Medicaid is a cornerstone of the health care system of New York State, providing coverage to over five million residents and accounting for $49 billion in annual health care spending.
Medicaid provides a broad range of health care services to a diverse group of New Yorkers. Its main roles include providing health insurance to low-income families, covering disabled individuals who have access to no other health care services, supplementing Medicare for the low-income elderly and disabled individuals, and providing subsidies directly to health care providers.
The Medicaid Institute™ at United Hospital Fund aims to be a force for positive change leading to the redesign, restructuring, and rebuilding of New York State's Medicaid program.
Two complementary reports presenting data on Medicaid spending for and utilization by Medicaid beneficiaries under the age of 21 in New York. This data brief and accompanying chartbook are part of a growing UHF body of work focused on children’s health, especially in the context of payment reform.
A guide distilling and explaining the New York State Roadmap for Medicaid Payment Reform, which lays out New York’s ambitious goals of moving toward value-based payment from a fee-for-service model.
This report gives an overview of the complex structure of New York Medicaid’s current services for children needing behavioral health services, reviews the State’s planned approach to reforming this system, and explores several important policy considerations for stakeholders as the reforms move forward.
This data brief provides a snapshot of the projects selected by emerging Performing Provider Systems as part of their application for New York Medicaid’s Delivery System Reform Incentive Payment (DSRIP) program.
This comprehensive overview of New York’s Medicaid program provides essential grounding in the dramatically changing program, focusing on the changes related to the federal Affordable Care Act and the State’s Medicaid Redesign Team; it also presents recent data on spending and enrollment and examines complex reforms underway or planned for the near future.
New York State began implementing mandatory Medicaid managed long-term care in 2012. This issue brief provides an overview of this shift; examines the growth in enrollment from 2010 to 2013, as well as growth by region and product line; and discusses key operational issues related to the major changes in eligibility and enrollment processes triggered by shifting high-need Medicaid beneficiaries from fee-for-service into managed care.
This data brief documents the shift of Medicaid home- and community-based services from fee-for service into managed care between 2010 and 2013. It presents regional differences in services and spending, and evaluates the growth in Medicaid managed long-term care and the corresponding decline in fee-for-service home- and community-based services, particularly in personal care use, reflecting an explicit policy goal of New York. Jointly released with an issue brief on New York’s mandatory Medicaid long-term care policy.
New York State is continuing to move high-cost Medicaid populations out of fee-for-service arrangements and into care management, to improve quality and lower costs. This report examines one such group of high-need Medicaid beneficiaries: children in foster care.
New York State's health home initiative is an ambitious program that seeks to establish a care management and coordination vehicle for Medicaid enrollees with chronic conditions. This report details the early stages of implementing the initiative.
This report focuses on a proposed New York State program to better manage care of beneficiaries who are enrolled in both Medicare and Medicaid, commonly referred to as “duals.”
An examination of how long-term care is financed nationally and in New York, with an analysis of the state's private long-term care insurance market, opportunities presented by alternative financial products, and the pivotal role of default payer played by Medicaid.
With the new State policy shifting the Medicaid behavioral health benefit into a new care management framework, this report explains and considers potential strategies and options for improving the management of long-term care services for elderly and disabled Medicaid beneficiaries, and addresses the issues of balancing residential and community-based long-term care, refining reimbursement for long-term care services, and providing effective care management.
One of two jointly released Medicaid Institute reports examining implementation of Medicaid policy changes in New York, this report explains the roles and responsibilities of newly authorized regional behavioral health organizations; discusses the long-term challenges of integrating behavioral and physical health care delivery; and considers how the State might measure effectiveness of care.
Quality measurement for Medicaid beneficiaries with complex needs—specifically those with multiple chronic conditions, behavioral health conditions, and long-term care needs—is important as a means of improving care and as a tool to advance the state’s strategies of reimbursement reform and service delivery redesign for vulnerable and high-cost populations, according to this new report.
This report explores the technical and policy decisions states can make when purchasing and managing prescription drugs in today’s Medicaid environment. It identifies best practices from around the nation and examines New York’s Medicaid prescription drug program in particular.