NYSDOH Announcement: Medicaid Redesign Efforts to Transform Healthcare in New York State Reaches Milestone

On June 1, the New York State Department of Health announced that through New York State Medicaid redesign efforts, providers are exceeding their goals, resulting in improved health care throughout the state. Please see below for the full announcement.

New York State Department of Health Announces Medicaid Redesign Efforts to Transform Healthcare in New York State Reaches Milestone

New York State Excels in Federal Medicaid Performance Review, Improving Lives of Recipients Statewide

ALBANY, N.Y. (June 1, 2018) – The New York State Department of Health today announced that through New York State Medicaid redesign efforts, providers are exceeding their goals, resulting in improved health care throughout the state. New York handily passed its first federal test of the Delivery System Reform Incentive Payment, or DSRIP, on four key statewide performance measures: statewide metrics performance, success of statewide projects, total Medicaid spending and Managed Care plan expenditures. As part of the program established in 2014, New York was required to submit a statewide report card to the Centers for Medicaid and Medicare Services (CMS) detailing performance.

“Medicaid redesign is improving health care and lives throughout New York State, while saving taxpayers millions of dollars each year,” said New York State Department of Health Commissioner Dr. Howard A. Zucker. “Thanks to Governor Cuomo’s leadership, we continue to exceed not only our own goals, but federal standards in making Medicaid more efficient and accountable.”

Currently in its fourth year, DSRIP has 25 Performing Provider Systems (PPS) made up of hospitals, providers and community-based organizations, who collaborate to provide Medicaid members and the uninsured with higher quality, more coordinated care. Through community-level collaborations and a focus on system reform, the ultimate goal of these projects is to improve quality of care and achieve a 25 percent reduction in avoidable hospital use over the five years of the program.

Today’s report shows that through DSRIP, New York State has exceeded performance goals on the majority of measures in place, related to the transformation of care. Statewide metrics show several areas of improvement including the following critical measures:

  • Preventable hospital readmission
  • Preventable emergency room visits
  • Patient Connection to Consistent Source of Primary Care
  • Access to timely appointments

Additional report highlights include:

  • Statewide Medicaid spending for emergency department and inpatient spending came in under target from the previous year.
  • New York State has far exceeded the 10 percent goal of Managed Care Organizations’ (MCO) service dollars being contracted by Value Based Payment (VBP) arrangements instead of Fee for Service. (Under Value Based Payment, MCOs and providers agree that a portion of compensation is dependent on provider performance.)
  • Majority of DSRIP performance and quality metrics were achieved.

“A passing grade on all four of the milestones proves that we are making monumental progress toward improving care for millions of New Yorkers,” said New York State Medicaid Director Donna Frescatore. “While we are on a clear path to success, our work is far from over. In the months and years ahead, we will shift our focus toward improving performance metrics and health outcomes as we work to change the culture of health care.”

New York must submit a statewide report card to CMS for each year remaining in the demonstration, which ends on March 31, 2020. Failure to meet any of the four milestones will result in a financial penalty of overall DSRIP dollars from the federal government.

The full report can be viewed here.

More information on the DSRIP program can be found here: www.health.ny.gov/DSRIP.