New York state’s Medicaid spending per
person dropped to a 13-year low over the past
12 months, Gov. Andrew Cuomo announced
in late June.
He said the significant spending decrease,
which resulted in billions of dollars of savings
for taxpayers, can be attributed to the
reforms instituted by his Medicaid Redesign
Team.
“The announcement further solidifies New
York state as a leader in redesigning Medicaid
to meet the needs of the 21st century,” said
Cuomo. “Billions of taxpayer dollars have
been saved thanks to the work of our Medicaid
Redesign Team, and we are reinvesting in
our healthcare system as a result – improving
care for millions of New Yorkers. This is
a fundamental step forward in our work to
build a healthier New York State, and I look
forward to seeing the progress continue in
the years to come.”
“MRT continues to bend the cost curve,”
said state Health Commissioner Dr. Howard
Zucker. “Significant savings are occurring
while health outcomes for Medicaid members
are improving, which means that MRT is
benefiting all New Yorkers.”
Under the federal Affordable Care Act,
more than 500,000 New Yorkers joined the
Medicaid program in 2013 and 2014. At the
same time of that 9 percent growth in enrollment,
annual spending per recipient fell
to $8,223, the lowest level in more than 10
years, officials said.
Additionally, overall Medicaid spending
growth has significantly slowed to 1.4 percent
per year since 2011, when Cuomo established
the MRT, his office said. Prior to that, the
2003-2010 rate of increase was 4.3 percent
annually. A chart detailing total Medicaid
spending per recipient is available here.
Cuomo also announced that the Delivery
System Reform Incentive Payment (DSRIP)
program, which enables New York to invest
$7.3 billion of Medicaid savings over the
next five years into transforming its health
care system, has now made specific funding
allocations to 25 provider networks across
New York state. The funding, a result of last
year’s groundbreaking waiver between New
York and the federal government, will enable
health care providers to implement reforms
that reduce avoidable hospitalizations,
improve care and reduce costs, Cuomo said.
DSRIP requires providers to collaborate by
forming a Performing Provider System (PPS)
to implement innovative projects focusing
on system transformation, clinical improvement
and population health improvement.
Through community-level collaborations and
a focus on system reform, the ultimate goal
of these projects is to achieve a 25 percent
reduction in avoidable hospital use over five
years. The total includes approximately $1
billion in additional federal funds which
will help ensure that the state achieves all
DSRIP goals.
Each PPS submitted a plan, upon which
awards (also known as ‘valuations’) are
based. PPS’s that meet benchmarks and performance
metrics will be eligible to receive
the full amount of their valuations. Twentyfive
Performing Providers Systems have
already received state and federal approval,
and have been notified of the dollar amounts
they may receive during the five-year DSRIP
program. The remainder of the waiver funds
are being used to enhance health homes,
the long term care workforce and behavioral
health services, officials said.
The Performing Provider Systems include
Adirondack Health Institute Inc. in Glens
Falls, which had a value amount of $186.7
Public PPSs are led by a public hospital
system, whereas Safety Net PPSs are run by
non-profit hospitals or other providers.
Congressman Paul Tonko said the state
“must take major steps toward reforming
our Medicaid system to ensure its long-term
viability. We also need to ensure that families
most in need of these crucial services do not
lose them in the process. DSRIP balances
these two goals, putting New York state in
the unique position to provide more efficient
and effective Medicaid services. I am glad to
hear about the new funds being allocated to
PPSs around the state, especially for those
in the Capital Region.”
Cuomo established the Medicaid Redesign
Team upon taking office in January 2011,
bringing together stakeholders and experts
from throughout the state to work cooperatively
to reform the system and reduce costs.
Officials said the collaborative process
ensured that the action plan outlined in the
MRT report has broad support among the
health care stakeholder community. Through
this collaborative effort, MRT initiatives have
transformed the program into a national
model that cut costs, puts the patient first,
and creates a sustainable model of growth
focused on quality of care. The MRT was
recently selected as a Top 25 program and
as a top five finalist by Harvard’s Kennedy
School of Government for its Innovations in
American Government Award.
More information on the MRT and its initiatives
is available at www.health.ny.gov/mrt.