Cuomo Announces Medicaid Redesign Efforts

Historic Reform Paves the Way for $7.3 Billion Investment in Health System Transformation 

New York’s Medicaid spending per person dropped to a 13 year low over the past 12 months, according to Governor Andrew Cuomo. 

This significant spending decrease, which has resulted in billions of dollars of savings for taxpayers, can be attributed to the reforms instituted by Governor Cuomo’s Medicaid Redesign Team.
 
“Today’s announcement further solidifies New York State as a leader in redesigning Medicaid to meet the needs of the 21st century,” said Governor 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 New York State Health Commissioner Dr. Howard Zucker. “Significant savings are occurring while health outcomes for Medicaid members are improving, which means that MRT is benefitting 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 nine percent growth in enrollment, annual spending per recipient fell to $8,223 - the lowest level in more than ten years. 

Additionally, overall Medicaid spending growth has significantly slowed to 1.4 percent per year since 2011, when Governor Cuomo established the MRT. 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.
 
Governor 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. This 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. 

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. 

Twenty-five 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.
 
The 25 Performing Provider Systems and specific valuation amounts are listed below. Public PPSs are led by a public hospital system, whereas Safety Net PPSs are run by non-profit hospitals or other providers

Safety Net PPSs	Total Amount
Adirondack Health Institute, Inc.	$186,715,496
Advocate Community Providers, Inc.	$700,038,844
Albany Medical Center Hospital	$141,430,547
Alliance for Better Health Care, LLC	$250,232,844
Bassett Medical Center	$71,839,379
Bronx-Lebanon Hospital Center	$153,930,779
Finger Lakes Performing Provider System, Inc.	$565,448,177
Maimonides Medical Center	$489,039,450
Montefiore Medical Center	$249,071,149
Mount Sinai PPS, LLC	$389,900,648
NYU Lutheran Medical Center	$127,740,537
Refuah Community Health Collaborative	$45,634,589
Samaritan Medical Center	$78,062,822
SBH Health System	$384,271,362
Sisters of Charity Hospital of Buffalo, New York	$92,253,402
Southern Tier Rural Integrated Performing Provider System, Inc.	$224,540,274
Staten Island Performing Provider System, LLC	$217,087,986
The New York and Presbyterian Hospital	$97,712,825
The New York Hospital Medical Center of Queens	$31,776,993
Public PPSs	Total Amount
Central New York Care Collaborative, Inc.	$323,029,955
Millennium Collaborative Care	$243,019,729
Nassau Queens Performing Provider System, LLC	$535,396,603
The New York City Health and Hospitals Corporation	$1,215,165,724
State University of New York at Stony Brook University Hospital	$298,562,084
Westchester Medical Center	$273,923,615

Congressman Steve Israel said: “This announcement to reinvest more than $7 billion in federal savings will dramatically improve the way health care is delivered to Medicaid beneficiaries in New York. These innovations will save money, improve patient care and fundamentally change the way Medicaid works for our communities.”

Congressman Paul Tonko said: “We 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, and I thank the Governor for his hard work on this issue.”

Congressman Sean Patrick Maloney said: “Working together, the federal, state, and private sector can ensure that New York continues to be a health care leader in our country. Today’s announcement brings us one step closer to providing more effective, helpful, and cost effective service by transforming the health care safety net, reducing avoidable hospital use and by improving public health measures to the communities we all serve.”

Congresswoman Kathleen Rice said: “This funding will allow providers in New York to give better care while also reducing costs. This is a major investment in public health and a major step in the effort to reform and improve the delivery of Medicaid services so that this program remains intact for all the New Yorkers who depend on it.”

About the Medicaid Redesign Team:
Governor 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. 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 http://www.health.ny.gov/mrt.