-
Are We There Yet? Reflections on the 5 Years of Children’s Medicaid Transformation
It is hard to believe that five years have passed since the New York State Children’s MRT Subcommittee released its blueprint to address the unique and complex needs of children in Medicaid Managed Care. In many ways the time has flown by yet today, New York State’s target date to fully...
-
The NYSPA Report: DSRIP Made Easy
New York State’s Delivery System Reform Incentive Payment (DSRIP) program is a five-year plan to disburse a total of $8 billion in federal funding in order to comprehensively transform the way that Medicaid services are provided and paid for, with the aim of reducing avoidable hospitalizations by...
-
Insurance Models to Achieve the Triple Aim
Most people think that the reason for bringing behavioral health services under managed care—a “carve-in”—is to save money. They’re partially right. Carving in services has resulted in savings for the Medicaid program and for States in many instances. In a carve-in, behavioral health...
-
Does Medicaid Redesign Pay Enough Attention to Older Adults with Behavioral Health Needs?
Major changes to the behavioral health system in New York State are underway at the same time that there is rapid growth of the population of older adults. Will the transformation of the behavioral health system benefit older adults? It could, but it is not at all clear that it will because there...
-
The NYSPA Report: New Medicaid Restrictions on the Prescription of Benzodiazepines
Late last year, the New York State Medicaid Drug Utilization Review Board (DURB) recommended new protocols in connection with the prescribing of benzodiazepines under the Medicaid program. Benzodiazepines, a controlled substance, are a class of psychotropic medication used to reduce symptoms of...
-
Behavioral Health Services Critical to Success of Managed Care in NYS
As New York State implements healthcare reform, Medicaid re-design, and the integration of primary care and behavioral healthcare, substance use and mental health disorder prevention, treatment, and recovery services will have to play an important role if the hoped for transformation is to be...
-
Perspective on Recent Developments in New York State Behavioral Health Reform
Since the last issue of Behavioral Health News, as summarized by the excellent update above written by Dr. Jorge Petit and Jenna McCready, the State has moved forward to aggressively implement managed behavioral health. This article presents a perspective on some of the developments. RFQ for...
-
If Only HOPSTOP Could Map Our Route to the Triple Aim
Health care reform is driving consumer focused, outcome-oriented change in New York and across the country. In the past decade we have come to look at health care differently and our technology-based tools have grown by leaps and bounds. Game changing opportunities are surfacing in supporting...
-
NYSPA Report: How Will New York State’s Transition to Medicaid Managed Care Impact Those with Serious Mental Illness?
Skepticism, not cynicism, will be in order during the coming year as New York State’s efforts to place all of its Medicaid enrollees, including those with serious and persistent mental illness, into Medicaid Managed Care Plans (MMCPs) is realized. Reaching this goal is an important part of the...
-
The NYSPA Report: Medicaid’s Fragmented Formularies
To control the spiraling cost of medications to the NYS Medicaid program, the NYS budget adopted during 2011 radically altered the way the program purchased and paid for that formulary. The previously unified Medicaid formulary was fragmented such that each Medicaid HMO was required to define and...
