Medicaid per-Recipient Spending Slashed to Lowest Level in 13 years
Historic Reform Paves the Way for $7.3 Billion Investment in Health System Transformation
Governor Andrew M. Cuomo today announced that New York’s Medicaid spending per person dropped to a 13 year low over the past 12 months. This significant spending decrease, which has resulted in billions of dollars of savings for taxpayers, can be attributed to the reforms instituted by Governor Cuomo’s Medicaid Redesign Team.
“Today’s announcement further solidifies New York State as a leader in redesigning Medicaid to meet the needs of the 21st century,” said Governor Cuomo. “Billions of taxpayer dollars have been saved thanks to the work of our Medicaid Redesign Team, and we are reinvesting in our healthcare system as a result – improving care for millions of New Yorkers. This is a fundamental step forward in our work to build a healthier New York State, and I look forward to seeing the progress continue in the years to come.”
“MRT continues to bend the cost curve,” said New York State Health Commissioner Dr. Howard Zucker. “Significant savings are occurring while health outcomes for Medicaid members are improving, which means that MRT is benefitting all New Yorkers.”
Under the federal Affordable Care Act, more than 500,000 New Yorkers joined the Medicaid program in 2013 and 2014. At the same time of that nine percent growth in enrollment, annual spending per recipient fell to $8,223 - the lowest level in more than ten years. Additionally, overall Medicaid spending growth has significantly slowed to 1.4 percent per year since 2011, when Governor Cuomo established the MRT. Prior to that, the 2003-2010 rate of increase was 4.3 percent annually. A chart detailing total Medicaid spending per recipient is available here.
Governor Cuomo also announced that the Delivery System Reform Incentive Payment (DSRIP) program, which enables New York to invest $7.3 billion of Medicaid savings over the next five years into transforming its health care system, has now made specific funding allocations to 25 provider networks across New York state. This funding, a result of last year’s groundbreaking waiver between New York and the federal government, will enable health care providers to implement reforms that reduce avoidable hospitalizations, improve care and reduce costs. DSRIP requires providers to collaborate by forming a Performing Provider System (PPS) to implement innovative projects focusing on system transformation, clinical improvement and population health improvement. Through community-level collaborations and a focus on system reform, the ultimate goal of these projects is to achieve a 25 percent reduction in avoidable hospital use over five years. The total includes approximately $1 billion in additional federal funds which will help ensure that the state achieves all DSRIP goals.
Each PPS submitted a plan, upon which awards (also known as ‘valuations’) are based. PPS’s that meet benchmarks and performance metrics will be eligible to receive the full amount of their valuations. Twenty-five Performing Providers Systems have already received state and federal approval, and have been notified of the dollar amounts they may receive during the five-year DSRIP program. The remainder of the waiver funds are being used to enhance health homes, the long term care workforce and behavioral health services.
The 25 Performing Provider Systems and specific valuation amounts are listed below. Public PPSs are led by a public hospital system, whereas Safety Net PPSs are run by non-profit hospitals or other providers.
Safety Net PPSs
Adirondack Health Institute, Inc.
Advocate Community Providers, Inc.
Albany Medical Center Hospital
Alliance for Better Health Care, LLC
Bassett Medical Center
Bronx-Lebanon Hospital Center
Finger Lakes Performing Provider System, Inc.
Maimonides Medical Center
Montefiore Medical Center
Mount Sinai PPS, LLC
NYU Lutheran Medical Center
Refuah Community Health Collaborative
Samaritan Medical Center
SBH Health System
Sisters of Charity Hospital of Buffalo, New York
Southern Tier Rural Integrated Performing Provider System, Inc.
Staten Island Performing Provider System, LLC
The New York and Presbyterian Hospital
The New York Hospital Medical Center of Queens
Central New York Care Collaborative, Inc.
Millennium Collaborative Care
Nassau Queens Performing Provider System, LLC
The New York City Health and Hospitals Corporation
State University of New York at Stony Brook University Hospital
Westchester Medical Center
Congressman Charles B. Rangel said: "I applaud Governor Cuomo for his leadership to protect and modernize Medicaid provided through New York State's health care system. The money being invested over the next five years will result in taxpayer savings and better quality care to all New Yorkers. I will continue to fight for access to quality, affordable healthcare and to protect and preserve Medicare and Medicaid."
Congresswoman Louise Slaughter said: “I am pleased that local healthcare professionals will have the opportunity to showcase Rochester’s history of providing excellent coordinated health care. I supported the governor’s Medicaid Redesign Team plans and the request for the reinvestment of the federal savings it would create because it would lead to a transformation in the way health services are delivered and improve the lives of our citizens. I am fully confident Rochester will continue to lead the way in providing better health care in New York."
Congressman Eliot Engel said: “The reinvestment of $7.3 billion in federal savings through the DSRIP will help some of New York’s finest health care institutions meet the needs of patients in the 21st century. As a senior member of the House Energy and Commerce Health Subcommittee, I know the value of Governor Cuomo’s efforts to redesign and improve our health care system, and I applaud his commitment to making New York a leader in the health care field.”
Congressman José E. Serrano said: “This announcement represents an important step in Governor Cuomo’s efforts to reform and improve New York’s Medicaid services and health care delivery system. Thanks to this funding, Medicaid service providers, including several in the Bronx, will be able to implement innovative projects to reform their services and improve care while reducing costs. Modernizing the Medicaid system will help more beneficiaries access quality health care services in their community, while helping our city save billions of dollars.
Congressman Jerrold Nadler said: "This is great news for New York State’s Medicaid program and the millions of New Yorkers who rely on it. I am glad to have been a supporter of the wavier amendment and commend Governor Cuomo for his work and leadership on this important issue to bring more efficient and effective care to our state."
Congresswoman Carolyn B. Maloney said: “Governor Cuomo has undertaken a tremendous effort to transform Medicaid delivery and make New York a leader in providing Medicaid services. These grants will help fund additional changes that will improve the overall health of our state. I am proud to have supported reforms at the federal level, which have allowed these improvements to move forward.”
Congressman Gregory W. Meeks said: “I applaud Governor Cuomo’s action to assist community hospitals develop better and more efficient Medicaid services. Healthcare providers across the state, including the New York Hospital Medical Center of Queens will now be able to modernize and improve care while lowering costs. In doing so, we take one step closer to the 21st century healthcare system that all New Yorkers deserve.”
Congressman Joe Crowley said: “New York has long been on the front lines of quality and innovation in health care, and I’m glad that so many community based organizations, hospitals, and other providers will be participating in this initiative to further improve health care in the state. I was proud to work with Governor Cuomo and our congressional delegation to support the state-federal partnership that enabled this project, and I look forward to seeing the results.”
Congressman Steve Israel said: “This announcement to reinvest more than $7 billion in federal savings will dramatically improve the way health care is delivered to Medicaid beneficiaries in New York. These innovations will save money, improve patient care and fundamentally change the way Medicaid works for our communities.”
Congressman Paul Tonko said: “We must take major steps toward reforming our Medicaid system to ensure its long-term viability. We also need to ensure that families most in need of these crucial services do not lose them in the process. DSRIP balances these two goals, putting New York State in the unique position to provide more efficient and effective Medicaid services. I am glad to hear about the new funds being allocated to PPSs around the State, especially for those in the Capital Region, and I thank the Governor for his hard work on this issue.”
Congressman Sean Patrick Maloney said: “Working together, the federal, state, and private sector can ensure that New York continues to be a health care leader in our country. Today’s announcement brings us one step closer to providing more effective, helpful, and cost effective service by transforming the health care safety net, reducing avoidable hospital use and by improving public health measures to the communities we all serve.”
Congresswoman Kathleen Rice said: “This funding will allow providers in New York to give better care while also reducing costs. This is a major investment in public health and a major step in the effort to reform and improve the delivery of Medicaid services so that this program remains intact for all the New Yorkers who depend on it.”
About the Medicaid Redesign Team:
Governor Cuomo established the Medicaid Redesign Team 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. The collaborative process ensured that the action plan outlined in the MRT report has broad support among the health care stakeholder community. Through this collaborative effort, MRT initiatives have transformed the program into a national model that cut costs, puts the patient first, and creates a sustainable model of growth focused on quality of care. The MRT was recently selected as a Top 25 program and as a top five finalist by Harvard’s Kennedy School of Government for its Innovations in American Government Award.
More information on the MRT and its initiatives is available at http://www.health.ny.gov/mrt.