N.Y. stakeholders recommend statewide healthcare changes

A workgroup comprised of various stakeholders in the New York state healthcare system composed a list of payment reform and quality measurement recommendations for the New York State Department of Health to consider as the state transitions to Medicaid payment models based on quality of care.

The Payment Reform & Quality Measurement Workgroup, whose findings were released Nov. 1, met three times over the course of one month and focused their activities on identifying innovative payment and delivery models that can be implemented in New York, exploring quality indicators that Medicaid could establish as standards, examining the viability of state programs related to indigent care, determining how to identify “safety net” providers and discussing the implications of recommendations made by other workgroups.

“It was particularly important to the workgroup that the concept of patient-focused and patient-centered care be the driving force behind any payment reform and quality measurement recommendations,” the workgroup’s final report read.

“The workgroup took responsibility to Medicaid beneficiaries/patients very seriously and tried to ensure that any recommendation they set forth would improve the N.Y. state healthcare system while improving the overall health outcomes of its patients,” it continued.

The workgroup developed a set of principles that, in their belief, the state should adhere to when developing innovative payment models and standardized quality measures.

According to those principles, innovative payment models should be transparent and fair, increase access to healthcare services, be accountable for patient outcomes, reduce fragmentation of services and reward both improvement and continued performance. Quality measures should be transparent and fair, include patient experience measurements, align payment models across payors and promote patient participation and responsibility in healthcare decision-making.

Based on its primary charge and the principles that it believes should guide New York’s effort to transform Medicaid payment models, the workgroup made four recommendations:

• Pursue partnership agreement with Centers for Medicare and Medicaid Services to integrate Medicaid and Medicare service delivery and financing for the dual eligible population;
• Adopt a series of accepted performance measures across all sectors of health, aligning measures already being collected in N.Y. in medicaid managed care, including managed long term care with federal requirements;
• Develop general principles that can be applied toward revising the New York State Disproportionate Share Program/Indigent Care program; and
• Create financing mechanisms that strengthen the financial viability of New York’s essential community provider network.

Each individual recommendation carries with it a set of specific goals intended to support the ultimate objectives – reduced healthcare costs and improved quality of care – of potential state policy changes, as well an estimate of financial impact.

The full report is available from the New York State Department of Health here.