“The Trump administration has decided to cut federal support for local programs that have been testing a new model of funding medical care.”
“The programs, which exist across the state and are overseen locally by the Finger Lakes Performing Provider System, have been working on a shift from the traditional fee-for-service model to a value-based model.”
“In the fee-for-service model, which underlies Medicaid, health care providers tell the federal government what procedures they did and what medicines they used, and the government reimburses them.”
“Critics say this prioritizes quantity of care over quality of care.”
“Dr. Bill Valenti is the Chief of Innovation at Trillium Health in Rochester, which receives funding to test alternatives to the fee-for-service arrangement. He has been working on approaches to health care that he said are designed to keep people out of the emergency room…”
“Focusing Medicaid reimbursements only on what happens in medical clinics fails to account for elements of a person’s life, like housing, food and transportation, that affect their health but are not reimbursed by Medicaid, he said…”
“The waiver that allows New York state to experiment outside the normal Medicaid system is set to expire at the end of this month. Earlier this year, the federal government denied an application to extend it…”
“Cuomo said FLPPS will lose close to $63 million in federal funding as the state’s waiver expires.” Read the full article here.
Source: Feds End Pilot Programs In New York Testing A Redesigned Medicaid – By Brett Dahlberg, March 2, 2020. WSKG.
