ActionHealthNYC for Health Accessibility

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: New York City Department of Health and Mental Hygiene

Disqualifiers: Not NYC resident, Income above 200% FPL, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine if the ActionHealth NYC program can improve healthcare access for immigrants in New York City. The study compares individuals who join the program with those who do not, focusing on access to primary and preventive care. Participants will receive guidance on healthcare options, and some will be assigned a primary care doctor with access to affordable services and screenings. This trial suits NYC residents who lack insurance due to their immigration status and have an income at or below 200% of the Federal Poverty Level (FPL). As an unphased trial, it offers participants a unique opportunity to contribute directly to enhancing healthcare access for underserved communities.

Do I need to stop my current medications to join the trial?

The trial information does not specify whether you need to stop taking your current medications. It's best to ask the trial organizers for more details.

What prior data suggests that the ActionHealth NYC program is safe for improving healthcare access?

Research shows that the ActionHealth NYC program aims to help uninsured immigrants in New York City access healthcare more effectively. While it doesn't introduce new medical treatments, the program focuses on organizing healthcare services.

The program connects participants with a primary care doctor and ensures they receive necessary screenings and tests, which helps manage health conditions more effectively. Early results indicate improved access to primary healthcare for participants. For example, emergency room visits dropped by 21%, suggesting that regular care might be improving.

Regarding safety, since the program doesn't involve new medications or direct medical procedures, typical clinical trial safety concerns don't apply. Instead, it seeks to improve access to existing health services, which is generally safe. No negative effects have been reported, as the program primarily coordinates and facilitates healthcare access rather than providing treatments. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about ActionHealth NYC because it offers a comprehensive approach to healthcare accessibility for underserved communities. Unlike the usual healthcare options that might involve navigating complex systems and unpredictable costs, this program assigns a primary care physician and uses a standardized fee scale, making healthcare more predictable and manageable. Additionally, it enhances care coordination, especially for those at high risk, by offering more integrated management of health services, including screenings and specialty care, all within a network of public hospitals and community centers. This streamlined approach could significantly improve access to essential health services and overall health outcomes for participants.

What evidence suggests that the ActionHealth NYC program could improve healthcare access for NYC resident immigrants?

This trial will compare two groups: one will participate in the ActionHealthNYC program, while the other will receive counseling on accessing healthcare without additional services. Research has shown that the ActionHealthNYC program helps people access primary care more easily. Participants in the program were 1.2 times more likely to have a primary care doctor than those not in the program. The program also led to a 21% decrease in emergency room visits, indicating better access to regular healthcare. Nine to twelve months after joining, participants reported improved access to healthcare services. Overall, ActionHealthNYC appears to make it easier for NYC residents without insurance to receive the care they need. ^{2 3 6 7 8}

Who Is on the Research Team?

Rishi Sood, MPH

Principal Investigator

New York City Department of Health and Mental Hygiene

Are You a Good Fit for This Trial?

This trial is for uninsured New York City residents aged 19 or older who are not eligible for Medicaid, the Essential Plan, or private insurance through federal marketplace subsidies because of their immigration status. Participants must have incomes at or below 200% of the Federal Poverty Level.

Inclusion Criteria

I am an uninsured adult living in New York City.

You cannot get Medicaid, Essential Plan, or private insurance with help from the government because of your immigration status.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Enrollment

Participants are enrolled and randomized into either the ActionHealthNYC program or the usual care group

2 weeks

Intervention

Participants in the ActionHealthNYC program receive enhanced services including assignment to a primary care physician, standardized fee scale, and care coordination. The study group receives counseling on healthcare access options.

12 months

Follow-up

Participants are monitored for healthcare access, utilization, and barriers to care

12 months

What Are the Treatments Tested in This Trial?

Interventions

• ActionHealth NYC

Trial Overview The study is testing the ActionHealthNYC program, which aims to improve healthcare access and coordination services for NYC immigrant residents without public insurance. It's a year-long demonstration to see if it helps participants get easier access to primary care and preventive services compared to non-participants.

How Is the Trial Designed?

Group I: Member Experimental Treatment 1 Intervention

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.

Group II: Study Active Control 1 Intervention

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.

Who Is Running the Clinical Trial?

New York City Department of Health and Mental Hygiene

Lead Sponsor

Trials

20

Recruited

19,400+

New York City Human Resources Administration

Collaborator

Trials

1

Recruited

2,400+

New York City Health and Hospitals Corporation

Collaborator

Trials

33

Recruited

8,500+

American Institutes for Research

Collaborator

Trials

8

Recruited

20,900+

Public Health Solutions

Collaborator

Trials

7

Recruited

15,700+

The New York Academy of Medicine

Collaborator

Trials

14

Recruited

14,200+

New York City Mayor's Office of Immigrant Affairs

Collaborator

Trials

1

Recruited

2,400+

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC8493168/

ActionHealthNYC: Effectiveness of a Health Care Access ... Nine to 12 months later, intervention participants were 1.2 times more likely to report having a primary care provider (58% vs 46%), were 1.2 times more likely ...

2. nber.org nber.org/system/files/working_papers/w29838/revisions/w29838.rev0.pdf

Reducing Frictions in Healthcare Access: The ActionHealth ... ActionHealthNYC targeted 345,000 undocumented NYC residents, over age 19, under. 200% of the FPL, ineligible for typical insurance options. The enrollment ...

3. ajph.aphapublications.org ajph.aphapublications.org/doi/abs/10.2105/AJPH.2021.306271?journalCode=ajph

ActionHealthNYC: Effectiveness of a Health Care Access ... Results. At baseline, 25% of participants had a regular source of care; two thirds had visited a doctor in the past year and reported 2.5 visits ...

4. researchgate.net researchgate.net/publication/352301921_ActionHealthNYC_Effectiveness_of_a_Health_Care_Access_Program_for_the_Uninsured_2016-2017

ActionHealthNYC: Effectiveness of a Health Care Access ... We leverage a novel survey-administrative data linkage to show that the program increased self-reported access to primary care, leading to 23 percent fewer ...

5. papers.ssrn.com papers.ssrn.com/sol3/papers.cfm?abstract_id=4056792

Reducing Frictions in Healthcare Access: The Actionhealth ... The program increased self-reported access to primary care, leading to a 21% fall in emergency department (ED) use. This effect was driven by ...

6. nber.org nber.org/papers/w29838

Reducing Frictions in Healthcare Access: The ActionHealth ... The program increased self-reported access to primary care, leading to a 21% fall in emergency department (ED) use.

7. digitalassets.jointcommission.org digitalassets.jointcommission.org/api/public/content/2d810b26633b4e34b4427cb7c91c1209?v=7e44be25

2022 Awardee Application - Tyson Health Care Equity Award NYC Care strove to deliver equity in healthcare access and health outcomes. Initial data showed that hypertension and diabetes control was comparable ...

8. nyc.gov nyc.gov/site/doh/data/data-home.page

About NYC Health Data Explore data on 311 complaints, initial inspections, compliance inspections, and exterminator visits. Data Modernization at NYC Health. Data sound alarms, spur ...