New York City hospitals say additional $1B needed for Medicaid reform initiative

Federal health officials believed an $8 billion cash infusion would be enough to overhaul how healthcare is delivered in New York’s Medicaid program, but some New York City hospitals are saying more funds are needed, according to a Crain’s New York Business report.

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In fact, the “certain powerful New York hospitals” have said an additional $1 billion is needed to overhaul the program, according to the report. The unnamed hospitals are unhappy with the way the money to overhaul the Medicaid program is being divided.

The money is being funneled through the Delivery System Reform Incentive Payment Program, an optional federal Medicaid waiver program for states with high Medicaid expenses. The program provides states with significant funding that can be used to support hospitals and other provider organizations as they aim to improve how they provide care to Medicaid beneficiaries. In New York, 25 groups of hospitals, physicians and other providers agreed to collaborate to improve the healthcare system.

An outside contractor determined the amounts each participating New York hospital got under the program using a complex point system. The scoring system is the source of frustration, as New York City hospitals participating in the program felt they were “shortchanged” due to how the scoring system weighted certain factors, according to the report.

The government is taking the concerns seriously, and New York state and HHS officials are now considering making an additional $1 billion to $1.2 billion available to hospitals throughout the state over the next several years.

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