Tuesday, January 9, 2024

Governor Hochul Announces Groundbreaking Medicaid 1115 Waiver Amendment to Enhance New York State’s Health Care System

 

$7.5 Billion Waiver Will Enable New York to Invest Nearly $6 Billion of Federal Funding into State’s Health Care System Over the Next Three Years

Waiver Amendment to Improve Health Equity and Address Health Disparities Throughout State

Waiver Will Deliver Critical Support to Address Health-Related Social Needs, Support Safety Net Hospitals, and Address Workforce Shortages

New York Plans to Submit an Amendment to its Demonstration in Early 2024 to Provide Continuous Medicaid Eligibility for Children Up to Age Six

Governor Kathy Hochul today announced the Centers for Medicare and Medicaid Services approved a groundbreaking amendment to New York’s Medicaid Section 1115 Demonstration that will be catalytic in New York’s continuing efforts to build a health care system that benefits all New Yorkers. The demonstration bundles a comprehensive series of actions to advance health equity, reduce health disparities, and strengthen access to primary and behavioral health care across the state, and will be supported through $7.5 billion in funding over the next three years.

“This amendment allows New York to make investments in critical Medicaid initiatives that will enhance health equity in this state,” Governor Hochul said. “CMS’ approval of the amendment will help us to continue to support underserved communities, provide New Yorkers with critical services such as nutrition and housing support, and improve access for individuals and families affected by substance use.”

New York State Health Commissioner Dr. James McDonald said, “This Medicaid 1115 waiver amendment will help the Department continue to invest in the health and well-being of New Yorkers. I thank CMS for giving us the opportunity to continue to invest in high quality health services and programs, expand the health care workforce, and strive towards true health equity.”

State Medicaid Director Amir Bassiri said, “After many months of negotiations, we have secured an agreement that is critical to the state’s health care system. Approval of this demonstration amendment will allow the state to advance health equity, reduce health disparities, support the delivery of health-related social needs, sustain critical safety net hospitals, and establish career pathways training programs for front-line health and social care professionals that will target workforce shortages throughout the state.”

CMS’ approval allows New York to make large investments across a series of wide-ranging Medicaid initiatives, including establishing Social Care Networks to integrate health, behavioral, and social care services that connect high-need members to critical nutritional and housing support services; enhancing access to coordinated and comprehensive treatment for substance use disorders; investing in primary care and making long-term, sustainable investments in the state’s health care workforce.

The demonstration amendment also includes funding to support a Medicaid Hospital Global Budget Initiative for a subset of financially distressed safety net hospitals looking to transition to payments that reward value rather than volume of care provided. This initiative will support essential safety net hospitals that help serve the most vulnerable populations and have significantly more adverse health risk factors and poorer health outcomes.

The demonstration will address significant health care workforce shortages in safety net settings through innovative career pathways training programs for front-line health and social care professionals that will increase access to culturally appropriate services. These career pathways training programs will train and educate for the purpose of creating a reliable healthcare workforce pipeline to address workforce shortages, as well as increasing opportunities for employment and career advancement.

The workforce initiatives also include a loan repayment program for certain healthcare workforce professionals who commit to working in community-based practices in underserved areas, including dentists, psychiatrists, and clinical nurse specialists.

By the end of the demonstration, the state’s goal is to have made significant progress in its Value-Based Payment (VBP) strategies and alignment across Medicare and Medicaid to advance primary care and population health outcomes.


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