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Medicaid Redesign Team Begins its Work

February 17, 2020 11:19 AM | Anonymous

On February 11th, the second iteration of the Governor’s Medicaid Redesign Team (MRT) met. The Team is charged with recommending $2.5 billion in Medicaid savings as part of an effort to enact a State Budget by April 1. 

The meeting reviewed the successes of the previous MRT, a statement of the general charge and activities for the MRT 2, and identifying the highest cost drivers in the Medicaid program that will be under the microscope for revisions.

Public input will be solicited online as well as through 3 upcoming public forums/evening webinars. The next one will take place on Tuesday February 18th from noon – 3pm, at the Monroe County Community College, High Falls Auditorium, 321 State St., Rochester, NY

To submit your ideas for Medicaid cost-saving suggestions visit their form online.

There are 3 meetings of the MRT 2 scheduled including one on March 2 in NYC and a third meeting to be announced for mid-March.  There will also be a Long Term Care advisory group established. 

Cost Drivers

In looking at the services for 6.2 million Medicaid enrollees, among the highest cost drivers identified included:

  • LTC and Consumer Directed Personal Care Program (800% growth from 2016 to 2021)
  • Prescription Drugs (36% growth from 2011 to 2019, exceeding 25% medical CPI)
  • Transportation (up 131% from 2011 to 2019)
  • Case management including Health homes
  • Program Integrity (reducing fraud and abuse, and ensuring cost-efficient delivery of care for Medicaid recipients)
  • Distressed Hospitals (160% increase)

It was also noted that, among the 770,000 “dual eligibles” in New York, only 3% are enrolled in managed care programs.

The only area where physician care under Medicaid appeared to be directly implicated was the stated 344% increase in the Patient Centered Medical Home program from 2011 to 2019, which pays physicians a PMPM bonus to help manage the care of certain Medicaid patients.  However, DOH also noted that patients enrolled in PCMH also had significantly lower health costs overall than non-PCMH enrollees.  

 

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