Health Services Accessibility
Conditions
Keywords
Healthcare Access, Undocumented Immigrants, Primary Prevention
Brief summary
The ActionHealthNYC program is a year-long demonstration program to improve access to high quality health care for NYC resident immigrants who do not qualify for public insurance with incomes at or below 200% of the Federal Poverty Level (FPL). The purpose of this study is to determine whether improved access and care coordination services provided through the ActionHealth NYC program allows participants to have easier access to healthcare (particularly primary care and preventive services) than non-participants.
Detailed description
The ActionHealthNYC program is a year-long demonstration program to improve access to high quality health care for NYC resident immigrants who do not qualify for public insurance with incomes at or below 200% of the Federal Poverty Level (FPL). Our goal in piloting the program and conducting the research study is to understand the following questions: * For clients participating in the ActionHealthNYC program, do they report having easier access to health care? * What are the differences in health care utilization for participants in the ActionHealthNYC program and those not in the program? * Do the participants in the ActionHealthNYC program report fewer barriers to needed care when compared to those not in the program? * Are the participants in the ActionHealthNYC program more likely to have received preventive services according to the United States Preventive Services Task Force (USPTF) or recommended services for those with a qualifying condition through their medical home? * How does the likelihood of receiving a new diagnosis compare between the ActionHealthNYC member group and the study group? * How does emergency department and hospital use compare between the ActionHealthNYC member group and the study group? We will be conducting a randomized controlled trial (RCT) where we will be enrolling 2,400 people that meet the eligibility criteria and randomizing half into the ActionHealth NYC program. We will be employing a mixed methods approach to address differences between participants randomized to receive enhanced services through ActionHealthNYC (AHNYC) and those receiving usual care, utilizing surveys, secondary data analysis, key informant interviews and participant focus groups.
Interventions
OTHERActionHealth NYC
care coordination, covered preventive services, and standardized costs for ambulatory care
Sponsors
New York City Department of Health and Mental Hygiene
American Institutes for Research
Public Health Solutions
The New York Academy of Medicine
New York City Health and Hospitals Corporation
New York City Human Resources Administration
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
19 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* New York City residents who are uninsured, 19 and older and * Not currently eligible for Medicaid, Essential Plan, or * Not currently eligible for private insurance via federal insurance marketplace subsidies due to their immigration status.
Exclusion criteria
* Not a New York City resident * Currently eligible for Medicaid, Essential Plan or private insurance at state exchange with federal subsidies * Income above 200% of the federal poverty level (FPL) Enrollees are required to have the NYC Municipal identification card (IDNYC). If they do not have the card, however, they can obtain it and come back for enrollment.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Improved access to healthcare | One year | e.g. fewer delays in getting needed care |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Enhanced healthcare utilization | One year | e.g. emergency department care utilization rate |
| Reduced barriers to needed care | One year | e.g. financial barriers |
| Enhanced utilization of preventive services | One year | Utilization of USPSTF recommended services through primary care home |
| Increased number of new diagnoses | One year | — |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORRishi Sood, MPH
New York City Department of Health and Mental Hygiene
Outcome results
None listed