![]() ![]() ![]() Every policy change must now be viewed in terms of what, if any, impact it will have on the allocation of finite Medicaid resources. This cap, which applies to the state share of Medicaid spending and is under the control of the Commissioner of Health, has fundamentally changed how state officials and stakeholders view the program. Perhaps the most important element of the MRT´s Phase 1 plan was to enact a global Medicaid spending cap. The MRT continued its innovative work in a second phase, breaking into work groups to address more complex issues, as well as monitoring the implementation of key recommendations enacted from their initial work. The MRT, made up initially of 27 stakeholders representing virtually every sector of the health care delivery system, including patient advocates, worked for nearly two months and developed a series of recommendations that not only lowered immediate spending - state share savings of $2.2 billion in SFY 11-12 - but also proposed important reforms that will lead to improved health outcomes, as well as further savings in years to come. Governor Cuomo´s vision for collaboration was effectuated through Executive Order #5 which created the New York Medicaid Redesign Team (MRT). He invited key Medicaid stakeholders to the table in a spirit of collaboration to see what could be achieved collectively to change course and rein in Medicaid spending, while at the same time improving quality. To address these underlying health care cost and quality issues, Governor Cuomo pursued a unique approach to reform. These quality issues are not limited to Medicaid but are reflected in the entirety of the health care system. Major disparities exist in health status among racial, ethnic, and socioeconomic groups in New York State. As mentioned, while national rankings tend to show New York in the middle of the pack when it comes to overall health care quality, those overall statistics mask major problems in areas such as avoidable hospital use, where New York ranks 50th in the country. In addition to a cost problem, New York has some significant quality issues. The Governor quickly determined that unless these underlying issues are addressed, and spending growth is contained, New York´s Medicaid program will no longer be sustainable. Buried within the complexity of the Medicaid program lie numerous policies (sometimes taking the form of formulas) that have led to runaway cost growth. Some of this growth has been driven by the recession however, other cost drivers have played a key role in program-wide spending which has risen from $46 billion in April 2007 to the current 2011 Medicaid budget of $53 billion. In addition to a high spending "base", New York´s Medicaid program has seen significant growth in recent years. Similar to the nation as a whole, New York taxpayers are not getting their money´s worth when it comes to its Medicaid program. At best, New York is in the middle of the pack when it comes to health care quality. New York´s Medicaid program, the nation´s largest, spends nearly $53 billion to serve 5 million people, which is twice the national average when compared on a per recipient basis. At the same time, key health indicators suggest that we are not getting our money´s worth. The United States currently spends 16 percent of its GDP on health care which is nearly twice as much as any other nation. Redefining the State/Local Relationship in MedicaidĮver rising health care costs are a national challenge.Strengthening and Transforming the Health Care Safety Net.Redesigning New York´s Medicaid Benefit.HIT - Interoperable EHR for All New Yorkers.Health Care Workforce for the 21st Century.Ensure Universal Access to High Quality Primary Care.Key Reform Elements: New York Achieving the Triple Aim Health System Redesign in New York: Triple Aim Final Report is also available in Portable Document Format (PDF, 2.2MB).All Health Care Professionals & Patient SafetyĪ Plan to Transform the Empire State's Medicaid Program Better Care, Better Health, Lower Costs.Clinical Guidelines, Standards & Quality of Care.Health & Safety in the Home, Workplace & Outdoors.Birth, Death, Marriage & Divorce Records.
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