New York, he said, is about the only place in the American economy that I can think of where we not only tolerate vertical integration but are mandating it, Gottfried said. Most of the panels discussion centered on the $8 billion Medicaid waiver and the difference it could make for healthcare statewide. The Medicare waiver is not funding projects, said Pamela Brier, president and CEO of Maimonides Medical Center, in her opening remarks. Its underwriting, I hope, a fundamental change in the healthcare system. Some $6.9 billion in the Medicaid waiver is devoted to the Delivery System Reform Incentive Payment program, or DSRIP, which will try over the next five years to reduce avoidable hospital use by 25 percent. Helgerson, the states Medicaid director, made no secret of what was at stake. We must come out of the waiver period with a stable healthcare delivery system, he said. We cannot go from crisis to crisis to crisis. The Health Department is running out of vehicles to keep struggling hospitals and other providers open. Proof of progress and the state report card distinguish New Yorks version of DSRIP from other programs that have come before it, Helgerson said. Money will be given based on how providers transform their care, how many Medicaid members they serve and the quality of the application they submit. Another key difference is that money allocated is attached to performance targets that show a decline in avoidable hospital use. Theres real serious accountability, Helgerson said.
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