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New York State’s big Medicaid gamble


Gamblers in the Ship of Fools (1494).

A look at New York’s big gamble on Medicaid: Can encouraging physicians to take financial risks improve medical outcomes and cut costs?

As Governing magazine notes: “New York is the latest in a small group of states that are attempting far-reaching Medicaid overhauls through what’s known as the Delivery System Reform Incentive Payment program. DSRIP varies in each state but at bottom it seeks to hold costs below a certain threshold and reinvest the savings in projects aimed at achieving specific goals, such as preventing patients from needlessly winding up in hospitals.

“New York’s program aspires to go beyond improvements in individual hospitals to improvements across entire regions, allowing or requiring different groups of doctors and even nonmedical social services organizations to work together toward certain goals. Texas has a similar $11.4 billion five-year project. New York’s is a few billion dollars smaller, but its ambitions are grander in some key respects.”

Consider that:

“By the end of 2019, all of New York’s privatized Medicaid plans will have to ensure that 90 percent of their payments to providers are value-based.”




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