NY Medicaid Overhaul Envisions Combined Outpatient Care


Using an estimated $8 billion as incentives, New York is overhauling Medicaid, pushing providers to establish more outpatient clinics, reduce hospital beds, use electronic records and enable low-income patients to see doctors and psychologists in the same visit.

Medicaid now covers almost one-third of all 19 million New Yorkers. Half this year’s $62 billion budget is paid by the federal government.

The so-called $8 billion Medicaid waiver, approved last year, will apply projected federal savings over five years to improved outpatient care. The goal is to cut avoidable hospital admissions by 25 percent.

“If you get upstream and start treating people sooner and more effectively, we’ll have downstream savings,” said Jason Helgerson, state Medicaid director.

New York hospitals and thousands of doctors and other providers have organized into 25 groups that have since received approval for taking specific new approaches to improve care and cut long-term costs. Five-year financial awards are expected this month.