ActionHealthNYC Research Study

ActionHealthNYC: A Health Care Access Program for the Uninsured

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.

Study Overview

• Status: Active, not recruiting
• Conditions: Health Services Accessibility
• Intervention / Treatment: Other: ActionHealth NYC

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.

• Study Type: Interventional
• Enrollment (Actual): 2428
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • New York
    • Long Island City, New York, United States, 11101
      • New York City Department of Health and Mental Hygiene

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 19 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes

Description

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.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Member; The member group will be able to join ActionHealth NYC program, where they are assigned a primary care physician and have a standardized fee scale for services obtained in network. Laboratory, diagnostic, and specialty services can be obtained at network H+H locations. They will be offered recommended USPSTF A+B tests/screenings, HIV and TB screening (if indicated), and care coordination. If they are deemed "high risk," enhanced care coordination services will be offered.	Other: ActionHealth NYC; care coordination, covered preventive services, and standardized costs for ambulatory care
No Intervention: Study; The study group will be counseled on their options to access health care, including at public hospitals and community health centers. They will receive no additional services from the study.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Improved access to healthcare	e.g. fewer delays in getting needed care	One year

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Enhanced healthcare utilization	e.g. emergency department care utilization rate	One year
Reduced barriers to needed care	e.g. financial barriers	One year
Enhanced utilization of preventive services	Utilization of USPSTF recommended services through primary care home	One year
Increased number of new diagnoses		One year

Collaborators and Investigators

• Sponsor: New York City Department of Health and Mental Hygiene
• Collaborators: Public Health Solutions; The New York Academy of Medicine; New York City Health and Hospitals Corporation; American Institutes for Research; New York City Human Resources Administration; New York City Mayor's Office of Immigrant Affairs
• Investigators: Principal Investigator: Rishi Sood, MPH, New York City Department of Health and Mental Hygiene

Study record dates

Study Major Dates

• Study Start (Actual): June 1, 2016
• Primary Completion (Actual): June 30, 2017
• Study Completion (Estimated): December 31, 2024

Study Registration Dates

• First Submitted: July 19, 2016
• First Submitted That Met QC Criteria: July 19, 2016
• First Posted (Estimated): July 22, 2016

Study Record Updates

• Last Update Posted (Actual): January 12, 2024
• Last Update Submitted That Met QC Criteria: January 11, 2024
• Last Verified: January 1, 2024

More Information

Terms related to this study

• Keywords: Undocumented Immigrants; Primary Prevention; Healthcare Access
• Other Study ID Numbers: NYCDOHMH IRB 16-020

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO