Department of Health Releases Update of Medicaid Value-Based Payment Roadmap

The Department of Health has released for public comment an update of its Value-Based Payment (VBP) Roadmap.  The state’s VBP Roadmap was approved by the Centers for Medicare and Medicaid Services (CMS) as a blueprint for Medicaid payment reform in July 2015. The update is accompanied by a "Reader's Guide," identifying major and minor changes to the original Roadmap.

Under its Medicaid waiver, New York State has committed to ensuring that at least 80 percent of Medicaid payments from managed care plans to providers will be made through value-based payment arrangements by the end of the waiver period in Fiscal Year 2019-20. This shift to VBP arrangements is intended to ensure the long-term sustainability of the delivery system by incentivizing health care providers to maximize value and by reinvesting the savings in the delivery system.

The Roadmap was developed as a living document, with the intention that it would be updated annually throughout the waiver period. This initial update provides additional information about the design of approved VBP arrangements, regulatory reforms to support VBP, amendments to managed care plan contracts, contacting with community-based organizations, and rewards and penalties for plans that fail to meet VBP targets. It does not include new information about managed long term care (MLTC) VBP arrangements, as the MLTC Clinical Advisory Group has not completed its deliberations.

Stakeholders may submit comments on the updated Roadmap to dsrip@health.ny.gov by 3 PM on April 18, 2016. LeadingAge New York members who would like their comments to be incorporated into the LeadingAge New York submission are encouraged to submit them to Karen Lipson by April 8th.

Contact: Karen Lipson, klipson@leadingageny.org, 518-867-8383, ext. 124.