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Consumer Perspectives on Change: for Better or for Worse
We were asked to consider whether changes in the way we receive and respond to behavioral health services has been for better or for worse, now that Medicaid Managed Care is the order of the day. It was a tough conversation because at the beginning, some of us really felt like we hadn’t even...
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Driving System Success During Times of Change
The adult New York State Behavioral Health System recently transitioned to Medicaid Managed Care. While everyone would acknowledge initial challenges and ongoing issues to be resolved, overall, the transition has been successful. This article will highlight the positive aspects of the...
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Fight Against Threats to Behavioral Heath Funding
The Trump presidency and Republican control of the Congress may do great damage to the already inadequate American mental health system by repealing the Affordable Care Act, eliminating Medicaid as an entitlement, privatizing Medicare, and limiting the authority of the states to regulate health...
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Supporting Youths in Their Recovery Journey to Adulthood
The New York State children’s behavioral health community is in the last stages of redesigning the children’s behavioral health Medicaid benefits. Once approved by the Centers for Medicaid and Medicare (CMS), the new benefits will represent the most significant expansion of children’s...
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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...
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Improving Children’s Health by Focusing on Value
New York State is well down the path to instituting significant changes in how the State pays for health care for low-income and disabled individuals, many of them children. Like many other states, New York is testing new payment methodologies in an effort to achieve positive changes in how health...
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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...
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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...
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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...
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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...
