| GC Pressures |
| Financial Plan Target |
$425.00 |
$425.00 |
| Total GC Pressures |
$425.00 |
$425.00 |
| Pharmacy Savings Initiatives |
| Establish Fair Drug Pricing Models in Managed Care through improved Pharmacy Benefit Manager (PBM) oversight |
($43.30) |
($43.30) |
| Drug Cap Enhancements |
($13.70) |
($22.60) |
| Total Pharmacy Savings |
($57.00) |
($65.90) |
| LTC Savings Initiatives |
| Establish per–member per–month payment for Fiscal Intermediary Services |
($75.00) |
($75.00) |
| CFCO Readiness |
($24.50) |
$0.00 |
| NH Case Mix Adjustment |
($122.80) |
($122.80) |
| SOFA EISEP Investment |
$15.00 |
$15.00 |
| SOFA EISEP DOH MA Offset |
($34.00) |
($34.00) |
| MLTC Manage Utilization of Personal Care |
($25.00) |
($25.00) |
| Total LTC Savings |
($266.30) |
($241.80) |
| Managed Care Savings Initiatives |
| State takeover of third party health insurance disenrollment |
($18.70) |
($18.70) |
| Additional TPHI Recoveries |
($3.90) |
($13.90) |
| Transition Flushing Support to Value Based Payment Quality Improvement Program (VBP–QIP) |
($29.60) |
($29.60) |
| Office of Medicaid Inspector General Managed Care Recoveries |
($4.10) |
($8.70) |
| Total Managed Care Savings |
($56.30) |
($70.90) |
| Other Savings |
| Promote promising DSRIP ideas to reduce unnecessary utilization |
($10.00) |
($10.00) |
| Health Home Rate Reduction |
($5.00) |
($5.00) |
| Reimburse National Diabetes Prevention Program |
($0.90) |
($1.20) |
| Supportive Housing Federal Waiver |
($18.30) |
($24.00) |
| Reinvest Supportive Housing |
$0.00 |
$15.00 |
| Eliminate Major Academic Centers of Excellence Payment |
($24.50) |
($24.50) |
| Total Other Savings |
($58.70) |
($49.70) |
| Other Investments |
| Recognize Applied Behavioral Analysts |
$6.40 |
$13.10 |
| Fund additional year of Ambulance Rate Adequacy Increase |
$3.10 |
$6.30 |
| SUNY Disproportionate Share Hospital Investment |
$60.00 |
$60.00 |
| Electronic Visit Verification (EVV) Investment |
$10.00 |
$15.25 |
| OTB Retiree – Shift to Medicaid |
$2.81 |
$2.81 |
| Increase the United Hospital Fund (UHF) |
$0.30 |
$0.30 |
| Nursing Home Transition and Diversion (NHTD) – Shift to Medicaid |
$1.84 |
$1.84 |
| Traumatic Brain Injury (TBI) – Shift to Medicaid |
$11.47 |
$11.47 |
| Behavioral Health Parity Staffing Investment |
$0.53 |
$0.53 |
| Maternal Mortality |
$4.00 |
$4.00 |
| Early Intervention Rate Increase |
$3.60 |
$3.60 |
| Total Other Investments |
$104.05 |
$119.20 |
| Adds/Avails |
| CFCO Revenue |
($49.00) |
($49.00) |
| Audit Recoveries |
($21.75) |
($24.00) |
| Reduce Managed Care Quality Bonus |
($10.00) |
($10.00) |
| Reduce Managed Long Term Care Quality Bonus |
($5.00) |
($5.00) |
| Federal Maximization/IMD |
($5.00) |
($10.00) |
| Additional Health Home Savings |
($20.00) |
$0.00 |
| Enhanced Safety Net Hospitals |
$16.00 |
$16.00 |
| ICS/VNS Investment |
$4.00 |
$4.00 |
| Medicaid Re–estimate |
$0.00 |
($37.90) |
| Total Adds/Avails |
($90.75) |
($115.90) |
| Total MRT |
$0.00 |
$0.00 |
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