Discuss Medicaid program restructuring in NYS Identify the g

Discuss Medicaid program restructuring in NYS. Identify the goals associated with this restructuring and describe the impact upon the beneficiary and the healthcare sector.

Hint: the accronym utilized for this is \"DSRIP\"

Please support your posts with reference and citations within the content.

Solution

New York’s Medicaid program is undergoing major restructuring with determined policies for further amendments. The State’s efforts to decrease spending are showing good improvement, with average beneficiary costs lessening while registration continues to increase. State Funds spending for Medicaid is anticipated to increase by nearly $700 million annually through State Fiscal Year (SFY) 2018-19, and improving the eminence of New York’s health care system remains a uphill task after more than two decades of developments.

Much work remains to improve the quality of care. The State’s share of annual Medicaid expenditures will rise by nearly $2.8 billion, to just below $25 billion, from the current State fiscal year to SFY 2018-19. In addition, New York’s entire health care system has some important quality problems that must be taken care of. Such as high rates of avoidable hospital use and emergency room visits, and potentially avoidable readmissions and complications, as well as major discrepancies in health outcomes among racial, ethnic and socio-economic groups. Regardless of comparatively high costs, the State’s overall health system graded 19th among the states in one independent scorecard, based mainly on national data from 2012 that measured health care access, quality, costs and outcomes.

Federal support for Medicaid in New York is anticipated to increase by $6.9 billion, or 25 percent, over the four years ending in SFY 2018-19, largely because of additional funding associated with the Affordable Care Act, or ACA, and the Federal Medicaid waiver. DOB projects that overall local Medicaid costs will decrease modestly starting in SFY 2016-17.

The major reforms planned for Medicaid in New York symbolize a determined restructuring that will affect the cost and quality of health care, as well as access to care. The State and the federal government approve that such restructuring may result in a better health care system as well as confine cost growth. Still, the ongoing changes and the new $8 billion waiver improvement present New York with risks as well as opportunities. As Medicaid plays a large role in New York\'s overall health care system, efforts to limit Medicaid spending could lead to costs being shifted onto private purchasers of health insurance, primarily New York employers. At the same time, hoped-for quality improvements driven by Medicaid alteration could increase health care for New Yorkers with private coverage, as well. Given the wide range of significant changes underway in Medicaid, in addition to closely observing developments, DOH should continue to report openly on each key step in the implementation process, and respond as needed to guarantee the best results for taxpayers, health care providers, and the millions of New Yorkers assisted by Medicaid.

References

http://publications.budget.ny.gov/eBudget1516/financialPlan/FinPlan.pdf www.health.ny.gov/health_care/medicaid/statistics/

www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Data-and-Systems/MBES/CMS-64-QuarterlyExpense-Report.html.

www.health.ny.gov/statistics/health_care/medicaid/eligible_expenditures/ www.health.ny.gov/statistics/health_care/medicaid/quarterly/

www.health.ny.gov/facilities/public_health_and_health_planning_council/meetings/2012-03-21/docs/health planning_in_nys.

www.health.ny.gov/facilities/state_hospital_review_planning_council/meetings/2010/2010-06-10/. www.health.ny.gov/health_care/medicaid/regulations/global_cap/monthly/docs/march_2012_report.pdf. www.governor.ny.gov/press/01052011medicaid.

www.health.ny.gov/health_care/medicaid/redesign/docs/2011-01-13_redesign_team_presentation.pdf. www.commonwealthfund.org/~/media/files/publications/fundreport/2014/apr/state_profiles_2014_all_states.pdf.