Medicaid savings won’t come easily

Staring at a $2.4 billion shortfall in state revenues, Gov. Andrew Cuomo is casting an eye toward Medicaid in his search for savings. But savings will not come easily.

The governor wants the state Department of Health to reconvene the Medicaid Redesign Team to conduct a comprehensive evaluation of the Medicaid program and offer recommendations to further improve access to high quality and cost-effective medical services, and to stabilize the long-term fiscal condition of the Medicaid Global Cap.

The Medicaid Redesign Team will be comprised of health care industry leaders and stakeholders from across the state and will convene during the year to conduct its evaluation and report recommendations to the governor. Topics for review will include, but are not be limited to, the following:

¯ addressing the needs of vulnerable populations

¯ responding to the current federal landscape

¯ evaluating options to enhance affordable health insurance coverage and access

¯ sustaining the future of the state’s long-term care system

¯ stabilizing fiscally distressed health care providers.

The governor is already proposing to reprogram health care transformation funding to pay for housing services projects, reducing indigent care payments to hospital systems and an across-the-board cut to Medicaid provider reimbursements. The last two of those cuts will hurt hospitals that already struggle under the weight of reimbursements that don’t come close to paying for the care hospitals provide.

New York has one of the more expensive Medicaid programs in the country, in part because the things that sound great in a news release come with heavy costs. How the newly recreated Medicaid Redesign Team navigates the state’s progressive ideals at a time when dollars are scarce will be a serious test for Cuomo and Democratic majorities in the state Senate and Assembly.