Redesigning New York's Medicaid Program
"It is of compelling public importance that the State conduct a fundamental restructuring of its Medicaid program to achieve measurable improvement in health outcomes, sustainable cost control and a more efficient administrative structure."
- Governor Andrew M. Cuomo, January 5, 2011
MRT Waiver Amendment Information
Governor Andrew M. Cuomo announced on August 6, 2012 that New York has submitted an application for a waiver from the federal government that will allow the state to invest up to $10 billion in savings generated by the Medicaid Redesign Team (MRT) reforms to implement an action plan to transform the state's health care system.
Partnership Plan Waiver Extension Information
New York State is requesting that the federal government extend the New York State's Medicaid Section 1115 Partnership plan Demonstration for an additional five years. This extension is necessary to allow the state time to fully implement the MRT amendment's reinvestment and multi-year action plan.
Medicaid Redesign Team Progress Updates
Medicaid Redesign Team Final Report and Action Plan
- Medicaid Redesign Team Final Report and Action Plan (PDF, 2.25MB, 49pgs.)
- Companion Document: Medicaid Redesign Team Work Group Final Recommendations (PDF, 17.57MB, 509pgs.)
About The Medicaid Redesign Team
Governor Cuomo established the Medicaid Redesign Team (MRT) by Executive Order 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.
In Phase 1, the MRT provided a blueprint for lowering Medicaid spending in State Fiscal Year 2011-12 by $2.2 billion. This phase was completed in February 2011 when the MRT submitted an initial report to meet the Governor's Medicaid spending target contained in his 2011-2012 Executive Budget. The initial report included 79 recommendations to redesign and restructure the Medicaid program to be more efficient and get better results for patients. 78 recommendations were approved by the Legislature as part of the enacted budget and are now being implemented. The recommendations met the Governor's Medicaid budget target, introduced significant structural reforms that will bend the Medicaid cost curve, and achieved the savings without any cuts to eligibility.
The MRT continued its innovative work in Phase 2 by establishing 10 work groups to address more complex issues, as well as monitoring the implementation of key recommendations enacted in Phase 1. These work groups provided an additional 175 stakeholders the opportunity to participate in the MRT process. All work group meetings were public and multiple public hearings were held.
The efforts of the MRT will result in a multi-year road map that will lead toward a more efficient program and system that is affordable and will achieve better health outcomes for New Yorkers.
- Medicaid Redesign Team Members
- Governor Cuomo Issues Executive Order Creating Medicaid Redesign Team
- Public Hearings and Meetings
- MRT Work Groups
Supplemental Information on Specific MRT Proposals
New York State Medicaid State Plan
Jason Helgerson recently presented a status update on MRT initiatives to the Citizens Budget Commission.
Other Key Initiatives
- Uniform Assessment System for New York
The UAS-NY is a web-based record of individuals involved in the State's Medicaid network for health care providers. The record includes the individual's demographic information, residential and service delivery addresses, assessment information, and assessment outcome information.
- PCMH Quarterly Report
The Patient-Centered Medical Home (PCMH) Quarterly Report provides a snapshot of the National Committee for Quality Assurance's (NCQA's) PCMH recognition program in New York State. The report includes three main sections: Provider Information, Enrollee Information, and Fiscal Information.
- NYS Balancing Incentive Program
Authorized under the Affordable Care Act, the NYS Balance Incentive Program (BIP) provides states additional federal funding to implement structural changes that are believed to best facilitate rebalancing the percentage of individuals in need of long term supports and services in home and community based settings as opposed to institutional settings.
- State Quality Strategy
Every three years, NYSDOH assesses the Quality Strategy objectives using assurance reports, surveys, and findings. The Strategy is made public for comment.
- Medicaid Redesign and Quality Measures (PDF, 382KB, 10pgs.)
The Medicaid Redesign Team seeks to embrace triple aims outlined by the Center for Medicaid Services (CMS) as follows: 1) improving care, 2) improving health and 3) reducing costs. In order to evaluate the fulfillment of these aims, the Medicaid quality of care and population health indicators are measured.
- Care Management For All Transition Summary & Timeline
Care Management for All, started in 11/12, is one of the most important Medicaid Redesign Team initiatives currently underway, which entails the transition of as many patient populations and services as possible to care management.
- HEAL NY Phase 21 - Restructuring Initiatives in Medicaid Redesign Awards Announced
The HEAL NY Phase 21 is an initiative that allocates funds for uniquely situated, hospitals, nursing homes, clinics and home care providers to reconfigure business strategies and clinical services to better meet community health care needs.
- Hospital Medical Home Demonstration Project
The Hospital-Medical Home Demonstration Project will help hospitals training primary care doctors transform outpatient sites serving Medicaid beneficiaries into Patient Centered Medical Homes and improve the quality and safety of medical care provided in the hospital.
- Medically Fragile Children Work Group
The Medically Fragile Children Work Group provides Medicaid services to eligible children who suffer from a chronic medical condition.