MRT II Executive Summary Scorecard
Executive Summary of Proposals
March 19, 2020
- Score Card is also available in Portable Document Format (PDF)
(State Share -- $ millions) | FY21 | FY22 |
---|---|---|
Medicaid Deficit | $3,079 | $3,515 |
Medicaid Savings Target | ($2,500) | ($2,722) |
FY20 Medicaid Savings Plan | ($851) | ($793) |
MRT Recommendations | ($1,649) | ($2,265) |
Hospital Actions | ($399) | ($459) |
Increase the progressivity of Indigent Care Pool distributions | ($157) | ($157) |
Strengthen NYC Health + Hospitals | ($186) | ($193) |
Realize additional savings without impacting core hospital operations | ($56) | ($109) |
Care Management Actions | ($43) | ($70) |
Implement Health Home Improvement, Efficiency, Consolidation and Standardization | ($33) | ($37) |
Promote Further Adoption of Patient-Centered Medical Homes (PCMH) | ($6) | ($18) |
Promote Effective and Comprehensive Prevention and Management of Chronic Disease | ($5) | ($14) |
Promote Maternal Health to Reduce Maternal Mortality | $1 | ($1) |
Mainstream Managed Care Actions | ($41) | ($8) |
Promote Encounter Data Accountability and Partially Restore Mainstream Managed Care (MMC) Quality Incentive Pools | ($47) | ($26) |
Enact statutory reforms intended to reduce inappropriate payment denials | $9 | $37 |
Standardized Medicaid Managed Care Prior Authorization Data Set | $0 | ($1) |
Explore new efforts to facilitate Value Based Payment arrangements | $0 | ($9) |
Explore boroughwide or regionwide integrated delivery system and global budget demonstrations for the Bronx and rural areas | $0 | ($5) |
Authorize Electronic Notifications | ($2) | ($5) |
Long Term Care Actions | ($715) | ($1,147) |
Promote Encounter Data Accountability and Partially Restore Managed Long Term Care Quality (MLTC) Incentive Pools | ($67) | ($55) |
Institute an HCBS Eligibility Lookback Period of 60 Months (to be consistent with look-back for nursing homes) | ($20) | ($24) |
Eliminate Spousal and Legally Responsible Relative Refusal | ($2) | ($2) |
Change Eligibility Criteria for Personal Care Services and Consumer Directed Personal Assistance Program (CDPAP) and Eligibility Criteria for Enrollment in MLTC Partial Plans | ($154) | ($360) |
Make Administrative Reforms to the Personal Care Services (PCS) and CDPAS Program | ($82) | ($263) |
Implement Comprehensive CDPAP Programmatic Reforms and Efficiencies | ($33) | ($41) |
Provide Integrated Care to Dual Eligible Members | ($5) | ($42) |
Reform the Fair Hearing Process | $0 | ($1) |
Delay Implementation of the Expansion of Community First Choice Option (CFCO) Services | ($47) | ($47) |
Cap Statewide MLTC Enrollment Growth at a Target Percentage | ($215) | ($215) |
Enhance Wage Parity Enforcement | $0 | $0 |
Issue a Request for Offer for LHCSAs | $0 | $0 |
Reduce Workforce Retraining and Retention Funding | ($45) | ($45) |
Require all UAS Community Health Assessments (CHA) and reassessments to be conducted by an Independent Assessor (IA) | ($8) | ($16) |
Implement Changes to the Community Spouse Resource Amount | ($6) | ($7) |
Offer Non-Medicaid Long-Term Care Programs to Encourage Delayed Enrollment in Medicaid including a private pay option for consumers to purchase on NYSoH | $0 | $0 |
Reduce Nursing Home Capital Funding | ($30) | ($30) |
Pharmacy Actions | ($71) | ($214) |
Fully Carve Out of the Pharmacy Benefit from Managed Care to Fee-for-Service (FFS) | $11 | ($125) |
Reduce Drug Cap Growth By Enhancing Purchasing Power to Lower Drug Costs | ($46) | ($43) |
Limit Coverage for Over-the-Counter Drugs (OTCs) | ($14) | ($19) |
Eliminate Prescriber Prevails | ($22) | ($27) |
Transportation Actions | ($94) | ($244) |
Program Integrity | ($60) | ($74) |
Modernize Regulations Relating to Program Integrity | ($60) | ($67) |
Modernize Medicaid Third Party Health Insurance | $0 | ($6) |
General Savings | ($224) | ($55) |
Additional ATB Rate Reduction | ($219) | ($50) |
Shift Water Fluoridation funding to Capital | ($5) | ($5) |
Health Information Technology | ($8) | ($13) |
Expand telehealth services | ($3) | ($10) |
Modernize Medicaid information technology and expand access to data | ($5) | ($3) |
Social Determinants of Health | $4 | $17 |
Advance Social Determinants of Health (SDH) to Improve Care and Reduce Medicaid Costs | $4 | $17 |
Total Spending Reductions | ($2,500) | ($3,058) |
Remaining Amount to Target | $0 | ($336) |
Confidential 3/19/2020
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