Alliance Alert: Today, the NYS Department of Health (DOH) announced the launch of the statewide HERO (Health Equity Regional Organization). This launch marks an important step forward in the rollout of New York’s 1115 Medicaid Waiver. This initiative is a critical part of advancing health equity by addressing health-related social needs and improving access to comprehensive services across the state.
The HERO will serve as a cornerstone of the 1115 Waiver by working to coordinate care and connect Medicaid members with vital services such as housing, transportation, and nutrition assistance. By leveraging regional expertise and bringing together healthcare systems, community providers, and other stakeholders, the HERO aims to create a more integrated and effective approach to addressing the social determinants of health.
The Alliance for Rights and Recovery is excited to see these efforts unfold and will continue to support this transformative initiative. Stay tuned as we announce additional details about our Waiver Community Connection Initiative on Monday, which will play a key role in connecting individuals and providers to the services and benefits offered through the HERO framework. See below for more information.
New York State Department of Health Launches State Medicaid Health Equity Regional Organization (HERO) Initiative
HERO Holds Integral Role Under New York’s Current 1115 Waiver to Better Integrate Medicaid Services for all New Yorkers
United Hospital Fund (UHF) to Lead Coordination of HERO Activities to Bridge Social Services and Health Care Delivery
ALBANY, N.Y. (January 24, 2025) – The New York State Department of Health today announced the launch of the state’s Health Equity Regional Organization (HERO), a core initiative under New York’s current 1115 waiver amendment, approved by the Centers for Medicare & Medicaid Services (CMS) in 2024. Establishing a HERO is part of the waiver amendment’s multi-pronged approach to strengthen the integration of social services and health care delivery.
United Hospital Fund (UHF) will coordinate HERO strategies with the goal to functionally bridge public health, social services and health care delivery. UHF will collaborate with the New York State Medicaid Program, healthcare providers, community stakeholders, and academic partners to understand effective regionally focused approaches to addressing the social needs of Medicaid beneficiaries, such as food insecurity, housing instability, and lack of transportation.
“The launch of the Health Equity Regional Organization is an integral step in fulfilling our mission to help improve health outcomes, advance health equity and reduce health disparities, ” State Health Commissioner Dr. James McDonald said.” We look forward to working with United Hospital Fund and other partners of the HERO and continuing to advance access to primary and social care and behavioral health resources.”
The waiver amendment package includes $7.5 billion in funding from both the State and federal government. The waiver amendment seeks to develop programs that support the delivery of health-related social needs (HRSN) services (i.e., housing, transportation, nutrition, and case management), manage challenges in the Medicaid workforce, advance health equity and reduce health disparities such as the delivery, access, and continuity of care that adversely affect vulnerable populations.
UHF’s support builds off experience under the Delivery System Reform Incentive Payment (DSRIP) program, launched in 2014, where health and social care providers across the state formed collaborative networks called Performing Provider Systems to implement a wide range of innovative demonstration projects. UHF’s Medicaid Institute reviewed the first four years of these efforts to identify key lessons and promising practices.
Investments in the HERO will lay the groundwork for a new statewide data infrastructure to support the design and development of new policies, interventions, and targeted investments to improve outcomes. By leveraging partnerships with academic centers and stakeholders, the state will develop and evaluate success metrics for existing and future programs, including significant investments in new health-related social needs services.
More information about New York’s current Health Equity Reform waiver amendment can be found under the MRT 1115 Waiver Amendments tab here.