UNITED HOSPITAL FUND OF NEW YORK
1411 Broadway 12th Floor, New York, NY 10018 www.uhfnyc.org

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Organizations Filed Purposes: UNITED HOSPITAL FUND WORKS TO BUILD A MORE EFFECTIVE HEALTH CARE SYSTEM FOR NEW YORKERS. AN INDEPENDENT, NONPROFIT ORGANIZATION, WE ANALYZE PUBLIC POLICY TO INFORM DECISION-MAKERS, FIND COMMON GROUND AMONG DIVERSE STAKEHOLDERS, AND DEVELOP AND SUPPORT INNOVATIVE PROGRAMS THAT IMPROVE THE QUALITY, ACCESSIBILITY, AFFORDABILITY, AND EXPERIENCE OF PATIENT CARE.

United Hospital Fund works to build a more effective health care system for every New Yorker. An independent, nonprofit organization, we analyze public policy(Sched O)

UHFs Quality Institute works to improve health and health care quality in New York by identifying and spreading best practices across the continuum of care, developing the next generation of quality improvement leaders, and helping to achieve consensus on the most effective quality assessment measures and patient engagement strategies. The Quality Institute builds on UHFs decade-long experience in implementing health care quality initiatives and grant-making activities-as well as its role as a neutral and trusted convener of diverse stakeholders in the health care community. UHF continued its work in 2019 on behalf of the New York State Department of Health as part of its State Innovation Model initiative, which aims to spread the Advanced Primary Care model throughout the state. As part of this effort, UHF staff worked on the annual refinement of the Advanced Primary Care Core Measure Set a set of standardized metrics including 28 quality measures across six domains. UHF staff also spearheaded convening two multi-stakeholder workgroups to help strengthen NYSDOHs transparency efforts through more meaningful and user-friendly profiles of provider quality that could inform New Yorkers decisions about where to seek both primary care and hospital care. During the past year, UHF, partnering with Greater New York Hospital Association (GNYHA), graduated the tenth class of its Clinical Quality Fellowship Program, and launched a new fellowship class of 30 physicians, nurses, and physician assistants, the largest ever class size. The program supports the training and professional development of early- and mid-career clinicians from hospitals across the region to help them to lead and champion quality improvement initiatives in their own institutions. The Quality Institute launched a new project in 2019 using patient-centered co-design methods to involve primary care providers from a large urban health system and their patients in the development of a prototype dashboard to support better communication between patients and their providers. Patients with diabetes will be invited to participate, alongside clinical staff, in a multidisciplinary project team and a co-design effort to identify the content, design, and communication guidelines for the dashboard. Completing the Quality Institutes long-standing work on antibiotic stewardship the Journal of Infection Control and Hospital Epidemiology published "A Model for Improving and Assessing Outpatient Stewardship Initiatives for Acute Respiratory Infections." The articale reported on the review and comparison of pre- and post-intervention visits that were conducted to detect differences in acute respiratory infection antibiotic prescribing in the final stage of the antibiotic stewardship initiative.

UHFs Medicaid Institute works to effect positive change in the design and operation of New York States Medicaid program, which serves approximately 6 million New Yorkers and accounts for spending of approximately $70 billion annually. Medicaid accounts for about a third of the States health care economy. The Medicaid Institute produces research, analysis, and publications that inform policy discussions at every stage and level, and sponsors briefings, meetings, and conferences with government officials, health care providers and insurers, program administrators, advocates, and other major stakeholders, to identify and address important issues affecting both health care providers and beneficiaries. In 2019 the Medicaid Institute conducted research on more than 600 individual projects associated with the States Delivery System Reform Incentive Payment (DSRIP) program and pubslighed "DSRIP Promising Practices: Strategies for Meaningful Change for New York Medicaid," which includes case studies of DSRIP projects across the state and an appendix of specific DSRIP measures, sorted by the outcomes that the promising practices sought to affect. The Institute also publshed "Healthier Homes, Healthier Childhoods: How Medicaid Can Address the Housing Conditions Contributing to Pediatric Asthma. Focusing on indoor air quality as a key aspect of substandard housing in New York City, this HealthWatch brief identifies neighborhoods that Medicaid providers and health plans might target to reduce asthma-related health care utilization through housing interventions-primarily looking at children enrolled in Medicaid and suggesting where interventions might be most needed. Other reports and data analyses were also prepared for the New York State Department of Health. Medicaid Institute provided staff level support to the State for the Childrens Health Subcommittee and Clinical Advisory Group charged with reviewing and recommending value-based payment measures for New Yorks Medicaid program. Staff also supported ongoing implementation of the States First 1,000 Days on Medicaid initiative. UHF also sponsored its annual Medicaid conference, keynoted by the state Medicaid director Donna Frescatore. Panels featured discussions on long term care, building on the success of DSRIP, and the future of Medicaid managed care.

UHFs Childrens Health Initiative works to build a strengthened primary care system for children that recognizes the impact of non-clinical determinates of health-and promotes optimal physical health, social and emotional well-being, and cognitive growth during the first five years of life. The initiative focuses on: 1) Building effective clinical-community partnerships to screen young patients and their families for one or more psychosocial risks to healthy development and connect families to social service organizations that can help. 2) Shaping a Value-Based Payment Model for Children Enrolled in Medicaid; and 3) developing child focused state policies that support evidence-based early childhood development. In 2019 the Childrens Health Initiative completed the second phase of Partnerships for Early Childhood Development, supporting 8 New York City hospitals and their community-based partners in an effort to help pediatric primary care practices initiate, expand, or improve on efforts to screen children ages 0-5 for social and environmental risks that interfere with healthy development, and connect them with the services that can address those risks. Publications from the program in 2019 included "It's About Trust" Parents' Perspectives on Pediatricians Screening for Social Needs" published in collaboration with Public Agenda and based on focus groups with parents. A related blog post "Screening For Social Needs" What Do Parents Think?" was published by Health Affairs. Seminal work on the effect of the opioid epidemic on children was conducted and released by the Childrens Health Initiative in 2019. In March, an initial report "The Ripple Effect: The Impact of the Opiod Epidemic on Children and Families" provided recommendations for an action agenda based on a multidisciplinary convening. In November, a first of its kind analysis "The Ripple Effect: National and State Estimates of the U.S. Opioid Epidemics Impact on Children" presented data mapping out the national and state-by-state impact of the opioid epidemic on children. The Childrens Health Initiative continued its work in 2019 on policy and health care payment to support early childhood development, publishing three pieces on these topics. "Achieving payment Reform for Children Through Medicaid and Stakeholder Collaborationits companion "Guide for Action" examined critical issues in overhauling payment for childrens health care, outlining specific steps advocates and state Medicaid programs could take to refocus health care payments on quality and outcomes. The Initiative also published a framework for a new concept of caring for children and their families together entitled "Plan and Provider Opportunities to Move Toward Integrated Family Health. Finally, work with New York State on value-based payment was highlighted in a published case study on "Reforming Payment for Children's Long-Term Health."

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