Publication | BRG

New York Health Equity Reform Promises Change

Patrick Dooley

May 2024

What the NYHER amendment—approved under Medicaid’s 1115 waiver—means for New York hospitals.

New York State recently took a significant step toward advancing health equity within its Medicaid program. On January 9, 2024, the Centers for Medicare & Medicaid Services (CMS) approved the state’s amendment to its existing 1115 waiver, titled “New York Health Equity Reform” (NYHER). This novel approach targets existing health disparities and aims to improve overall health outcomes for vulnerable populations by addressing health-related social needs (HRSNs).

Patrick Dooley is an expert on state regulatory and public policy issues, innovative healthcare models, and strategic planning. He shares insights into key provisions of NYHER and outlines next steps safety-net hospital executives should consider. Below is a summary of some unique opportunities and risks associated with NYHER.

Opportunities Risks
Greater focus on HRSNs connects Medicaid beneficiaries with services and improves overall health. X The provider network to address HRSNs does not meet demand.
Moving into global budgets could stabilize safety-net hospitals and prevent future closures. X Hospitals move to global budgets but still operate like fee-for-service.
Budgets could better align hospitals and payers. X Misalignment of incentives limits success.
Successful implementation provides blueprint for other states.


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Patrick Dooley

Managing Director