CHOICE SelectHealth HIV Special Needs Plan Gets Go-Ahead for Expansion into Nassau and Westchester

CHOICE SelectHealth, VNSNY’s Medicaid special needs plan (SNP) for individuals who are HIV-positive, has received the green light from New York State’s Department of Health to expand its operations from New York City into Nassau and Westchester Counties. This will be the first time since the launch of the HIV SNP model in 2003 that a specialized plan is offered outside of New York City.

“This expansion is going to give hundreds of additional HIV-positive individuals access to enhanced support for managing their condition and keeping their viral load suppressed—which not only helps those individuals stay healthy themselves, but also means they can’t transmit HIV to others,” notes Dr. Hany Abdelaal, President of VNSNY CHOICE.

One key benefit of an HIV SNP is that plan members have access to a network of specialized HIV medical experts. CHOICE had already been in discussions with leading HIV care providers in both Nassau and Westchester, and now has a robust provider network in place in both counties.

“Our main partner in Nassau will be Northwell, which operates a highly regarded HIV clinic at its main facility in Manhasset,” says Senior Vice President Tom Dwyer, who oversees the SelectHealth plan. “In Westchester, we’ll be partnering with the Montefiore Medical Center system, which runs HIV programs in Mount Vernon, New Rochelle and White Plains. Another major partner will be Hudson River Health Care, which has 28 Federally Qualified Health Centers in Westchester and Long Island.”

The announcement of SelectHealth’s expansion coincides with a recent New York State quality report showing that SelectHealth has the best viral suppression rate among its HIV-positive members of any SNP in the state. “We’ve put a lot of work into bringing even our most vulnerable members into regular medical care,” says Tom. “This effort, which utilizes a peer outreach model that includes literally knocking on doors, really distinguishes us from any other health plan.”

Medicaid recipients with HIV in Nassau and Westchester who enroll in SelectHealth will also benefit from the plan’s ability to coordinate their care and cut through regulatory red tape, notes Tom. “Day to day, we’re able to facilitate things like obtaining preauthorization of certain services and HIV medications, making these transactions much easier for both care providers and their patients,” he says.

It’s estimated that both counties currently have several thousand residents who are HIV-positive, and about half of this population is eligible for Medicaid. “SelectHealth has been a leader in Governor Cuomo’s initiative to end the HIV-AIDS epidemic, and we’re excited to be extending our program beyond the five boroughs of New York City,” says Tom. SelectHealth also serves Medicaid-eligible individuals who are transgender or are homeless, regardless of their HIV status—meaning that Nassau and Westchester residents in these categories can now enroll in the plan as well.

“I especially want to acknowledge Jay Dobkin, Eli Camhi and the numerous other staff members who have been with SelectHealth since its inception in 2003,” adds Tom. “It’s thanks to their vision and dedication that we’ve been able to expand our model. Everyone is very enthusiastic about this expansion, including our provider partners in Nassau and Westchester. By having the opportunity to deliver our care in these counties, we believe we can improve the lives of many hundreds of people.”

To read the Crain’s Health Plus announcement about the SelectHealth expansion, click here.