Helgerson OpEd: NY Now 'A National Model For Medicaid Reform'

A National Model For Medicaid Reform

By Jason Helgerson, Commentary Albany Times Union March 7, 2013

Last week, theHouse Committee on Oversightand Government Reform accepted a highly biased report that alleged to describe New York's Medicaid program. While the report as well as committee members did acknowledge some of the efforts being made in New York to reform Medicaid, the true impact of Gov.Andrew Cuomo's redesign efforts wereignored.

Cuomo inherited a giant Medicaid mess when he took office. The program, which had become the ultimate "political football," was on path to grow by 13 percent. Within days of taking office, Cuomo created the Medicaid Redesign Team to both craft a first year Medicaid budget proposal as well as develop a multiyear reformplan.

The Medicaid redesign has been a tremendous success. Not only did it propose a budget plan that saved $4 billion in its first year and held spending growth to less then 1 percent, the Medicaid redesign also crafted the most ambitious such reform plan in the nation. That's now well on its way to beingimplemented.

The Medicaid reform plan is premised on the idea that the only way to really control costs is to improve the health of program participants. The plan launched a series of innovative solutions designed to better manage care and reward providers that help keep people healthy. This approach differs from other states, which have relied on taking away benefits from low-income people or by cutting provider payment rates as ways to cut Medicaidcosts.

New York has the nation's only Medicaid spending cap. Per recipient spending is down 9 percent, after years of growth. This has allowed us to begin relieving the Medicaid burden felt by local property taxpayers. In addition, the Medicaid redesign is lowering costs for the federal government. In its first year alone, the savings was enough to "flat line" the national growth rate in Medicaid, according toCongressional Budget Officeestimates.

MRT hasn't been just about cost control. The quality of care is also beingimproved.

One million additional Medicaid members now have access to high quality of primary care through nationally accredited PatientCentered Medical Homes. These primary care practices are reducing emergency room use and improving the actual health of Medicaidmembers.

Other strategies, such as "health homes," are also being launched to reduce inappropriate hospitalizations for some of Medicaid's sickest patients. These strategies are being closely watched by states all across the country that are looking to follow New York's lead in Medicaidredesign.

The House committee report, which was based primarily on news accounts and out-dated reports, did not do justice to all the Medicaid reform that is actually happening in New York. Instead, the report used the program's past sins in an inappropriate manner to suggest that these problems currently plagued New York'sprogram.

Now, New York is now a national model for Medicaid reform. Unfortunately, the House committee report did not reflect thisreality.

Jason Helgersonis the state's Medicaiddirector.