In the midst of Medicaid reaching its 50-year milestone in July, New York is hosting its own renaissance for the federal-state health insurance program. Transformation ignited in 2011 when Governor Andrew Cuomo created a Medicaid Redesign Team and began passing policies to slow annual spending growth.
Why was Medicaid chosen as the golden goose? According to 2006 New York State Spending Budget, Medicaid accounts for 37 percent of the overall budge at a whopping $57 billion. Under Cuomo, New York has a plan to invest $9 billion to implement a Medicare rebirth in the form of its Delivery System Reform Incentive Payment program.
New York aims to utilize the Delivery System Reform Incentive Payment program to spend less by delivering more care to Medicaid patients outside the hospital, keeping expensive emergency room costs down. The goal stands at a 25 percent reduction in avoidable hospital use over five years.
Major reforms will change the way healthcare providers are paid. According to the Centers for Medicare and Medicaid services (CMS), instead of being paid based on the number of services or tests conducted, Medicaid healthcare professionals will increasingly be paid based on the quality of work they do and how well it helps their patients.
Additionally, New York will implement 25 new delivery networks called preforming provider system (PPS) to coordinate Medicaid patient care. This system targets the issue that enrollees are going to multiple doctors and receiving duplicate or ineffective treatment.