Governor Andrew M. Cuomo today announced that New York has finalized terms and conditions with the federal government for the Medicaid 1115 waiver that will allow the state to reinvest $8 billion in federal savings generated by Medicaid Redesign Team (MRT) reforms. The MRT waiver amendment’s primary goal is to transform the state's health care system, bend the Medicaid cost curve, and ensure access to high quality care for all Medicaid members.
“As critical Medicaid safety net providers, federally qualified health centers are ready to work with other providers to transform the health care system in New York,” said Elizabeth Swain, President and CEO of the Community Health Care Association of New York State (CHCANYS). “We applaud Governor Cuomo’s call for new community-based primary care centers in neighborhoods that need them. We hope that the waiver can accelerate that critical strategy and enable FQHCs to expand their contributions to delivery system transformation.”
The Medicaid 1115 waiver amendment will enable New York to fully implement the MRT action plan and allow the state to reinvest over a five-year period $8 billion of the $17.1 billion in federal savings generated by MRT reforms. At the heart of the waiver is the Delivery System Reform Incentive Payment (DSRIP) program, which will seek to promote community-level collaborations to transform health care delivery and reduce avoidable hospital use by 25% over five years. Safety net providers will be required to collaborate to implement innovative projects focusing on system transformation, clinical improvement and population health improvement. Single providers will be ineligible to apply. All DSRIP funds will be based on performance linked to achievement of project milestones and outcomes.
The Governor’s announcement indicated that the $8 billion reinvestment will be allocated in the following ways:
$500 Million for the Interim Access Assurance Fund – temporary, time limited funding to ensure current trusted and viable Medicaid safety net providers can fully participate in the DSRIP transformation without disruption;
$6.42 Billion for Delivery System Reform Incentive Payments(DSRIP) – including DSRIP Planning Grants, DSRIP Provider Incentive Payments, and DSRIP Administrative costs;
$1.08 Billion for other Medicaid Redesign purposes – this funding will support Health Home development, and investments in long term care, workforce and enhanced behavioral health services.
The announcement also indicated that the special terms and conditions commit the state to comprehensive payment reform and continuing New York’s effort to effectively manage its Medicaid program within the confines of the Medicaid Global Spending Cap.
Public comment on the MRT waiver amendment will be solicited through the MRT website, webinars and public hearings to take place over the next several weeks. Additional information, including the waiver special terms and conditions, list of eligible safety net providers, descriptions of eligible projects, and other overview documents will soon be available here.