CM Restler on Medicaid recertification and navigator investment

Do you have any suggested models for how, I know we don't yet have rules or policies from the state on exactly what the certification process is going to look like, but any suggestions of things we should be doing now to plan for and invest to help ensure that we're recertifying people

and providing that hand-holding?

We're already increasing the use of navigators.

I mean, I think that's the key thing is that you can't just assume that people are going to, you know, be able to fax things or scan things or send things to portals or even get the right documentation.

But if we had enough people doing that work, that we could, in fact, do it.

I think that New York City will need to invest in a large number of people to help.

People to enroll.

I don't see any other way around it.

And we'll need that over the course of this fiscal year.

Yes.

I mean, how well or badly we do in the food will tell you a lot about the health insurance.

Okay.

A couple other questions.

Does H&H have an estimate of how much you'll be losing from federal state-directed payment cuts?

And do you believe that those cuts could have an impact on the financial sustainability of the H&H Maimonides merger?

Well, the state, in a sense, the directed payment is the one place we've done better, right, because we got the average commercial rate.

And even when that caps, it's still so much better than anything that we had before.

So, I mean, I think that were it not for the average commercial rate, we would be in a very different picture already.

But it's the average commercial rate that's protecting us.

And do you all have an estimate of how large the financial impact will be from Medicaid and the essential plan coverage loss?

Is there a model that you can share on that?

And will the city need to contribute?

I mean, this is what I was getting at before, but I'm just asking it again.

Will the city need to contribute more to maintain services, or are we just waiting on the elections before we make that determination?

No, we have factored into our model in this budget, right, that there will be the loss and the impact of EP5, right?

We've also factored in maybe 10% to 13%.

Of our current patients around Medicaid may be disrupted, right, because of these barriers that we'll put in place.

So we factor that into our model.

And as Dr.

Cass mentioned, the average commercial rate, which was part of HR1 and it was approved by CMS, and we have our third year.

year right before CMS for approval that's really our first line of defense because it throws off a lot of money about two billion dollars for us

and as people are being disenrolled from Medicaid our plan right anticipates that they can then draw from the federal dish dollars okay the last question before I get in trouble because I'm getting a dirty look