Only 5% of spending goes to primary care
New York has received approval from the Centers for Medicare and Medicaid Services (CMS) for a Medicaid waiver.
While the Medicaid waiver is not an expansion of coverage-New York has already expanded-it is an agreement to use Medicaid funds for other uses outside of direct service. In this instance, the Medicaid waiver is $8 billion to restructure and transform New York’s health system using patient-centered primary care to improve health, lower costs and reduce disparities.
According to the Primary Care Development Corporation, a not-for-profit, 2.3 million people across the state lack sufficient access to primary care, and only about 5% of healthcare spending goes to primary care. The shortage of providers is one of the chief reasons New York has one of the highest rates of avoidable hospital use and cost in the country.
In 2011, Governor Andrew Cuomo established a Medicaid Redesign Team by executive order with the goal of bending the 13% cost-growth curve for Medicaid. A stakeholder group has recommended phasing out fee for service and replacing it with a delivery system focused on care management.
NEXT: See our map of Medicaid expansion -->
Utah was the most recent state to announce expansion, and New Hampshire is waiting in the wings.
The Departments of Health and Human Services (HHS), Labor, and the Treasury, released final rules on short-term, limited-duration insurance (STLDI) and independent, non-coordinated excepted benefits coverage, addressing issues related to the low-quality insurance, or "junk insurance" plans.
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In this second part of a two-part podcast episode, Managed Healthcare Executive's Managing Editor Peter Wehrwein spoke with Ceci Connolly and Margaret "Meg" Murray about Medicare Advantage utilization and challenges, highlighting proposed CMS payment cuts and prior authorization issues.
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2024 Emerging Leaders in Healthcare — Submit For a Chance to Be Featured in MHE's August Issue
March 28th 2024MHE Editors are seeking diverse healthcare professionals from different backgrounds and healthcare sectors, with individual interests. Eligible candidates are early or mid-career leaders with less than 10 years of experience. Award winners will enjoy complimentary passes to the PBMI Annual National Meeting in Orlando, Florida, from Sept. 4-6. Additional perks include a feature in our August issue, a subscription to MHE and more!
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In this first part of a two-part podcast episode, Managed Healthcare Executive's Managing Editor Peter Wehrwein kicks off our new podcast series "DC Roundtable," with guests Margaret "Meg" Murray, CEO of the Association of Community Affiliated Plans, and member of MHE's Editorial Advisory Board, and Ceci Connolly, president and CEO of the Alliance of Community Health Plans, for a discussion on healthcare policy issues.
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With aging populations, osteoporosis rates are set to increase, and researchers are looking for the next innovative drug to help prevent or manage the bone disease as there is currently no drug that completely does so effectively, according to a recent study published in Advanced Science.
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