Medicaid Institute

Medicaid Institute

Focus Areas: Coverage and Access, Quality and Efficiency, Clinical-Community Partnerships

UHF established the Medicaid Institute in 2005 to provide information and analyses explaining New York’s Medicaid program, in order to help all stakeholders build a more effective health care system for low-income New Yorkers.

Medicaid provides a broad range of health care services to diverse groups of New Yorkers. The program’s responsibilities include three main roles:

Medicaid covers more than 6 million New Yorkers each year at a total cost of over $60 billion. Between 2009 and 2015 total enrollment increased more than 36 percent, while per member spending on the program decreased by more than 13 percent. More than 75 percent of Medicaid members are enrolled in some form of managed care. Children account for 37 percent of the population, but less than 20 percent of Medicaid expenditures. Members dually eligible for both Medicare and Medicaid make up 13 percent of the total population.

The program is currently going through a substantial shift in how services are provided and paid for. Reforms envisioned by Governor Cuomo’s Medicaid Redesign Team in 2011 have led to a large increase in the number of members and health care services provided by managed care organizations. The state is also implementing an $8 billion Medicaid waiver with the federal government, intended to transform how care is delivered through the Delivery System Reform Incentive Payment (DSRIP) program, and eventually how services are paid for through a roadmap to value-based payment.

Contact: Chad Shearer

 
Medicaid Institute
    The Medicaid Institute Team

    Chad Shearer is the Vice President for Policy at United Hospital Fund, supervising work in the Medicaid Institute and in UHF’s Innovations, Health Insurance, and Children’s Health programs. Previously, Mr. Shearer was at the Woodrow Wilson School of Public & International Affairs at Princeton University, where he served as deputy director of the Robert Wood Johnson Foundation’s State Health Reform Assistance Network, a project coordinating technical assistance to 11 states on the implementation of the Affordable Care Act’s coverage expansion provisions. He was also a lecturer in public affairs at the university, teaching a capstone policy workshop.

    Mr. Shearer also was senior program officer at the Center for Health Care Strategies, where he helped shape its Medicaid Leadership Institute, an intensive training program for selected state Medicaid directors. Before that, he served as legislative director for Congressman Pete Stark, who was Chairman of the Ways and Means Subcommittee on Health, in the United States House of Representatives.

    Mr. Shearer holds both a law degree and a master’s of health administration from the University of Iowa.

    Misha Sharp, MPH
    Misha Sharp, MPH

    Publications
    July 16, 2019
    DSRIP Promising Practices: Strategies for Meaningful Change for New York Medicaid

    Identifying key lessons and promising practices from the first four years of New York State’s Delivery System Reform Incentive Payment program.

    March 21, 2019 | Chad Shearer
    Plan and Provider Opportunities to Move Toward Integrated Family Health

    A framework for integrated family health care

    March 11, 2019
    Achieving Payment Reform for Children Through Medicaid and Stakeholder Collaboration

    Harnessing payment reform to improve children's health