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Report
Health Care
A New Approach to Funding New York City Health + Hospitals
December 16, 2019
This report analyzes the system’s finances, compares H+H to other providers in the City, and outlines options to right-size the City subsidy and improve H+H's fiscal future.
Report
State Budget
Overdue Bills
Time to Face the Reality of Rising Medicaid Costs
October 09, 2019
State leaders have two options to reconcile the disconnect between reality and the budget: reduce Medicaid spending and/or achieve savings in other areas of the budget.
Report
Transportation
Switching Gears
A New Way to Fund Transportation
May 08, 2019
The new congestion pricing fee serves the dual goals of raising revenue and reducing traffic congestion; however, the measure is not a complete solution to the State’s need for transportation funding.
Report
Public Workforce
Reform at the Bargaining Table
Labor’s Participation Needed to Improve the MTA’s Financial Outlook
April 30, 2019
The MTA's fiscal outlook is dire, and improving it requires a multipronged approach. Paramount in the effort is slowing the growth of labor costs.
Report
Health Care
Options to Enhance the Coordination of Care for Dually Eligible Individuals in New York State
A Discussion Paper
April 25, 2019
This discussion paper outlines lessons from previous and existing efforts to coordinate the care of duals, and suggests five strategies for the State to consider moving forward.
Report
Transportation
Swimming in Subsidies
The High Cost of NYC Ferry
March 28, 2019
NYC Ferry serves more than 4 million passengers at a high level of operating subsidy: $10.73 per ride, 10 times that of the New York City Transit.
Report
Transportation
Building a Sound Fiscal Future for New York's Highway and Mass Transit Systems
March 19, 2019
Options for raising sufficient funds for roads and transit statewide include increasing tolls and fees, enacting congestion pricing, and implementing a vehicle-miles traveled (VMT) fee.
Report
Transportation
NYS Infrastructure Policy
A Background Paper for the CBC Conference on The Most Important Fiscal and Economic Issues Facing New York State
December 13, 2018
This paper was prepared by HR&A Advisors as a background paper for the December 2018 CBC Conference on most important fiscal and economic issues facing New York State. The paper provides recommendations for how NYS should prioritize, fund, and deliver key infrastructure investments.
Report
Health Care
Still a Poor Way to Pay for Medicaid
October 01, 2018
For more than 50 years New York State has financed its Medicaid program in a unique way: the State requires New York City and the 57 other counties to pay more for Medicaid than all other local governments in the nation combined.
Report
Transportation
Getting Back on Track
Replacing and Repairing Subway Cars Will Be Expensive and Take More Than a Decade
July 18, 2018
Decisions to redirect capital dollars to other priorities and stretch inspection and maintenance cycles contributed to the decline in subway reliability, and challenges lay ahead for plans to purchase 3,600 new subway cars and retrofit 1,200 existing cars.
Report
Health Care
Options for Enhancing New York's Health Home Initiative
A Discussion Paper
May 01, 2018
This paper addresses the challenges in extending Health Homes to all who can benefit from their services in a cost-effective manner.
Report
Transportation
4 Things You Should Know About the MTA's Commuter Railroads
April 18, 2018
The Long Island Rail Road is much more inefficient than Metro-North. Here's why.
Report
Taxes
Practical Policy in Challenging Circumstances:
How NYS and NYC Should Respond to the Tax Cuts and Jobs Act
March 18, 2018
Strategies to mitigate the federal tax law's threat to New York's competitiveness and New Yorkers' wallets.
Report
Health Care
Lessons from La La Land
Can the Turnaround of Los Angeles' Public Hospitals Be Replicated in New York?
January 08, 2018
Does LA's experience hold lessons for NYC Health + Hospitals?
Report
Taxes
New York City Property Taxes
3 Things Owners and Renters Should Know
December 22, 2016
Why do owners of the same type of property pay vastly different rates?
Presentation
Health Care
The Berger Commission: 10 Years On
November 29, 2016
This presentation, from the CBC panel discussion "The Berger Commission: 10 Years On," reviews how health care services in New York City have evolved since the New York State Commission on Health Care Facilities in the 21st Century, known as "The Berger Commission" issued its recommendations in 2006.
Report
Transportation
Access-A-Ride
Ways to Do the Right Thing More Efficiently
September 20, 2016
This report identifies strategies and options the Metropolitan Transportation Authority (MTA) can pursue to improve the financial outlook and quality of Access-A-Ride, the paratransit program.
Report
State Budget
Predicting the Peak, Preparing for the Trough
An Examination of the Impact of a Possible Recession on New York State
June 20, 2016
The impact of a possible recession could be as high as $59 billion, or 18.2 percent of tax revenues over four years.
Report
Health Care
What Ails Medicaid in New York?
And Does the Medicaid Redesign Team Have a Cure?
May 20, 2016
This report assess the progress of the Medicaid Redesign Team (MRT), launched in 2011, in implementing strategies to curb costs and improve the quality of care in Medicaid.
Report
Transportation
Recessions and Revenues
The Case of the MTA
December 16, 2015
This policy brief considers the implications of a recession for the Metropolitan Transportation Authority’s (MTA) current financial plan.