The majority of New York's beneficiaries are now enrolled in Medicaid managed care (MMC), and policymakers are extending MMC's reach to include more disabled and elderly enrollees. While MMC holds promise for improving services, New York's experience to date indicates that meeting that promise will require changes in the ways providers and patients, respectively, deliver and access health care services.
Rethinking service delivery for "high-cost" Medicaid beneficiaries, whether in MMC or another form form of care management, is a priority because this small share of enrollees represents some of the program's most complex patients and accounts for a large share of Medicaid spending. Through the establishment of the Medicaid High-Cost Care Initiative, the Fund, collaborating with researchers and clinicians, explored opportunities to improve Medicaid service delivery for these patients.
Published: 2011
This new Medicaid Institute report points to the importance of quality measurement for Medicaid beneficiaries with complex needs — specifically those with multiple chronic conditions, behavioral health conditions, and long-term care needs — as a means of improving care but also as a tool to advance the state’s strategies of reimbursement reform and service delivery redesign for vulnerable and high-cost populations.
Published: 2011
This report paints a detailed picture of New York's Medicaid beneficiaries receiving care for mental health and substance abuse conditions—who they are, what kind of services they regularly seek, and how they differ from or resemble other Medicaid beneficiaries not receiving the same kinds of care.
Published: 2011
This report examines policy considerations faced by New York on how to care for Medicaid beneficiaries with mental health and substance abuse conditions.
Published: 2010
This Medicaid Institute publication lays out the challenges and opportunities facing New York’s Medicaid program, against a backdrop of a historic federal health care reform law and an unprecedented state budget deficit.
Published: 2010
This paper, written by staff from the Lewin Group for the Fund's Medicaid Institute, describes New York's program for providing transportation services to Medicaid beneficiaries, considers the strengths and weaknesses of the state's program, and assesses alternative approaches to improve the program and reduce costs.
Published: 2009
A report from the United Hospital Fund's Medicaid Institute™ concludes that, for Medicaid beneficiaries with chronic physical health conditions and serious and persistent mental illness, the more integration of physical and behavioral health care services the better.
Published: 2009
This report lays out the formidable challenges to improving care for certain high-cost Medicaid beneficiaries, focusing on those with multiple and substantial needs who rely disproportionately on costly hospital inpatient services.
Published: 2008
Delivered at the Third National Medicaid Congress in Washington, DC, this presentation reviews the findings and policy implications from the Medicaid Institute™ report Medicaid Managed Care for Persons with Severe Mental Illness: Challenges and Implications.Published: 2008
This publication is the most comprehensive independent report produced in recent years examining the status of managed care for Medicaid beneficiaries in New York.
Published: 2007
Focusing on the latest group of disabled Medicaid beneficiaries required to join a managed care plan, this issue brief from the Fund's Medicaid Institute™ illustrates the demands of care management for Medicaid's most complex and costly cases.Published: 2006
This new issue brief reviews the characteristics and experiences of Supplemental Security Income (SSI) Medicaid enrollees—who are poor and elderly or disabled—under the fee-for-service Medicaid program and explores the implications of a new policy mandating that some of these beneficiaries must now enroll in a Medicaid managed care plan.