United Hospital Fund Releases Guide to NY’s Value-Based Medicaid Reimbursement Roadmap

 

A new guide from the United Hospital Fund distills information about the State’s value-based payment roadmap (A Path toward Value Based Payment: New York State Roadmap for Medicaid Payment Reform) and the process for implementing it for several critical audiences, including health care providers, health plans, policymakers, and other Medicaid stakeholders.

 

The UHF guide Navigating the New York State Value-Based Payment Roadmap frames the State’s plans to transform the way it finances health care services, moving from volume- to value-based payments. That payment transition is recognized as essential for reinforcing the goals of the Medicaid Redesign Team and for sustaining the delivery system reforms that will emerge from the Delivery System Reform Incentive Payment (DSRIP) program.

 

The guide also gives providers and other stakeholders a list of open questions, many of which are in the process of being answered by the State’s active stakeholder engagement process. It aims to help Medicaid stakeholders keep track of the many moving parts involved in this considerable effort. The outstanding questions address such topics as the attribution of patients to providers, the benchmarking of costs, and the tying of quality measures to payments.

 

“In interviews we conducted and other discussions we’ve had with stakeholders in virtually every setting, we’ve heard repeatedly that the roadmap’s concepts were complex and difficult for even the most knowledgeable to get their arms around,” said Chad Shearer, director of the Medicaid Institute at United Hospital Fund. “We hope our new guide will help health care providers, health plans, and many others to understand the key takeaways that allow them to move forward in their organizational planning.”

 

Navigating the New York State Value-Based Payment Roadmap was prepared for UHF by Rob Houston, Katherine J. Heflin, and Tricia McGinnis of the Center for Health Care Strategies, Inc., and is available from the UHF website at https://www.uhfnyc.org/publications/881083.

 

“The State’s roadmap is an ambitious vision to change the way health care is paid for in Medicaid, a critical change to ensuring that other reforms underway are sustainable for the long term,” said Jim Tallon, president of the United Hospital Fund. “We hope that this guide—which clarifies the things that are known and the things still to be decided—proves useful as a tool to the many organizations that are committed to making the State’s vision for health care reform a reality.”