NY Workgroup Offers Medicaid Reform Package

The Payment Reform and Quality Measurement Work Group of New York’s Medicaid Redesign Team released its final recommendations in December. Chaired by Dan Sisto, President of the Healthcare Association of New York State, and William Streck, MD, Chair of the New York State Public Health and Health Planning Council, the 21-member Work Group agreed on four goals: (1) seek a waiver from the Centers for Medicare & Medicaid Services to integrate Medicaid and Medicare service delivery for 700,000 “dual eligible” individuals with chronic conditions; (2) adopt incentive-based performance reporting across all sectors of the health care system; (3) reform the state’s Indigent Care Program using a simple and fair approach that targets uncompensated care and Medicaid service delivery but does not include bad debt; and, (4) establish an Essential Community Provider Network and a Vital Access Providers Program offering temporary funding to facilitate closures and mergers, as well as long-term enhanced reimbursement to financially-stressed providers treating vulnerable populations. The Payment Reform and Quality Measurement Work Group is one of ten panels supporting the State’s Medicaid Redesign Team. Phase 1 of the Team’s work centered on developing proposals to meet the Governor’s first-year budget target. Phase 2 is intended to address multi-year program enhancements. The Redesign Team Chairs are Michael Dowling, President and CEO of North Shore LIJ Health System, and Dennis Rivera, Senior Advisor to the International President of SEIU.