MetroPlus, a subsidiary of NYC Health + Hospitals (H+H), offers low-cost to no-cost health insurance coverage to eligible New Yorkers through a variety of plans. Between February 2020 and June 2022, MetroPlus enrollment reached a record high of 670,915 members, an increase of 159,284 (31%), according to a report released today by State Comptroller Thomas P. DiNapoli. The financial stability of H+H is impacted by MetroPlus’s membership levels and members use of H+H health services. The amount of MetroPlus spending at H+H facilities has also increased but not yet reached H+H’s target of 45 percent.
“My report shows that New Yorkers have enrolled in MetroPlus health plans in record numbers over the course of the COVID-19 pandemic,” DiNapoli said. “MetroPlus and H+H will have to continue to work together to provide robust managed care and high-quality services to its members, while implementing effective strategies to retain members and improve utilization levels that contribute to the financial stability of H+H.”
DiNapoli’s report attributed increased MetroPlus enrollment to conditions and policy changes spurred by the COVID-19 pandemic. The factors that led to this increase, including continuous enrollment, may wind down as the pandemic’s designation as a federal public health emergency expires. During this wind down period, enrollment in these plans will likely decline as the member renewal process returns to normal and members either do not renew or become ineligible for coverage. To help members, MetroPlus needs to actively engage with its partners in the city and the state to ensure a smooth transition for its members and avoid interruptions in insurance coverage that could result in lapses of care.
MetroPlus plays a vital role in providing healthcare access for many low-income New Yorkers and is an important part of the city’s public hospital system. H+H’s ability to execute its strategic plan will, in part, depend on whether it can maintain membership levels by among other things, providing quality care and improving patient satisfaction.
Economic and Policy Insights
Track state and local government spending at Open Book New York. Under State Comptroller DiNapoli’s open data initiative, search millions of state and local government financial records, track state contracts, and find commonly requested data.