Highlights from NYS Medicaid in 2017: Innovating in an Era of Uncertainty, presented by United Hospital Fund
By Valerie E. Pillo
New York state’s Medicaid expansion program has experienced a 26 percent growth in enrollment from 2010 to 2016. However, great uncertainty lies with potential cutbacks and large scale change at the federal level.
New program targets children
New York state announced a new program focused on children ages 0 to 3, of which 59 percent are on Medicaid.
Called the First 1000 Days on Medicaid, stakeholders will develop a 10-point plan focusing on improving outcomes and access to services for budget consideration in 2018. The goal is to create a healthy lifestyle to prevent long-term high utilization of health care services.
Even though support for the program was evident, it begs the question: “Do we need another NYS Medicaid initiative?” Critics say there is too much project overlap, outcomes are difficult to meet, and funds aren’t utilized efficiently.
DSRIP panelists express concerns
As the payment focus shifts and value-based contracting begins, DSRIP panelists were asked what keeps them up at night.
- Sustainability. What happens on DSRIP day one year six? There has to be ROI generated with risk
- Performance now completely drives earnings
- Need integration across the board for improved outcomes to begin and be sustainable
Behavioral health integration with NYS Medicaid
- Children will transition into Managed Medicaid Care plans July 1, 2018
- State has allocated $60 million to assist in creation of Behavioral Health Care Collaboratives
- By 2020, 85 percent of contracts must be value-based
New York has implemented ambitious Medicaid initiatives for the state’s poorest citizens in search of the triple aim. While some goals have been met, many challenges remain. The successful transition to value-based contracting is the state’s end game – and that will be the biggest challenge of all.
About the writer
Valerie E. Pillo is a market analyst for Decision Resources Group. She covers the healthcare market in New York, Texas, Connecticut, Rhode Island, New Hampshire, and Vermont. DRG, a subsidiary of Piramal Enterprises Ltd., is the premier source for global healthcare data and market intelligence. DRG helps companies competing in the global healthcare industry make informed business decision through its in-house team of expert healthcare analysts, data scientists, and consultants for critical guidance.