Skip to main content

NYS primary care practices: Leverage New York’s 1115 Medicaid Waiver

NYS primary care provider reading about the New York state Section 1115 Medicaid Redesign Team (MRT) Waiver

In April, we wrote about the updated New York state Section 1115 Medicaid Redesign Team (MRT) Waiver and how it was a game changer for New York state primary care practices.  

Almost a year later, we have updates to share so you can drive meaningful change for your practice — while solving some of the biggest pain points in primary care. Keep reading for key summaries or to check out our complete New York 1115 Medicaid Waiver white paper that includes:   

  • an essential summary of the 1115 Medicaid Waiver; 

  • enhanced payment overview; 

  • anticipated challenges and how to navigate them; 

  • how DataGen can help you achieve and retain NCQA PCMH status. 

[Access it here]

New York 1115 Medicaid Wavier updated summary 

Primary care practices in New York state have an unprecedented opportunity to boost their revenue, improve care quality and strengthen patient outcomes through the state’s 1115 Medicaid Waiver.  

This initiative, backed by $7.5 billion in federal funding, introduces enhanced incentives for practices aligning with PCMH models and Social Care Networks (SCNs). 

Program highlights: The three pillars 

The MRT Waiver is built on three foundational pillars: 

  1. Population health: Practices with NCQA PCMH recognition can earn retroactive enhanced per member per month (PMPM) payments starting April 1, 2024. 

  1. Strengthen the workforce: Focuses on equipping primary care teams with tools and resources for better outcomes. 

  1. Social Care Networks (SCNs): A framework to connect healthcare providers with social services, ensuring holistic care. 

In part two, we’ll explore exactly how you can secure backdated payments, enhance your care model and align your practice with SCNs for long-term success. 


What’s in it for New York state primary care practices? 

  1. Retroactive enhanced PMPM payments for PCMH-recognized practices starting April 1, 2024. 

  1. Tools to connect with SCNs and address social determinants of health. 

  1. Practical strategies to overcome operational challenges and unlock financial benefits. 

Not yet PCMH recognized? DataGen’s Medical Practice Consulting services can help your practice navigate the recognition process, streamline workflows and secure these valuable incentives. 

Ready to position your practice for success in value-based care? 

Download the full white paper to explore actionable strategies, eligibility requirements and how DataGen can support your journey. 

[Get your download now] 

Labels:
Location: New York, NY, USA

Comments

Post a Comment

Popular posts from this blog

Five key components of a strong patient safety culture

In today’s healthcare environment, ensuring patient safety is more than just a priority — it’s a fundamental component of quality care. Establishing a strong patient safety culture within hospitals and health organizations can dramatically reduce errors, increase patient satisfaction and improve overall healthcare outcomes. But what exactly is a patient safety culture, and how can institutions cultivate it effectively?  This blog post explores the five key components that make up a robust patient safety culture, along with insights from the Agency for Healthcare Research and Quality (AHRQ) and The Joint Commission.  What is patient safety culture?  AHRQ defines patient safety culture as how an organization's culture supports and promotes patient safety. This can extend to multiple levels, from individual units to departments to system levels. The AHRQ patient safety culture survey encompasses the shared values, beliefs and norms of healthcare practitioners and staff that...
Post a Comment
Read more

NCQA PCMH 2025 annual reporting: Standards and guidelines

For practices recognized under the National Committee for Quality Assurance’s (NCQA) Patient-Centered Medical Home (PCMH) model, understanding and meeting the NCQA PCMH 2025 annual reporting requirements is critical to sustaining recognition.  NCQA continues to refine its NCQA PCMH standards and guidelines , emphasizing team structure, care continuity and data integrity. Here’s what your practice needs to do to stay compliant and ensure a smooth reporting process. This blog is a continuation of our piece back in July 2024, which listed three updates to NCQA PCMH's 2025 annual reporting requirements . What is NCQA PCMH?  The NCQA Patient-Centered Medical Home (PCMH) is a model of care that emphasizes care coordination, patient engagement and continuous quality improvement. The PCMH framework is designed to improve healthcare outcomes by fostering strong patient-provider relationships and enhancing team-based care.  Since its inception, the NCQA PCMH program has evolved to...
Post a Comment
Read more