaid costs, and reduce preventable hospitalizations, emergency room visits, and unnecessary care for Medicaid members. This is in stark contrast to former Medicaid Service Coordination (MSC) provider agencies.
The CCO/HH Care Managers are essential resources and advocates to New York’s high-risk and vulnerable population. Health care and clinical staff/teams support the CCO/HH Care Managers to assess and align disability supports and services based upon a comprehensive person-centered assessment and Life Plan for each individual. CC/HH Care Managers coordinate medical; home and community-based services; and other community resources for individuals with I/DD needed and desired to live a quality life.
The New York State Department of Health (DOH) and the New York State Office for People with Developmental Disabilities (OPWDD) received approval from the Centers for Medicare and Medicaid Services (CMS) to expand the Health Home Care Management program to serve Individuals with Intellectual and/or Developmental Disabilities (I/DD) through specialized I/DD Care Coordination Organization/Health Homes (CCO/HHs).
Provider agencies from over 350 I/DD agencies across New York partnered and invested in creating the seven (7) Care Coordination Organization/Health Homes (CCO/HHs) to meet the July 1, 2018 implementation date. Each CCO/HH made significant investments in resources to launch the new organizations. The provider agencies’ “Medicaid Service Coordinators” (MSC) were hired to fill the new, “Care Manager” positions and were provided with comprehensive and ongoing training and education to meet the expectations of their new roles. 108,000 individuals with I/DD opted into this new, comprehensive model of Care Management. This transition ensured the provision of conflict-free care coordination with the goal to improve access to services, improve care coordination of services and improved health outcomes.
In only 2 years, CCOs have developed and implemented a comprehensive, holistic, and integrated care coordination infrastructure to serve 108,000 individuals with I/DD and their families.
Innovations include the following:
Work with individuals with I/DD and their families to create individually tailored Life Plans that include I/DD services, health and behavioral health services, social and community supports to live well-rounded and fulfilling lives.
For many individuals without family and natural supports, CCO/HH Care Managers provide a safety net, checking in on them regularly and ensuring access to supports/services including housing, food, medical care, medication, and transportation.