7 Years - Partners Health Plan Gets Results

Dear Members Families, & Friends,

We invite you to join us in celebrating PHP’s 7th Anniversary!

In 2016, we launched a non-profit organization and a new model of care for Individuals with Intellectual and Developmental Disabilities (IDD). We have delivered life-changing benefits and person-centered care coordination under a single and holistic plan. For the past seven years, we have been dedicated to improving lives.

We are very proud of what we have done to make healthcare more accessible to reduce health disparities. Below are highlights from last year.

Thank you for putting your trust in Partners Health Plan. We are grateful each and every day that we can assist members and families live their best lives!

With Gratitude

Kerry Delaney, CEO

What Did We Do in 2022?

We Excelled

An independent evaluation funded by the Centers for Medicare & Medicaid Services (CMS) reports that PHP’s innovative solutions like the pharmacy management program reduced errors, unnecessary emergency department visits, and length of hospital stays.

The telehealth program successfully resolved 90% of member’s concerns which prevented trips to the hospital.
More members completed colorectal cancer screening; diabetes testing and controls; controlled high blood pressure; completed annual dental visits and received annual flu vaccines compared to national and New York State health plans.
90% of PHP members have received at least one dose of the primary COVID-19 vaccination.
70% of the eligible members have received the booster dose.

We Talked About Diversity, Equity, & Inclusion

We expanded the Diversity, Equity, & Inclusion (DEI) Department, added more staff volunteers to our dedicated DEI council with representation from across the organization, held multiple cultural recognition forums and safe space conversations, and added to our DEI related education modules for staff.

We Expanded Our Services & Supports

We added 1,200 new providers, including Stonybrook Medicine enhancing our Network for members on Long Island.
Implemented an in-house Patient Care Assessment team to quickly get home care services in place.
New contracts with DentaQuest & Ridehealth to provide better dental & transportation services.
Partnered with Solvere Health to pilot specialized IDD mobile dental clinics at select-day service locations in Metro New York.
Over-the Counter (OTC) cards were added to the benefit package for more than 600 community members.
We launched a text messaging program to provide health care reminders, supporting preventative health care and wellness for our members.

We Supported You

Our Designated Representative Committee met 96 times to review more than 700 Life Plans.
PHP hosted 3 Member & Family meetings, 4 Participant Advisory Committee meetings, 6 family education sessions, and 8 Peer Empowerment Group meetings.

We Advocated

Provided recommendations to OPWDD Commissioner Neifeld regarding COVID-19 protections for people with IDD.
Members and families testified before the General Assembly on the 2023-2027 OPWDD 5.07 Strategic Plan.
Members, families, and staff rallied at the NYS Capitol in support of Direct Support Professionals (DSPs).
Comments provided by PHP resulted in modifications to the proposed DOH 1115 waiver changes.

We Celebrated

PHP earned NCQA-Certification on the HEDIS Compliance Audit

Are You Concerned About Diabetes?

If You Are Concerned About Diabetes

Diabetes is a disease that affects how your body turns food into energy. A lot of what you eat turns into sugar (glucose) and goes into your blood. As your blood sugar goes up your body produces insulin to let the blood sugar go into cells to produce energy. If you have diabetes your body doesn’t produce insulin (Type 1) or the cells don’t respond to insulin (Type 2), so too much sugar stays in your blood.

The biggest health risks of diabetes are associated with high blood sugar, which can increase the likelihood of blood clots and impaired blood flow by making cells sticky and blood vessels stiff. This can damage tissues, resulting in high blood pressure, heart attacks, stroke, kidney failure, blindness, and skin infections, especially on the feet. A blood test called Hemoglobin A1C (HgbA1c) can measure the effects of blood sugar on their cells over time. Regular measures of blood sugar will allow a person with diabetes or pre-diabetes to take measures to reduce their risks and improve their health.

Making deliberate food choices is an excellent way to manage your weight, which makes a difference to controlling diabetes. Here are some tips:

Load up on proteins first-don’t leave yourself feeling hungry by the time you get to those side dishes!
Choose high-quality plant-bases carbs instead of sugary items (e.g. sweet potatoes minus the marshmallows)
Portions should always be small, with a variety of colors and textures-try shaving your veggies-looks are deceiving, so you’ll load your plate without needing large portion!
Keep moving! Helping to set/clear the table are simple ways to get some steps in!
Holiday baking can swap out white flour for a variety of options-no need to skip dessert if you plan right when baking!

Schedule activities such as walking, taking stairs, gardening, house cleaning, playing with a pet, anything that gets you moving!

If you have diabetes, we are here to support you, your care manager can assist you with making sure you see your PCP and specialist if needed (Diabetes doctor called an Endocrinologist). To support your best health, it is important to see your doctors regularly and make sure you take all medications as prescribed. Your doctor may take a blood sample to check your A1c (this is a test to check how much sugar has been in your blood over the last few months), this test is a great way to see how you have been doing managing your diabetes.

Schedule a visit with your doctor. And it’s always a good idea to have someone you trust come with you. Sometimes when we get to the doctor, we get nervous and don’t always hear what the

doctor is saying. Having a second pair of ears helps. Also, that person can help you remember all your questions and give you support during an exam the doctor may need to do.

Remember if you have any questions or need help to make an appointment, find a doctor to support you or need help getting your medication, your care Manager is here to help. For more information check out this helpful flyer.

Details can be found: https://www.prevention.com/food-nutrition/healthy-eating/g20495209/diabetes-friendly-thanksgiving-recipes/

Actual recipes: https://www.tasteofhome.com/collection/diabetic-friendly-recipes-for-thanksgiving/ and https://diabeticgourmet.com/recipes/holiday-and-special-occasions/thanksgiving-recipes

Visit Partners Health Plan's Health Resources to learn more about the diabetes as well as other informative health-related articles.

H9869_Diabetes Article_2022

ARPA Workforce Stabilization Payment Initiative Update

February 2, 2023

Dear Provider:

Partners Health Plan (PHP) wants to provide you with an update regarding the ARPA Workforce Stabilization Payment Initiative. PHP distributed the FIDA pass-thru portion of the cost-based Longevity payment and the survey-based COVID-19 Service payments in November 2022.

With respect to distribution timing for the Retention and second half of the survey-based balances and for any omissions or corrections related to the Longevity payment and the survey-based funds paid in November, to date we have not received guidance yet from the State. As always, we will immediately share any updates that are received from the State.

For providers that either did not submit the requisite attestations to acquire Retention or Longevity cost-base funds or need to correct COVID-19 survey data, OPWDD recently published information about one-time vehicles to do so. PHP would encourage providers to contact OPWDD for more information if either of these scenarios might apply to them. If you have any questions please contact us at This email address is being protected from spambots. You need JavaScript enabled to view it..

Sincerely,

Partners Health Plan

Network Development and Provider Relations

Do you have questions or concerns for the Network Development and Provider Relations team? Please CLICK HERE to submit a ticket to receive assistance.

BronxNet Highlights Partners Health Plan's Specialized Dental Care Services

Karleen Haines, Chief of Member Relations and Advocacy, appeared on the BronxNet OPEN to discuss the Partners Health Plan (PHP) non-traditional care management model that will be offering specialized dental care services for PHP members-- enrollees with Intellectual and Developmental Disabilities (IDD)-- via mobile dental clinics in a partnership with Solvere Health.

PHP is the first-in-the-nation, non-profit, provider-led managed care organization, designed by IDD experts, that fully integrates Medicare and Medicaid for individuals 21 years and older with IDD.

Celebrating 6 Years: A Time to Look Ahead

This month we celebrate the PHP FIDA-IDD Plan’s 6-year birthday!

It was April 1, 2016, that the Centers for Medicare & Medicaid Services (CMS) and New York State began enrollment in New York, Long Island, Rockland & Westchester counties for the Fully Integrated Duals Advantage for Individuals with Intellectual and Developmental Disabilities (FIDA-IDD) Plan. It was designed to test a new model of care for providing Medicare-Medicaid enrollees with Intellectual and Developmental Disabilities (IDD) an opportunity to experience a more integrated, coordinated, and person-centered care focused on individuals’ long-term health and well-being so they may live a quality life.

PHP FIDA-IDD members have more opportunities to direct their own services, be involved in care planning, and live as independently in the community as possible. Click here for PHP member stories.

As we celebrate the FIDA-IDD’s 6^th birthday, we recognize the commitment of our staff to helping our members achieve their goals and the positive healthcare outcomes they deserve. We look forward to the future and to bringing more options and opportunities for our members.

Kerry Delaney, CEO, Partners Health Plan

DentaQuest Selected by Partners Health Plan to Administer Dental Benefits for Individuals with Intellectual and/or Developmental Disabilities in New York

DentaQuest, one of the nation’s largest and most experienced Medicaid dental benefits administrators, today announced its new engagement with Partners Health Plan (PHP) to increase access to oral health care and improve outcomes for individuals with intellectual and/or developmental disabilities (I/DD).

Partners Health Plan (PHP), a nonprofit managed care organization serving individuals with I/DD, selected DentaQuest to administer dental benefits and specialized services for its members. With the addition of PHP to its other government clients, DentaQuest now serves 63% of Medicaid enrollees in the state.

“We are honored to support Partners Health Plan in its commitment to serving adults with I/DD,” said Steven Pollock, president of DentaQuest. “We’ve long recognized the importance of increasing health equity for all, and health plans like PHP that focus on underserved populations are critical to making it happen. Oral health is often overlooked as more immediate medical needs take precedence, but as we know good oral health drives overall health and everyone can benefit from routine, preventive care. Innovative approaches, such as our industry-leading case management program, provide an extra level of support for individuals with I/DD and their caregivers to navigate a complex, imperfect health system to ultimately get the right treatment, at the right time.”

DentaQuest’s case management program helps identify appropriate resources needed to resolve a member’s issue – often unrelated to health care – and coordinates access to those resources with PHP care managers to ultimately achieve optimal oral health. Together, DentaQuest’s case management team and PHP care managers partner to secure transportation, medical clearance, sedation and anesthesia, hospital level care and other dental services. The collaboration between PHP and DentaQuest has led to a substantial increase in member utilization and appears to be addressing long standing access challenges faced by the I/DD population.

Launched in 2016, PHP develops and coordinates personalized life plans that ensure participants receive the essential medical, behavioral, dental, habilitation, and other services and supports needed. Dental care is the primary unmet need for adults with I/DD. More than 30% of children with I/DD are likely to have their first dental visit delayed, and in general, individuals with I/DD are less likely to receive necessary restorative care. Addressing this disparity is a critical component in impacting overall health equity for individuals with I/DD, as poor oral health can result not only in dental caries and gum disease, but can impact overall health, potentially leading to heart disease, cancer, and diabetes.

“The work we are accomplishing with DentaQuest shines a light on what is possible across the nation – people with I/DD deserve and can achieve lifelong optimal oral health and wellness when we create the right partnerships and invest in the right programs,” said Kerry Delaney, CEO, PHP. “We look forward to continuing our partnership and the measurable results we are seeing in dental care for PHP members.”

In the future months, PHP will also be piloting teledentistry and mobile dentistry programs in partnership with DentaQuest to increase access to oral health care for members.

About DentaQuest

DentaQuest is a purpose-driven health care company dedicated to improving the oral health of all. We do this through Preventistry® — our inclusive approach to quality care and expanded access built on trusted partnerships between patients, providers and payors. As one of the nation’s largest and most experienced Medicaid dental benefits administrators, we manage dental and vision benefits for more than 33 million Americans through a nationwide network of providers in all 50 states. Our outcomes-based, cost-effective dental solutions are designed for Medicaid and CHIP, Medicare Advantage, small and large businesses, and individuals. At the same time, we are expanding our footprint of more than 70 oral health centers in six states to deliver direct patient care in rural and underserved populations. Learn more at www.DentaQuest.com and follow us on Facebook, Instagram, LinkedIn, and Twitter.

About Partners Health Plan

Partners Health Plan (PHP) is the first-in-the-nation, provider-led managed care organization that fully integrates Medicare and Medicaid for individuals 21 years and older with Intellectual and Developmental Disabilities (IDD), so they have the most complete care package. PHP provides person-centered care for whole-person wellness addressing the physical, behavioral, and social needs of individuals to assist them in living a quality life. The plan operates in 4 New York State regions (nine downstate counties): New York City, Long Island (Nassau and Suffolk counties), Rockland County, and Westchester County. For more information, visit www.phpcares.org.

eFMAP Funds Update

eMAP Funds Update

August 2022: Once again, Partners Health Plan wants to provide an update regarding NYS Workforce Stabilization Longevity and Retention Supplemental pass-thru payments that we will be distributing on behalf of NY State.

We have not received guidance with respect to timing since our July 6, 2022 communication to you. As always, we will immediately share any updates that are received from the State.

As a reminder, the Workforce Stabilization Longevity and Retention Supplemental pass-thru distributions will be made via hard-copy check. Because we want to make sure the funds are received timely, we have been collecting addresses from providers specifically for the mailing of this payment. If we do not receive your billing address confirmation form, the Workforce Stabilization Longevity and Retention Supplemental pass-thru payments will be mailed to the billing address we have on file in our claims system.

If you would like to guarantee that the checks are distributed correctly please complete the form at the following link:
→ Provider Billing Address Form.

As always if you have any questions, please contact us at providerrelations@phpcares.org.

See below for all previous communications with providers regarding the NYS Workforce Stabilization Longevity and Retention Supplemental Pass-thru Payments and the request for Provider Billing Information.

End of Public Health Emergency – How will this Impact the use of StationMD for Behavioral Health?

End of Public Health Emergency:
How will this Impact the use of StationMD for Behavioral Health?

As you know, PHP has been working with StationMD since 2018, the outcomes from this benefit for members has been extremely positive and we will continue our relationship with StationMD as we move past the Public Health Emergency.

We wanted to share some updates as to how this will change some of the flexibilities that were allowed over the past 3 years. The national public health emergency (PHE) is scheduled to end on May 11, 2023. The PHE granted StationMD some flexibilities related to their operations, with the end of the PHE, there will be some impacts to StationMD practices, the main effect is around the prescription of controlled medications.

For StationMD’s Urgent/Emergent line of business to be compliant with federal DEA regulations, after May 11, 2023, their urgent care service line clinicians will no longer be able to prescribe controlled substances. All other urgent care services will remain in place. This currently represents <1% of all calls, and we continue to encourage members to utilize StationMD for urgent supports including those related to medications, the StationMD physician can advise if a requested or needed medication is on the controlled substance list and something they cannot provide in their capacity.

For StationMD’s Behavioral Health line of business, to be compliant with federal DEA regulations, after, May 11, 2023, their behavioral health practitioners will only be able to prescribe controlled substances if a qualified telemedicine referral is obtained. The DEA details specific requirements for this referral. The referral must be obtained from a physician, nurse practitioner, or a physician assistant that has a DEA license in the state the patient resides and has seen the patient, in person, for a medical reason. It must have the patient demographics, the referring clinician’s name and NPI, the consulting clinician’s name and NPI, a list of diagnoses, list of medications, and a treatment plan. Most commonly, the patient’s primary medical provider can complete the referral, but it can be any provider that meets the above requirements.

Members who currently receive behavioral health supports from StationMD have been contacted regarding the steps required to continue working with their current StationMD provider and all future referrals will include the appropriate physician referral as part of the intake packet.

Need Provider Assistance?

The Partners Health Plan Network Development and Provider Relations team is here to assist you with your billing, claims, authorization, education, and any other general inquiry. Use the Contact Us button below to complete a Provider Ticket Submission Form.

Contact Us

Health Care Options Expanded for PHP Members: Stony Brook Medicine Joins PHP Provider Network

BRONX, NY, October 4, 2022— On September 1, 2022, Stony Brook Medicine joined the Partners Health Plan (PHP) provider network offering services to PHP members.
Kerry Delaney, PHP CEO stated, “We are very happy to welcome them back into our network. This will expand care options for PHP members. Stony Brook Medicine is an extensive health care system. It includes three acute care hospitals and many affiliated specialty groups and physicians with specialized services for individuals with Intellectual and Developmental Disabilities (IDD). This relationship will deepen the care choices that PHP members and their families have come to expect from us in providing state-of-the-art supports and services.”
For more information on the Stony Brook Medicine providers and locations that are now part of the PHP provider network, please contact: This email address is being protected from spambots. You need JavaScript enabled to view it..
About the facilities and services in the Stony Brook Medicine – PHP relationship
3 Acute Care Hospitals:
• Stony Brook University Hospital, Stony Brook, NY
• Stony Brook Eastern Long Island Hospital, Greenport, NY
• Stony Brook Southampton Hospital, Southampton, NY
Affiliated specialty groups and physicians that offer the following services:
• Ambulatory Health Centers
• Cardiovascular Disease
• Dialysis
• Family Medicine
• GI and Hepatology
• Inpatient/Outpatient Psychiatry
• Mammography
• Oncology
• Orthopedics
• Podiatry
• Radiology
• Sleep Disorders
• Urology

Important eFMAP Funds Update from Partners Health Plan

Important eFMAP Funds Update

October 27, 2022

Once again, Partners Health Plan (PHP) wants to provide an update regarding the NYS Workforce Stabilization Longevity and Retention Supplemental pass-thru payments that we will be distributing on behalf of NY State.

We have been notified that the Department of Health (DOH) has received the necessary approval to fund the two Calendar Year 2021 ARPA Workforce Stabilization Initiatives – the cost-based Longevity Payment and the survey-based COVID-19 Service Payment. DOH has provided PHP with the specific provider award amounts to be paid to each provider. PHP is scheduled to receive the related pass-thru funds from DOH in the third week of November 2022. We will remit the payments to providers according to the list provided by the DOH shortly thereafter.

As we previously informed you, the payments will be made in the form of a check. Unless we have been provided payment instructions pursuant to our previous solicitations specific to this process, payments will be sent based on provider-payment information from our claim system.

More details will follow as we get closer to the third week of November.

If you have any questions, please contact us at providerrelations@phpcares.org.

Join Partners Health Plan at Autism Conference: Living Your Best Life Neurodiverse Partnerships

Join Partners Health Plan at the 2022 Hudson Valley Autism Conference: Living Your Best Life Neurodiverse Partnerships

Partners Health Plan will be at the 2022 Hudson Valley Autism Conference: Living Your Best Life Neurodiverse Partnerships to share information about PHP, member benefits and more. LEARN MORE about the conference and how you can register to join.

Medical Director Dr. Steven Merahn, MD Featured on ABA Podcast

Medical Director Dr. Steven Merahn, MD
Featured on ABA Podcast

An amazing podcast, Building Better Businesses in ABA (Applied Behavior Analysis), featured Partners Health Plan Medical Director, Dr. Steven Merahn, MD.

Dr. Merahn shares his views on health as a social imperative to equitably improve the ability for individuals with IDD to succeed in the world on their own terms and participate authentically as active members of family and community.

Members Only Event: Partners Health Plan (PHP) Seeks to Overcome Dental Health Disparities For Individuals with IDD

Specialized Dental Care for those with Intellectual and Developmental Disabilities (IDD) Comes to Metro NY.

January 9, 2023 — New York
Individuals with Intellectual and Developmental Disabilities (IDD) are known to have poorer oral/dental health than people without IDD. Studies show that people with IDD have 30% more untreated cavities, 50% more missing teeth, and 150% more gum disease.

The biggest reason for this health disparity is access to oral health care for children and adults with IDD: lack of preventive and regular care, including management of secondary medical conditions that are related to oral health, leads to more significant oral health problems. Wait times for IDD specialized services can be as long as a year at practices and dental school programs that offer them.

But Partners Health Plan (PHP), a NY-based health plan that is exclusively dedicated to supporting the health and well-being of individuals with IDD, is committed to ensuring the oral health of its members.

“Improving access to dental care for our community of service in New York State is mission-critical,” added Steven Merahn, MD, Medical Director, Partners Health Plan. “Our overarching goal is to improve the quality of life of our members and the relationship between oral health and overall well-being is well established.”

“Our overarching goal is to improve the quality of life of our members and the relationship between oral health and overall well-being is well established.”

Steven Merahn, MD, Medical Director, Partners Health Plan.

To achieve this goal, PHP has partnered with Solvere Health to deploy specialized IDD mobile dental clinics at select-day service locations in Metro New York to reduce travel demands. Solvere Health is a company that specializes in the delivery of high-quality clinical services through group health events via mobile medical units or pop-up clinics to underserved populations. Individuals with IDD may struggle with the sights, sounds and experiences encountered during dental care, and the PHP-Solvere Dental Health Program will conduct specialized desensitization sessions to prepare individuals for the dental care experience and mobile clinic environments. The mobile dental units are also fully accessible for individuals with mobility challenges.

“Expanding the availability of quality healthcare services to underserved communities is central to Solvere Health's mission. We view the collaboration with Partner Health Plan as a way to make quality dental care accessible to persons with I/DD,” stated Edward Lorch, CEO, Solvere Health, “Our mobile clinics offer a solution that is empathetic and considerate. We factor in the patient population's comfort (including desensitization), convenience, mobility, and communication. When engineering and staffing the mobile clinic, we understand that taking a holistic view of the patient leads to a positive oral healthcare experience and repeat preventative care.”

“This mobile dental clinic initiative is a very exciting opportunity as it will open access to oral healthcare,” noted Rita Marie Bilello, DDS, CEO, and former Dental Director of Metro Community Health Centers. “This new dental care model will bridge a much-needed gap for Partners Health Plan (PHP) members, all adults with IDD, who have been unable to access routine preventative oral health care services. Mobilizing dental services will begin to address some of the access issues and will allow for PHP to better assist in getting their members the oral care that they need.”

The first mobile dental clinic for PHP members is scheduled at the PHP corporate headquarters located at 2500 Halsey Street in the Bronx on Saturday, February 18, 2023. Future mobile health clinic locations will include locations in the New York City, Long Island (Nassau and Suffolk counties), Rockland County, and Westchester County where PHP operates. PHP welcomes partnerships with local agencies to serve as destination sites for a mobile clinic.

For more information please contact: This email address is being protected from spambots. You need JavaScript enabled to view it..

News organizations that want to attend/cover the first clinic should reach out to Elizabeth Wales, Assistant Vice President, Strategic Communications at This email address is being protected from spambots. You need JavaScript enabled to view it. or by phone at 518-410-5629.

About Partners Health Plan
Partners Health Plan (PHP) is the first-in-the-nation, provider-led managed care organization that fully integrates Medicare and Medicaid for individuals 21 years and older with Intellectual and Developmental Disabilities (IDD), so they have the most complete care package. PHP provides person-centered care for whole-person wellness addressing the physical, behavioral, and social needs of individuals to assist them in living a quality life. The plan operates in 4 New York State regions (nine downstate counties): New York City, Long Island (Nassau and Suffolk counties), Rockland County, and Westchester County. For more information, visit www.phpcares.org.

About Solvere Health
Working with state and federal, institutional, and corporate partners, Solvere Health brings a business discipline to health challenges across the United States through onsite, mobile, and digital healthcare solutions. Deploying a team of highly motivated, accountable problem solvers, we stand up sustainable, end-to-end programs in rapid response to group health events, disaster relief, and underserved rural communities, via onsite pop-ups, mobile clinics, and strategically placed brick-and-mortar locations. Our efficient approach combines exacting strategic planning, comprehensive compliance management, unparalleled logistics, state-of-the-art mobile healthcare technology, and emerging digital health applications.

New Report Determines Partners Health Plan’s FIDA-IDD Demonstration Shows Positive Impact and Progress for Enrollees with Complex Care Needs

BRONX, NY, July 6, 2022— Partners Health Plan (PHP), a nonprofit managed care organization dedicated to serving individuals with Intellectual and Developmental Disabilities (IDD), is pleased to announce that the results of an independent evaluation funded by the Centers for Medicare & Medicaid Services (CMS) indicate positive returns for enrollees in the New York Fully Integrated Duals Advantage for Individuals with Intellectual and Developmental Disabilities (FIDA-IDD) demonstration.

The FIDA-IDD demonstration is a pilot program established to test the success of delivering services that address the whole person and promote community involvement and independence for people with IDD eligible for both Medicare and Medicaid benefits. According to the findings, PHP is well on its way toward meeting those objectives.

“This is an extremely positive report,” said Kerry Delaney, CEO of PHP, “but also acknowledges in a realistic way the challenges we have faced.” Those challenges stemmed from the newness of managed care for providers in the space, lack of plan coverage awareness for covered entities, and providers’ refusal to participate or offer services to the population just to name a few. Despite these challenges, key findings reflect that if implemented correctly, managed care can be a viable option to serve people with IDD.”

Key Findings:

Through the comprehensive “It’s All About Me” (I AM) assessment tool, PHP effectively elicited responses from the IDD population about health and wellness needs allowing enrollees to leverage control over benefit options impacting their everyday lives.
Innovative solutions like the pharmacy management program reduced errors, unnecessary emergency department visits, and length of hospital stays. Similarly, the telehealth program successfully resolved 90% of consultations virtually. The rewards incentive program “Choose Health” also received positive feedback for motivating members to achieve preventive health goals.
While the new rate payment method has been a challenge to cover certain member populations, like older and frailer members, programs like pharmacy management are viewed as innovative cost-savings strategies.
Regularly engaging stakeholders from the Participant Advisory Committee helped to address real-time needs, like improvements to transportation services and communications efforts.

One of the best measures of the impact Partners Health Plan has had on member health and experiences comes from the members themselves. PHP FIDA-IDD plan member, Jessica, stated, “Recently I needed special comprehension therapy for my legs and was able to get something to help me at home. This keeps me healthy and helps my ability to walk. I want to keep my independence. I also have support from my Care Manager and my Broker with my self-direction!”

As the agency responsible for the IDD program in New York State, the Office for People With Developmental Disabilities (OPWDD) was integral in the demonstration’s design and implementation. “OPWDD has been pleased to collaborate with Partners Health Plan on the FIDA-IDD program, which has offered people an opportunity to coordinate their health and long-term care services in a new and innovative way,” said OPWDD Commissioner Kerri Neifeld. “We look forward to continuing to work with Partners Health Plan and the larger provider community to ensure quality supports and services are available to NYers with intellectual and developmental disabilities.”
Read the full report here: https://innovation.cms.gov/data-and-reports/2022/fai-ny-fida-idd-prelim-firstsecondevalrpt.

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About Partners Health Plan: Partners Health Plan (PHP) is the first-in-the-nation, provider-led managed care organization that fully integrates Medicare and Medicaid for individuals 21 years and older with intellectual and/or developmental disabilities (I/DD), so they have the most complete care package. PHP provides person-centered care for whole-person wellness addressing the physical, behavioral, and social needs of individuals to assist them in living a quality life. The plan operates in 4 New York State regions (nine downstate counties): New York City, Long Island (Nassau and Suffolk counties), Rockland County, and Westchester County. For more information, visit www.phpcares.org.

About CMS Financial Alignment Initiative: The Centers for Medicare & Medicaid Services (CMS) created the Medicare-Medicaid Financial Alignment Initiatives (FAI) Demonstrations to test in partnership with States integrated care models for dually eligible beneficiaries with the goal to improve care for dually eligible beneficiaries and reduce program costs through an aligned financial and person-centered care coordination structure. A longstanding barrier to coordinating care for Medicare-Medicaid enrollees has been the financial misalignment between Medicare and Medicaid. For more information, visit Financial Alignment Initiative (FAI) | CMS.

NYS Workforce Stabilization Payments

IMPORTANT UPDATE: NYS Workforce Stabilization Payments

November 18, 2022

Dear Provider:

Partners Health Plan (PHP) wants to provide you with an update regarding the NYS Workforce Stabilization Longevity and Retention Supplemental pass-thru payments that we will be distributing on behalf of NY State.

We have received the pass-through dollars related to the two Calendar Year 2021 ARPA Workforce Stabilization Initiatives – the cost-based Longevity Payment and the survey-based COVID-19 Service Payment. Accordingly, payments to the providers will be remitted by November 22 pursuant to the list provided to PHP by the Department of Health so your funding should be received shortly thereafter.

As we previously informed you, the payments will be made in the form of a check. Unless we have been provided payment instructions pursuant to our previous solicitations specific to this process, payments will be sent based on provider-payment information from our claim system. If your payment is not received within a reasonable period of time after November 22, please contact us at This email address is being protected from spambots. You need JavaScript enabled to view it..

Provider News

Partners Health Plan Chief Medical Officer Featured Presenter at a Resources for Integrated Care (RIC) Webinar

Strategies For Improving Care Coordination for Individuals With Intellectual & Developmental Disabilities

Stephan Deutsch, M.D., Chief Medical Officer, Partners Health Plan (PHP), a nonprofit managed care organization dedicated to serving individuals with Intellectual and Developmental Disabilities (IDD), will be a featured presenter at a Resources for Integrated Care (RIC) webinar on August 9 @ 2:00 pm – 3:00 pm. The webinar will discuss strategies for providing coordinated care for individuals with IDD, risk stratification strategies to drive interventions, and family or caregiver support, education, and outreach.

Other webinar presenters include Joan Beasley, PhD, Research Professor, National Center for START Services, Director, National Research Consortium on MH-IDD, Institute on Disability (UCED), University of New Hampshire; and Emily Lauer, PhD, MPH, Director, Eunice Kennedy Shriver Center, UMass Chan Medical School. Presenters will describe the current gaps in care for individuals with IDD and they will share strategies for delivering person-centered care using interdisciplinary teams (IDTs) and innovative care coordination models.

Partners Health Plan has operated the New York Fully Integrated Duals Advantage for Individuals with Intellectual and Developmental Disabilities (FIDA-IDD) demonstration since 2016. It is the only FIDA-IDD plan in the nation and has been successfully delivering services that address the whole person and promote community involvement and independence for people with IDD who are eligible for both Medicare and Medicaid benefits.

“Webinar participants will understand the impact of person-centered coordinated care strategies based on data,” stated Dr. Stephan Deutsch, Chief Medical Officer for Partners Health Plan, “in a managed care environment to enhance the quality of care for each individual with IDD so he/she may achieve optimal healthcare and social outcomes.”

Webinar Registration

Click here to visit the RIC website to complete the webinar registration form. If you need assistance in registering, please email: This email address is being protected from spambots. You need JavaScript enabled to view it.. Continuing Education (CE) credits are available for Continuing Nursing Education and the National Association of Social Workers. Individuals are encouraged to check with their specific licensing boards or other agencies to confirm that courses taken from these accrediting bodies will be accepted by that entity.

About Partners Health Plan

Partners Health Plan (PHP) is the first-in-the-nation, provider-led managed care organization that fully integrates Medicare and Medicaid for individuals 21 years and older with intellectual and/or developmental disabilities (I/DD), so they have the most complete care package. PHP provides person-centered care for whole-person wellness addressing the physical, behavioral, and social needs of individuals to assist them in living a quality life. The plan operates in 4 New York State regions (nine downstate counties): New York City, Long Island (Nassau and Suffolk counties), Rockland County, and Westchester County.

Partners Health Plan Presents at The Arc National convention

Partners Health Plan Presents at The Arc National Convention

Inclusion Benefits All: An Employment Success Story

Partners Health Plan's Cheif of Member Relations and Advocacy, Karleen M. Haines, along with PHP member Ackeem, were asked to present at the Arc’s National Convention “Inclusion Benefits All: An Employment Success Story.

They shared how Ackeem seeks to continue his successful path to independence and community involvement and how he received support and gained the confidence to seize opportunities or create them where they did not exist. They also looked at the value of hiring an inclusive workforce, the country’s general employment outlook, and how social determinants of health and access to care are crucial in order to grow, work, and live a fulfilling life.

Learning Objectives:

The business case for inclusion of employees with IDD and neurodiversity in the workplace
How circle of support teams can advocate in the current state of employment for those with disabilities
A personal story of employment success and growth, of a talented and determined individual

Partners Health Plan Presents: Leadership Speaking Engagements

Partners Health Plan Presents:
Leadership Speaking Engagements

Steven Merahn, MD, Medical Director, present "Value and Outcomes in IDD Care: A Radical Proposal” at the NY Alliance Annual Conference on April 19, 2023. The presentation focused on new models for outcomes measurement and value of services provided to the Intellectual and Developmental Disabilities (IDD) community. Dr. Merahn explored how to drive meaningful impact for individuals with IDD, supporting their efforts to fully participate (emotionally, socially, economically) and succeed as active, productive members of family and community.

Dr. Steven Merahn also presented on Autism Outcomes at the annual meeting of the Council of Autism Service Providers (CASP) in Tampa, FL on April 23, 2023. Dr. Merahn’s “Radical Proposal” engaged participants in a discussion about the ongoing challenges of defining the value of services provided to children with autism and how to best measure them. The goal is to look beyond autism symptoms and help map a plan for children with autism across their lifespan. CASP is an international trade association of autism service provider organizations focused on delivering quality, safe and effective care. 

Partners Health Plan Presents: Leadership Speaking Engagements at the NY Alliance Annual Conference

On April 19, Karleen Haines, Chief of Member Relations and Advocacy with PHP member, Ackeem Duggan, presented, “Inclusion Benefits All: An Employment Journey," at the NY Alliance Annual Conference. An inspiring employment journey of an individual to achieve independence and community involvement and how advocacy paved his bright future of employment and other neurodiverse individuals in the country and in New York.

Recruiting, hiring, and maintaining a workforce inclusive for those with Intellectual and Developmental Disabilities (IDD) form the bedrock of this presentation.

Ackeem works for the New York City Police Department as the Director of Community Affairs Bureau. LEARN MOREabout Ackeem's employment story.

Partners Health Plan To Present at The Arc Leadership Institute

Partners Health Plan (PHP) submitted a proposal to The Arc of the United States to present at the National Conference of Executives (NCE) Summer Leadership Institute (July date TBD) on the “Positive Impact of Telemedicine in the IDD Field.” It was successfully selected from a competitive submission process.

Scott Doolan, RN, BSN, MBA, AVP Health Care Management, will present and provide participants with details related to the PHP telemedicine program and provide a detailed analysis of emergency room and admission avoidance related to the program with the clinical and positive financial implications leading to the justification in maintaining a proactive member/caregiver-initiated telemedicine program post- pandemic to improve the quality of care for the IDD population.

The NCE unites executives, leaders, and professionals from across the disability sector in pursuit of a shared mission. This summer’s conference will focus on the most pressing issues faced by the disability community, including COVID-19 vaccination, HCBS developments, the DSP workforce crisis, the American Rescue Plan, and more.

For more information, please contact Elizabeth Wales, AVP Communications at: This email address is being protected from spambots. You need JavaScript enabled to view it.