Updates on value-based payment and health care reform
for the nonprofit human services sector
News and Publications
***NYSDOH CBO Survey***: NYSDOH has released a survey for CBOs that provide that address social determinants of health (SDH). The state will use the survey results to understand the current landscape of SDH services, gauge CBO integration with the VBP program, and build a public inventory of Tier 1, 2, and 3 CBOs that can be used to facilitate VBP contracting. CBOs will be asked to complete this survey on an annual basis. HSC strongly encourages CBOs to complete the surveyhere.
New Funding: The State will issue 19 awards totaling $60 million over three years to mental health and addiction services providers. The awards will help behavioral health providers transition to VBP.
OPWDD HCBS Waiver Update: DOH has determined that all OPWDD HCBS Waiver applicants must obtain Medicaid coverage via their Local Department of Social Services (County Medicaid office) rather than through NYSoH (District 78/Exchange). This includes new Waiver/Medicaid applicants as well as HCBS Waiver applicants who present to OPWDD with existing Medicaid coverage via NYSoH.
Did you know? The Roots of Medicaid Redesign
Below is a one-minute explanation of the roots and mechanics of Medicaid redesign.
Authority: State Medicaid redesign efforts were made possible by Section 1115 of the Social Security Act, which gives the Secretary of Health and Human Services the authority to approve "any experimental, pilot, or demonstration project which, in the judgment of the Secretary, is likely to assist in promoting the objectives of [the Medicaid program]." In practice, the Secretary does this by granting waivers of key Medicaid requirements.
Waivers and Funding: Under these so-called demonstration waivers (also referred to as "section 1115 waivers"), the Centers for Medicaid and Medicare (CMS) awarded states funding-based on projected savings-for their public health care systems to test innovative delivery and payment models. As of December 2017, sixteen states had approved demonstration waivers, while three states' waivers were pending.
DSRIP: Each state's demonstration project is known as a Delivery System Reform Incentive Payment program (DSRIP). To obtain the funding mentioned above, states were required to articulate a clear plan for achieving the "Triple Aim" of better care, better population health, and lower cost. New York's plan is called the New York State Roadmap.
Further Reading: See the Kaiser Family Foundation's report, "Section 1115 Medicaid Demonstration Waivers: The Current Landscape of Approved and Pending Waivers", for more information about approved and pending waivers.
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