NYC Care’s Studies Showcase Program As National Model For Health Equity Among Uninsured

NYC Health + Hospitals’ NYC Care today announced the release of two observational studies that underscore the program’s role as a national model for municipalities to improve the health of uninsured patients.

The studies in the Journal of General Internal Medicine (JGIM) and the Journal of Public Health Management & Practice (JPHMP) find that NYC Care has been successful across a range of factors including enrollment, utilization of services, chronic disease management, and implementation.

NYC Care’s patient-centered approach includes simplifying steps to affordable care access, building trust with hard-to-reach populations through public awareness campaigns and partnerships with grassroots community-based organizations, and prioritizing health services accessibility, resulting in a patient experience similar to that of Medicaid enrollees.

The study in JGIM leveraged statistical analysis to compare NYC Care patients to Medicaid patients and found that, controlling for sociodemographic characteristics, NYC Care members had a higher rate of primary care usage, similar emergency department usage, and fewer hospitalizations, demonstrating that the program succeeds in promoting preventative health care services in its members while maintaining high-cost services low.

The study in JGIM highlighted health care service utilization among NYC Care members, finding that 83,003 members had completed on average 2.4 primary care visits and 3.9 specialty care visits. 50.7% of enrollees with diabetes had a hemoglobin A1c less than 7.0%, and 75.2% of enrollees with hypertension had blood pressure less than or equal to 140/90 mmHg., chronic disease control metrics comparable to Medicaid enrollees. Together, the studies show how in lieu of increased health insurance access municipalities can use the NYC Care-like health care access programs to improve the care and health of uninsured persons.

“Health care is a human right. With that as our foundation, in NYC we make health care services accessible to all regardless of immigration status or one’s ability to pay. NYC Care is a remarkable program having more than 145,000 enrollees. It’s a model on which other cities can build to continue adding to health care coverage options for their residents,” said Anne Williams-Isom, Deputy Mayor for Health and Human Services.

“NYC Care has improved the health and well-being of countless New Yorkers and their families and signaled to the nation that health care is a human right. With the release of the studies in JGIM and JPHMP, I hope we can continue to inspire other municipalities to adopt a similar approach to reducing health inequities, regardless of ones’ immigration status or ability to pay,” said NYC Health + Hospitals President and CEO Mitchell Katz, MD.

“NYC Care embodies New York City’s commitment to treating health care as a human right. For its 145,000 members, NYC Care has not only unlocked access to primary care, but this critical research shows that NYC Care members have been able to control chronic diseases and even avoid hospitalizations. Further, this research shows that other municipalities could create similarly impactful programs, which would move a step toward treating health care as a human right for all Americans,” said NYC Health + Hospitals Senior Vice President for Ambulatory Care and Population Health Ted Long, MD, MHS.

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“NYC Care has succeeded in improving the health outcomes of thousands of individuals, however, this success must not be restricted to New York City. As long as there are individuals excluded from health insurance, there will be a demand for comprehensive health care access programs to connect individuals to primary and preventive care so they receive the care they need before they get sick,” said Jonathan Jiménez, MD, MPH, Executive Director of NYC Care from NYC Health + Hospitals. “I am proud to have co-authored these groundbreaking studies and look forward to encouraging other municipalities and health systems to adopt the NYC Care model.”

“I could not be more proud of our City and the NYC Health and Hospitals team for leading the way for making health care accessible to ALL New Yorkers regardless of immigration status,” said Manuel Castro, Commissioner of the NYC Mayor’s Office of Immigrant Affairs. “These studies are critical to our understanding of good public policy and demonstrate something we have seen for some time. Often, New Yorkers who lack health care access with chronic health conditions don’t receive the preventive care and treatment they need, resulting in a heavy reliance on emergency care.  Programs such as NYC Cares are good not just for the individual but for the entire community and city and serve as a great model for cities across the country to follow.”

“NYC Care has successfully expanded access to medical services for uninsured and underserved communities in New York City. This is a testament to the powerful impact of initiatives that prioritize affordable and community-focused healthcare solutions. As a partner organization, advocating for Latinx and Indigenous individuals, we have witnessed firsthand how simplifying access to health care and building trust with immigrant populations can lead to healthier communities. These studies reinforce the importance of continuing to support and expand programs like NYC Care that prioritize health equity for all New Yorkers, regardless of immigration status or ability to pay,” said Lorena Kourousias, Executive Director of Mixteca.

“We regularly see community members consider their health as a secondary issue despite the need to visit the doctor and get the care they deserve. These studies on the efficacy of NYC Care highlight how prioritizing our often-overlooked immigrant communities can uplift the health and wellness of our city as a whole. We look forward to our continued partnership with NYC Care to connect community members with this valuable resource,” said Hager Shawkat, MPH, Program Director, Sauti Yetu Center for African Women and Families.

The studies are co-authored by NYC Care Executive Director Jonathan Jiménez, MD, MPH and NYC Health + Hospitals Senior Vice President for Ambulatory Care and Population Health Ted Long, MD, MHS along with leadership from NYC Health + Hospitals and researchers from the University of Pennsylvania. Dr. Jiménez, Dr. Long, and Dr. Mitchell Katz, President and Chief Executive Officer of NYC Health + Hospitals, expanded upon the findings in a recent op-ed in Becker’s Hospital Review, entitled “NYC Care: A blueprint for universal healthcare access.”

While highlighting NYC Care’s success, the studies assess the demand for comprehensive health care access programs, pointing out that while the uninsured rate in the United States reached an all-time low of 7.7% in early 2023, the uninsured rate of undocumented adults is up to 50%. The Affordable Care Act made strides to reduce the uninsured rate in the United States, however, it failed to plan for undocumented immigrants and people with incomes too high to qualify for federal subsidies but low enough to make insurance premiums a burden. While community health centers have stepped in to provide low and no-cost services, uninsured patients are less likely to receive preventive care. The studies find that NYC Care’s pioneering approach addresses these disparities and has generated a consistent demand, as exhibited by its continuous growth.

NYC Care has grown to over 145,000 active members and has provided over one million primary care appointments for its members. Since launching in 2019, it has provided hundreds of thousands of specialty care appointments, including 365,226 Women’s Health appointments, 284,766 Eye Care appointments, and 187,425 Behavioral Health appointments.

NYC Care’s CBO partners have reached over 1 million New Yorkers, scheduled over 43,000 enrollment appointments, and facilitated over 17,000 direct enrollments. In June, the program announced that over 500,000 calls have been received by the NYC Care 24/7/365 hotline. From working with the Department of Health & Mental Hygiene to launch the Groceries to Go program providing discounted groceries for members, to developing multi-lingual video series about the program and deploying public awareness campaigns, NYC Care continues to champion the health needs of the city’s most vulnerable.

NYC Care

NYC Care is a health care access program that provides comprehensive and low or no-cost healthcare services through NYC Health + Hospitals for New Yorkers who cannot afford or are ineligible for health insurance. NYC Care provides a membership card, 24/7 customer service, access to comprehensive and affordable healthcare services, like primary care, mental health services, and sexual and reproductive healthcare, low-cost medications, and member materials in multiple languages – regardless of your immigration status or ability to pay. Call 646-NYC-CARE (646-692-2273) or visit NYCCare.NYC to learn more and sign up today – privacy and confidentiality guaranteed.

NYC Health + Hospitals

NYC Health + Hospitals is the largest municipal health care system in the nation. We are a network of 11 hospitals, trauma centers, neighborhood health centers, nursing homes, and post-acute care centers. We are a home care agency and a health plan, MetroPlus. Our health system provides essential services to more than one million New Yorkers every year in more than 70 locations across the city’s five boroughs. Our diverse workforce of more than 43,000 employees is uniquely focused on empowering New Yorkers, without exception, to live the healthiest life possible. 

For more information, visit www.nychealthandhospitals.org