New York DEHQ State Report
In New York, the state coordinates care for approximately 1 million dual-eligible individuals through a combination of programs including Mainstream Medicaid Managed Care (MMMC), Managed Long Term Care (MLTC), Medicaid Advantage Plus (MAP), Dual Eligible Special Needs Plans (D-SNPs), and the Program of All-Inclusive Care for the Elderly (PACE). These programs are designed to provide seamless access to medical, behavioral health, and long-term services and supports (LTSS) in a person-centered, coordinated, and cost-effective way.
Dual-eligibility refers to someone who qualifies for both Medicare and Medicaid coverage. They are often individuals with limited income that are either age 65 or older or under 65 with a qualifying disability. You can find more on the basics of dual-eligibility here.
Our latest New York Dual-Eligible HQ State Report, published in April 2025, takes a deep dive into how dual eligibility is structured and delivered in the Empire State. It includes the most up-to-date information available on eligibility, program models, care integration efforts, and enrollment trends. Whether you’re a policymaker, provider, or researcher, this report offers a critical overview of how New York supports its dual-eligible population.
In the New York Dual-Eligible HQ State Report, you’ll find answers to questions like:
- How is New York Medicaid structured, and how do managed care options differ for dual-eligible individuals?
- What is the difference between D-SNPs, IB-Dual programs, HARP, MAP, and PACE in terms of care delivery and integration?
- Who qualifies as a dual-eligible in New York, and how are physical health, behavioral health, and LTSS coordinated?
- How are IDD services delivered to dual-eligible individuals?
- How does care coordination work across MMC plans, D-SNPs, MLTC plans, and integrated models?
- What are the latest enrollment figures for dual-eligible individuals in New York?
- How is New York using value-based payment models to improve outcomes and manage costs for dual-eligible populations?
