Description

This report examines the New York DSRIP process. This roadmap is a multiyear plan for comprehensive Medicaid payment reform including how the State will amend its contracts with Managed Care Organizations. This Roadmap was developed as a living document. It is not a blueprint; but rather attempts to demonstrate the State’s ambition and the elements of what the State and its stakeholders consider to be the payment reforms required for a high-quality, financially sustainable Medicaid delivery system. Working closely with MCOs, providers, beneficiaries and other stakeholders, many details will be added and changed over the next months. In addition, the State will work with CMS to optimally align these efforts with the goals for the U.S. Department of Health and Human Services on value-based purchasing and alternative payment models recently announced. Over the next five years, many lessons will be learned from DSRIP and the emergence of PPSs in New York; nationally, CMS’ priorities might evolve, and initiatives such as the Health Care Payment Learning and Action Network will yield new best practices. Therefore, this Roadmap will be updated yearly throughout the DSRIP period so as to not lock in policies that may require adjustment in the future, and also to ensure that the New York DSRIP remains a national leader in committing towards the national goals for the U.S. Department of Health and Human Services (DHHS) on value-based purchasing and alternative payment models.