Published On: January 13, 2024By

New York State Embarks on Transformative Healthcare Initiative with Medicaid 1115 Waiver

On January 10th, in a landmark decision poised to reshape healthcare delivery, New York State has secured approval for a significant amendment to its Medicaid program, signifying a proactive step towards addressing health inequities and social needs. The 1115 Waiver, a specialized federal approval, empowers the state to test innovative strategies that veer from traditional Medicaid rules, with an ambitious budget allocation of $7.5 billion spread over the next three years.

Key Highlights of the Waiver:

  • Addressing Social and Health Needs:1 The waivers main strategy focus is on Health-Related Social Needs (HRSN) through newly established Social Care Networks (SCNs). These networks will operate across the state, delivering essential services and support directly to Medicaid beneficiaries. This includes a comprehensive range of benefits, right down to the provision of housing in certain medical circumstances, underscoring a holistic approach to healthcare.
  • Regional Health Equity Initiatives:2 The establishment of the Health Equity Regional Organization (HERO) is another cornerstone of the waiver. With funding of up to $125 million, HERO is set to conduct region-specific strategies to improve health disparities, leveraging data analytics and comprehensive regional assessments. This initiative is expected to tailor and enhance the effectiveness of health programs to meet distinct regional health challenges.
  • Investment in Healthcare Workforce:4 Recognizing the critical role of healthcare professionals, the waiver will allocate substantial funds (up to $694 million) towards workforce development. This investment is anticipated to bolster the availability and quality of healthcare services, indirectly reinforcing various health initiatives.

Implications for Food Pharmacy Prescriptions:1,3 The waiver’s emphasis on HRSN is particularly beneficial for programs related to food pharmacy prescriptions. This includes an array of services like medically tailored meals, produce and grocery boxes, and benefit cards. The targeted support envisioned under the waiver is expected to significantly address the nutritional needs of diverse populations under Medicaid. Innovative Food as Medicine strategies will be able to use the waiver reimbursements to address both food insecurity and nutrition insecurity.

New York Healthcare, The New Blueprint: This development signals a new era in New York’s healthcare landscape, and potentially the country. It highlights a commitment to not just healthcare in the conventional sense, but a broader, more inclusive approach that recognizes the fundamental role of social factors in overall health. As these initiatives unfold, they are poised to offer key insights into the potential of such comprehensive healthcare models, not only in New York but as a blueprint for other states and regions. Nearly 45%4 of Americans suffer from one or more chronic diseases such as cancer, heart, disease, obesity, and diabetes. More staggering is 7 out of every 10 deaths in America are from a lifestyle disease.4 Of the $4.1 Trillion annual health spend, 90% of that is spent on those with chronic diseases.4 Using behavioral, access, and nutrition interventions to aid in risk factors and prevention could save the state millions in future healthcare costs.


  1. Raths D. CMS Approves New York’s Medicaid Waiver to Address SDOH. Healthcare Innovation. Published January 9, 2024. Accessed January 9, 2024 of NY
  2. LeadingAge New York. Medicaid 1115 Waiver Amendment Approved by CMS. LeadingAge New York. Accessed January 9, 2024 Cost of Health
  3. Governor Hochul Announces Groundbreaking Medicaid 1115 Waiver Amendment to Enhance New York State’s Health Care System. Governor Kathy Hochul. January 9, 2024. Accessed January 9, 2024
  4. Costs of Chronic Diseases. Centers for Disease Control and Prevention. Updated March 23, 2021. Accessed January 10, 2024
Published On: January 13, 2024By