The Manhattan Institute for Policy Research, Inc.

New York’s Medicaid Redesign Team (MRT) pursued dramatic changes to Medicaid as a way to better manage care, mitigate costs, and improve health outcomes for New York’s Medicaid recipients.

Many of the Medicaid changes sought to create incentives for health care providers through capitated payments, care management fees, the establishment of health homes, and potential investments in more supportive housing. However, the changes may not adequately create incentives for patients to alter their behaviors and use of services. Patient education, incentives targeted directly to beneficiaries, and some level of personal investment could potentially increase the impact of the policy changes. Combining patient-level and provider-level activities could create more meaningful change. In 2012, NYHealth awarded Manhattan Institute for Policy Research (Manhattan Institute) a grant to identify patient-level incentives that could be incorporated into MRT’s recommendations to better promote health and decrease costs.

With support from NYHealth, MI aimed to achieve the following:

• investigate incentive-based reforms in other states to move Medicaid populations toward greater use of prevention and primary care services, identify how these incentives were financed, and identify which approaches had greatest success with cost-containment and health outcomes;
• examine approaches to intensive outreach and patient engagement, particularly health plan models that have worked well with Medicaid populations;
• identify state managed-care initiatives that could be promising for New York and complementary to particular MRT recommendations; and
• describe how these reforms, both MRT’s and MI’s recommendations, might be financed.

Read the report associated with this grant, “Taking Ownership: The Patient Role in Medicaid.”