NYS Department of Health welcomes new innovator network for Medicaid providers

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ALBANY — The New York State Department of Health announced Tuesday a new innovator under Medicaid’s Value-Based Payment Roadmap, a key component to the Delivery System Reform Incentive Payment Program.

NYU Langone Independent Practice Association, the chosen innovator, is the second organization involved in the value-based payment method, joining Montefiore, designated earlier this year.

NYU Langone’s network includes Tisch Hospital, Rusk Rehabilitation, NYU Langone Orthopedic Hospital, NYU Langone Hospital-Brooklyn and Hassenfeld Children’s Hospital. The network additionally extends to over 3,500 health care providers, representing more than 30 specialties. Within its first year, it is estimated the network will care for 67,000 Medicaid members.

When Montefiore joined as an innovator in February, it offered a network of 11 hospitals, including a rehabilitation hospital and mental health clinic. An estimated 115,000 Medicaid patients will receive care from this network, according to a news release.

This program’s goal is to switch health care payments from fee for service — based on charges incurred by patients — to fee for outcomes, which rewards providers for creating a healthy patient base.

Medical providers approved as innovators are eligible for “an increased portion of the monthly payment made by Medicaid to the Managed Care Plan.” This process requires innovators to include community-based organizations and social determinants of health interventions, such as housing, food insecurity or transportation.

These social determinants of health are recognized as having significant impacts on the health of Medicaid members.

As part of the $8 billion DSRIP federal waiver, approved by Gov. Andrew M. Cuomo in 2014, the value-based payment roadmap “paves the way for New York’s Medicaid program to shift to paying for value over volume,” a release from the state reported.

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