Scribd Logo
Upload

Welcome to Scribd!

  • 237 views

    Executive Summary Card

    Uploaded by

    Jonathan LaMantia
    The document outlines New York's Medicaid deficit and savings targets for fiscal years 2021 and 2022. It details recommendations from the Medicaid Redesign Team (MRT) to reduce spending through actions focused on hospitals, long-term care, pharmacy benefits, program integrity, and other areas. These recommendations aim to close deficits of $3.079 billion in 2021 and $3.515 billion in 2022 through a combination of reduced spending, increased efficiencies, and targeted reforms.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Executive Summary Card

    Uploaded by

    Jonathan LaMantia
    237 views1 page
    The document outlines New York's Medicaid deficit and savings targets for fiscal years 2021 and 2022. It details recommendations from the Medicaid Redesign Team (MRT) to reduce spending through actions focused on hospitals, long-term care, pharmacy benefits, program integrity, and other areas. These recommendations aim to close deficits of $3.079 billion in 2021 and $3.515 billion in 2022 through a combination of reduced spending, increased efficiencies, and targeted reforms.

    Original Description:

    Medicaid Redesign Team budget scorecard

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    The document outlines New York's Medicaid deficit and savings targets for fiscal years 2021 and 2022. It details recommendations from the Medicaid Redesign Team (MRT) to reduce spending through actions focused on hospitals, long-term care, pharmacy benefits, program integrity, and other areas. These recommendations aim to close deficits of $3.079 billion in 2021 and $3.515 billion in 2022 through a combination of reduced spending, increased efficiencies, and targeted reforms.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    237 views1 page

    Executive Summary Card

    Uploaded by

    Jonathan LaMantia
    The document outlines New York's Medicaid deficit and savings targets for fiscal years 2021 and 2022. It details recommendations from the Medicaid Redesign Team (MRT) to reduce spending through actions focused on hospitals, long-term care, pharmacy benefits, program integrity, and other areas. These recommendations aim to close deficits of $3.079 billion in 2021 and $3.515 billion in 2022 through a combination of reduced spending, increased efficiencies, and targeted reforms.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    You are on page 1of 1

    MRT II Executive Summary Scorecard

    (State Share -- $ millions) FY21 FY22

    Medicaid Deficit $3,079 $3,515


    Medicaid Savings Target ($2,500) ($2,722)

    FY20 Medicaid Savings Plan ($851) ($793)

    MRT Recommendations ($1,649) ($2,264)

    Hospital Actions ($399) ($459)


    Increase the progressivity of Indigent Care Pool distributions ($157) ($157)
    Strengthen NYC Health + Hospitals ($186) ($193)
    Realize additional savings without impacting core hospital operations ($56) ($109)

    Care Management Actions ($43) ($70)


    Implement Health Home Improvement, Efficiency, Consolidation and Standardization ($33) ($37)
    Promote Further Adoption of Patient-Centered Medical Homes (PCMH) ($6) ($18)
    Promote Effective and Comprehensive Prevention and Management of Chronic Disease ($5) ($14)
    Promote Maternal Health to Reduce Maternal Mortality $1 ($1)

    Mainstream Managed Care Actions ($108) ($63)


    Promote Encounter Data Accountability and Partially Restore of Managed Care Quality Incentive Pools ($114) ($81)
    Enact statutory reforms intended to reduce inappropriate payment denials $9 $37
    Standardized Medicaid Managed Care Prior Authorization Data Set ($0) ($1)
    Explore new efforts to facilitate Value Based Payment arrangements $0 ($9)
    Explore boroughwide or regionwide integrated delivery system and global budget demonstrations for the Bronx and rural areas $0 ($5)
    Authorize Electronic Notifications ($2) ($5)

    Long Term Care Actions ($647) ($1092)


    Institute an HCBS Eligibility Lookback Period of 60 Months (to be consistent with look-back for nursing homes) ($20) ($24)
    Eliminate Spousal and Legally Responsible Relative Refusal ($2) ($2)
    Change Eligibility Criteria for Personal Care Services and Consumer Directed Personal Assistance Program (CDPAP) and Eligibility Criteria for
    ($154) ($360)
    Enrollment in MLTC Partial Plans
    Make Administrative Reforms to the Personal Care Services (PCS) and CDPAS Program ($82) ($263)
    Implement Comprehensive CDPAP Programmatic Reforms and Efficiencies ($33) ($41)
    Provide Integrated Care to Dual Eligible Members ($5) ($42)
    Reform the Fair Hearing Process ($0) ($1)
    Delay Implementation of the Expansion of Community First Choice Option (CFCO) Services ($47) ($47)
    Cap Statewide MLTC Enrollment Growth at a Target Percentage ($215) ($215)
    Enhance Wage Parity Enforcement $0 $0
    Issue a Request for Offer for LHCSAs $0 $0
    Reduce Workforce Retraining and Retention Funding ($45) ($45)
    Require all UAS Community Health Assessments (CHA) and reassessments to be conducted by an Independent Assessor (IA) ($8) ($16)
    Implement Changes to the Community Spouse Resource Amount ($6) ($7)
    Offer Non-Medicaid Long-Term Care Programs to Encourage Delayed Enrollment in Medicaid including a private pay option for consumers to
    $0 $0
    purchase on NYSoH
    Reduce Nursing Home Capital Funding ($30) ($30)

    Pharmacy Actions ($71) ($214)


    Fully Carve Out of the Pharmacy Benefit from Managed Care to Fee-for-Service (FFS) $11 ($125)
    Reduce Drug Cap Growth By Enhancing Purchasing Power to Lower Drug Costs ($46) ($43)
    Limit Coverage for Over-the-Counter Drugs (OTCs) ($14) ($19)
    Eliminate Prescriber Prevails ($22) ($27)

    Transportation Actions ($93) ($243)

    Program Integrity ($60) ($74)


    Modernize Regulations Relating to Program Integrity ($60) ($67)
    Modernize Medicaid Third Party Health Insurance $0 ($6)

    General Savings ($224) ($55)


    Additional ATB Rate Reduction ($219) ($50)
    Shift Water Fluoridation funding to Capital ($5) ($5)

    Health Information Technology ($8) ($13)


    Expand telehealth services ($3) ($10)
    Modernize Medicaid information technology and expand access to data ($5) ($3)

    Social Determinants of Health $4 $17


    Advance Social Determinants of Health (SDH) to Improve Care and Reduce Medicaid Costs $4 $17

    Total Spending Reductions ($2500) ($3057)

    Remaining Amount to Target $0 ($335)

    Confidential 3/17/2020 Page 1

    You might also like