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New York's primary care waiver
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.
Bridging the Diversity Gap in Rare Disease Clinical Trials with Harsha Rajasimha of IndoUSrare
November 8th 2023Briana Contreras, an editor with Managed Healthcare Executive, spoke with Harsha Rajasimha, MD, founder and executive chairman of IndoUSrare, in this month's episode of Tuning in to the C-Suite podcast. The conversation was about how the disparity in diversity and ethnicity in rare disease clinical trials in the U.S. has led to gaps in understanding diseases and conditions, jeopardizing universal health, and increasing the economic burden of healthcare.
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Managing Editor of Managed Healthcare Executive, Peter Wehrwein, had a discussion with William Shrank, M.D., a venture partner with Andreessen Horowitz, a venture capital firm in Menlo Park, California, about how artificial intelligence's role is improving healthcare, where we are today with value-based care and the ongoing efforts of reducing waste in the healthcare space for this episode of the "What's on Your Mind" podcast series.
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Air Pollution May Negatively Affect Male Reproductive Health
November 30th 2023A potential mechanism by which air pollutants may affect reproductive health is by endocrine disruption. Air pollutants are made up of mixtures of particulate matter that may include endocrine disruptors, such as polycyclic aromatic hydrocarbons (PAHs) and heavy metals.
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35th World AIDS Day Marks 20 Years of PEPFAR: Challenges and Strategies to Combat HIV/AIDS
November 29th 2023PEPFAR, having invested $100 billion and saved 25 million lives in the global fight against HIV/AIDS, faces Congressional hurdles in its reauthorization due to abortion debates. Despite widespread support and no evidence of abortion-related activities, the legislative process is at a standstill. Members of PEPFAR and authors of a recent editorial stress the significance of PEPFAR and advocate for integrating behavioral and social science into healthcare programs to achieve UNAIDS targets and address barriers in HIV/AIDS testing and treatment.
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