Letter to CMS

October 6, 2015

Hon. Sylvia Mathews Burwell
U.S. Department of Health and Human Services
200 Independence Avenue, S.W.
Washington, DC 20201

Dear Secretary Burwell:

First, thank you for your continued leadership on value-based care- we could not be more supportive or appreciative of your commitment to developing this path forward to the future of our healthcare system.

As you know, New York State is fully committed to the move to Value Based Payment, and we have embarked on an ambitious journey to improve outcomes for patients and populations, reward the delivery of high value care by providers, and increase long-term financial sustainability. In the State's Medicaid Payment Reform Roadmap, New York State commits itself to have 80-90% of MCO payments to providers through alternative payment mechanisms (APMs) within five years. This Roadmap was recently approved by CMS, and the State is currently working with over 400 stakeholders in 17 subcommittees and working groups to fill in the details and prepare Managed Care Organizations and Providers for the first large scale pilots to start early 2016.

Over the last few months New York State has worked with a large group of Stakeholders to discuss and develop an approach to maximally align CMS' payment reform efforts for Medicare to the NYS' Medicaid Payment Reform Roadmap. We believe that these efforts will improve patient care experience by reducing barriers and discontinuities across the system and align provider incentives across systems. By aligning the value based payment mechanisms of the two largest payers in NYS, providers' costs of entry would be reduced, while their interest in joining this initiative would increase. This would not just help the NYS Medicaid Reform agenda, but also help CMS reach its alternative payment goals.

Please find the Alignment proposal included. We look forward to discussing this proposal with you, and will reach out shortly with a proposed agenda.

We thank you in advance, and we look forward to beginning this discussion.


Jason A. Helgerson
Medicaid Director
Office of Health Insurance Programs

cc: Andrew Slavitt
     Victoria Wachino
     Eliot Fishman
     Patrick Conway
     Sean Cavanaugh
     Michael Melendez