Dear Partners,
Thank you for joining us at last week’s convening. The theme — From Start-Up to Sustainability — was not chosen for rhetorical effect. With roughly a year remaining in this phase of the Medicaid waiver, we are at a genuine inflection point, and I wanted to share some reflections with those who could not be there, and to reinforce what we discussed with those who were.
For most of our history together, we have been writing a start-up chapter: standing up the platform, onboarding partners, training navigators, and proving that this work could be done at the scale New York City demands. That chapter is closing. We are entering a harder and more consequential one — the work of becoming sustainable.
The numbers tell part of the story, and the slope matters more than any single point. Screening has grown from 41 members per day a year ago to more than 2,000 per day today. Services delivered through the network have moved from just over $30 thousand in our first quarter to more than $30 million to date. Time to payment has compressed from 77 days to under 28. Days from a member’s referral to receipt of service has fallen from six to roughly two. By every meaningful measure, access, payment efficiency, and member experience — we are a high-performing network.
Performance, however, is not sustainability. Performance is what we owe our members today. Sustainability is what we owe them five years from now, and it rests on business development as much as on operational excellence. On that front, we are positioning the network as a valued partner across three converging shifts: the inclusion of social care in Medicaid risk adjustment beginning in 2027, the recertification and work requirements coming under HR1, and the State’s revised value-based care roadmap, which will need to address regional health disparities more directly than the current model does.
This is not work Public Health Solutions can do alone, and we are not trying to. Over the past several weeks we have been holding one-on-one executive sessions with our priority partners to shape the strategy together, and I look forward to continuing those conversations in the weeks and months ahead.
The transition from start-up to sustainability is one we make together — so thank you for bringing us this far.
