As Helgerson Departs, Providers Prepare To Carry On His Work
Crain’s Health Pulse February 22, 2018
When he started in 2011 as Medicaid director, Jason Helgerson said the health care program felt like a "political minefield" for Gov. Andrew Cuomo and the state Legislature. There was no clear agreement on how the state could curb costs to make it sustainable.
"It was to some extent paralyzed by the politics that surrounded it," Helgerson said. "It wasn't an agent for progressive, positive change. Now it has become that."
Helgerson plans to leave the job in early April, after the completion of state budget negotiations, to explore other opportunities in the private sector, he said Wednesday in an interview with Crain's. Helgerson's departure was first reported by the Times Union in Albany.
He has spent more than 20 years in public policy, including a four-year stint leading Wisconsin's Medicaid program. He said the decision wasn't related to any tension with the governor, who was supportive throughout his tenure.
"It's been a tremendously rewarding experience," he said. "But I reached a point in my life where I needed to move on and experience things a little differently."
Helgerson, 46, said he might look to take on multiple roles after leaving state government but he wants to continue to be involved in health care, working on how to address delivery system and payment reform. He doesn't see a role as a lobbyist in his future.
During Helgerson's tenure, the Medicaid program grew to cover nearly 6.6 million people, about one-third of the state's population, at a cost of about $68 billion. Through Gov. Cuomo's 2011 Medicaid redesign team, a group of industry experts, the state introduced reforms to generate savings.
Their proposals included the introduction of a global spending cap, which led the state to further rein in costs. The state said that 2014 per-beneficiary spending represented a 13-year low.
Helgerson was also responsible for spearheading the state's more than $8 billion Medicaid 1115 Waiver that allowed the state to reinvest some of its savings in programs including the Delivery System Reform Incentive Payment program.
In building that program, Helgerson managed to maintain credibility with areas of the industry, including labor, patients, hospitals, insurers, doctors and community groups, that are sometimes at odds, said Joseph Conte, executive director of the Staten Island Performing Provider System.
"To build consensus on that spectrum is almost unfathomable," Conte said. "A lesser man would have run."
Helgerson also pushed to speed health care providers' adoption of value-based payments. He said about 38% of payments are now based on value, rather than the fee-for-service system which rewards a greater volume of tests and procedures.
"He had a very clear vision, and it was we should get more for what we pay," said Dr. Steven Safyer, president and CEO of Montefiore Medicine, which receives about 45% of its reimbursement from Medicaid. Safyer said Helgerson leaves behind a capable team and that DSRIP groups around the state will be able to carry out their work.
Helgerson said he is confident that providers will be able to carry on, too. He was in Brooklyn Wednesday visiting the Maimonides Medical Center-led Performing Provider System, where he noted staffers energy and enthusiasm for the work. With DSRIP and the move toward value-based payments in later stages of development, now seemed as good as time as any to make a change, he said.
"There's never a perfect time. The job's never completely finished. —J.L.