Meeting Medicaid Spending Caps in NY

Date: February 1, 2013||   0  Comments

Ahead of the state budget making process, the New York Department of Health (DOH) has outlined its proposed 2013-2014 Medicaid budget and its multi-year plans for meeting the state’s Medicaid spending cap.

As part of New York’s plan to limit Medicaid spending growth to the average medical growth rate in the Consumer Price Index (about 4 percent), the DOH is overseeing a Medicaid redesign that started two years ago, with a focus on managed care and streamlined administration, in tandem with federal health reform implementation.

New York DOH has been transforming its Medicaid information management system to a web-based program and is moving administration from regional districts to the agency’s head office, which is also preparing to operate some of the administrative duties of the health insurance exchange — while the agency is transitioning from fee-for-service to an almost entirely managed care system.

Two years into the redesign, as the only state using a global spending cap, New York Medicaid director Jason Helgerson said the program has shown signs of savings. For 2011-2012, the DOH’s Medicaid spending was $14 million under the target of $15.3 billion (about 75 percent of the state’s share) and per-recipient spending decreased by 9 percent, even as enrollment grew in a weak economy.

“We lived within the global cap, not by a lot, but by a little,” Helgerson said in an online budget briefing. “I think many people doubted that was going to happen.”

Helgerson previously advised the mayor of San Diego and ran Wisconsin’s Medicaid program. With about 70 pilot and demonstration programs under the Medicaid redesign, Helgerson said he’s trying to control costs while reinvesting some of the savings in improved technology and care models, to support the program as certain federal funding streams wane after 2017 and to help make it more dynamic to economic trends.

via Government Health IT | continue reading

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