NYS Department of Health Announces Results of Medicaid Redesign Efforts to Improve Patient Care Statewide, Yielding Measurable Reductions in Avoidable Hospital Use

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On June 19th, the New York State Department of Health released the results from the Medicaid Accelerated eXchange or MAX Series, showing avoidable hospital us for the state’s most vulnerable people has been significantly reduced. Since its launch in 2015, the MAX series has been an integral part of the Department’s strategy toward successfully achieving Delivery System Reform Incentive Payment (DSRIP) goals.

The objective of the MAX Series is to empower hospital and community partners in their care redesign efforts, increase patient and workforce satisfaction and reduce avoidable hospitalizations. More than 900 professionals from 68 hospitals and 11 community-based practices from around the State have participated in the MAX Series to date, and early results among teams are showing an 18% reduction in hospital readmissions and n 8% reduction in hospitalizations overall.

“Under the leadership of Governor Cuomo, our Medicaid redesign efforts are constantly increasing the efficiency of the healthcare system, resulting in improved outcomes and cost savings for New Yorkers,” said New York State Health Department Commissioner Dr. Howard A. Zucker. “The MAX Series is yet another example of our use of innovative techniques to use data and multi-disciplinary cooperation to transform healthcare delivery in New York State.”

The MAX Series places front-line healthcare and community based professionals from throughout the state at the helm of change and provides them with the tools to restructure processes in a manner that is sensitive to local needs. Collectively, Action Teams, which consist of clinicians, administrators, healthcare workers, and community-based professionals, have worked to identify the highest need patients, develop innovative solutions to provide better care, and to rapidly implement, test, and measure improvements for positive change.

“For years, we have known that a relatively small number of patients frequently visit hospital emergency rooms or are admitted to the hospital – sometimes many times a week or month – at a significant cost to the Medicaid program,” said New York State Medicaid Director Donna Frescatore. “The MAX Series empowers local Action Teams to ask the patient why. Many times, the answer may be that the patient needs help with housing, making or getting to doctor’s appointments, or help taking their medications. By focusing on the patient and thinking in a different way, the MAX Series has not only reduced hospital admissions and readmissions, it’s made a difference in the lives of these patients.”

Jodi Ramano, Director of Mental Health Services at Elmhurst Hospital said, “Usually when you think about performance improvement we think about big projects. What MAX brought to the picture is that small changes in processes can make huge differences and I think that’s the beauty of the program.”

Cara Pace, Chief Operating Officer of PEOPLe, Inc said, “MAX focuses on what the individual needs, not trying to make the individual fit into a process but having a process be available and ready for different types of scenarios.”

Dr. Faizon Arshad, Emergency Department Physician at Vassar Brothers Medical Center said, “MAX helps to really connect the dots and to understand our patients in a broader sense – what specific challenges they have on a daily basis and how as a community we can really band together and provide leadership as an organization to steward our patients to higher quality care and overall improved outcomes, as well as improved quality of life.”

To date, the MAX effort has tracked 15,000 patients across the state. For additional information on the MAX Series, visit https://www.health.ny.gov/health_care/medicaid/redesign/dsrip/pps_workshops/max.htm

Currently in its fourth year, DSRIP has 25 Performing Provider Systems (PPS) made up of hospitals, providers, and community-based organizations, who collaborate to provide Medicaid members and the uninsured with higher quality, more coordinated care. Through community-level collaborations and a focus on system reform, the ultimate goal of these projects is to improve quality of care and achieve a 25% reduction in avoidable hospital use over the five years of the program. More information on the DSRIP program can be found on the NYS Department of Health website.