Significant funding is coming to New York state to improve health outcomes. 

The Center for Medicare and Medicaid Service (CMS) approved major changes totaling $7.5 billion to New York’s 1115 Medicaid waiver. The redesigned waiver aims to help the state improve health equity; reduce health disparities; support the delivery of health-related social needs services such as nutrition, housing and transportation for high-risk populations; and promote workforce development. The waiver also gives the state Substance Use Disorder demonstration authority. The waiver period will begin April 1, 2024, and will cover three years.

“This amendment allows New York to make investments in critical Medicaid initiatives that will enhance health equity in this state,” said NY Gov. Kathy Hochul. “CMS’ approval of the amendment will help us to continue to support underserved communities, provide New Yorkers with critical services such as nutrition and housing support, and improve access for individuals and families affected by substance use.”

Key components of the waiver include: 

  • $2.2 billion for a Medicaid Hospital Global Budget Initiative
  • $3.67 billion for health-related social needs services and activities and infrastructure
  • $694 million for recruitment and retention of health care workers
  • $125 million to establish a statewide Health Equity Regional Organization (HERO)

The waiver also aims to accomplish additional movement towards value-based payment strategies, multi-payor alignment and population health accountability. 

The goals of approval include:

  • Improving quality and health outcomes by better integrating primary care providers and community-based organizations
  • Improving quality and outcomes for enrollees in areas with a history of health disparities and disengagement from the health system, including through incentives to safety net providers 
  • Establishing Social Care Networks to integrate primary care, behavioral health and health-related social needs to improve population health and health equity outcomes for high-risk enrollees including kids/youth, pregnant and parenting individuals, the chronically homeless and individuals with substance use disorder.
  • Investing in the health care workforce with a goal of equitable and sustainable access to care in Medicaid
  • Developing regionally-focused approaches, including new Value-Based Payment programs, with a goal of statewide accountability for improving health, outcomes and equity.

“This Medicaid 1115 waiver amendment will help the Department continue to invest in the health and well-being of New Yorkers,” said NYS Health Commissioner Dr. James McDonald. “I thank CMS for giving us the opportunity to continue to invest in high quality health services and programs, expand the health care workforce, and strive towards true health equity.”

See full details of the approval on the NYS Department of Health website.

A Jan. 25 webinar from the Finger Lakes Waiver Planning team offering an overview of the waiver and what it could mean for the Finger Lakes region is available here, and slides from the webinar are available here. The waiver planning team is comprised of Finger Lakes Performing Provider System, Common Ground Health and the Rochester Regional Health Information Organization. To stay up-to-date on waiver news, visit www.fingerlakes1115waiver.org and sign up for email updates.