Medicaid redesign meets resistance in Rochester
Members of Gov. Andrew Cuomo’s Medicaid redesign team were in Rochester on Tuesday for a public forum on plans to cut costs in one of the state’s most expensive programs.
The team is supposed to present recommendations next month to save the state $2.5 billion in Medicaid expenses in the next fiscal year.
In Rochester, they heard from a succession of health care workers and executives who are worried about potential cuts.
Mike Bove is a deputy chief with Monroe Ambulance. He said the emergency transport system is already short on money, with some companies consolidating and others going out of business entirely.
“It’s in dire need,” Bove said.
Travis Heider, the CEO of Pandion Optimization Alliance, the industry group that represents hospitals in and around Rochester, said they, too, are in a precarious financial situation.
“Hospitals in upstate New York are operating in the red, so we just don’t think we can bear any further cuts,” said Heider.
For Joseph Slomba, who lives in Chili and has cerebral palsy, Medicaid cuts could mean his brother is no longer able to help him with daily needs. Ben Slomba is paid for his caregiving work through a Medicaid program.
“I need help with dressing. I need help with eating. I need help with toileting,” Joseph said. “I’m starting a job, so I’ll need help with job training.”
The siblings are afraid the funding Ben relies on could be cut, leaving Joseph without consistent care.
“I am paid to care for my brother. You can’t give care and work a full-time job at the same time,” Ben said. “Either I go out and work, and he’s left unattended, or I care for him and get reimbursed for that.”
The redesign team, now in its second iteration after a panel convened to rein in “runaway cost growth” in 2011, is looking for ways to close a budget gap without cutting programs.
Chet Fox, the chief medical officer for a health network in Buffalo, came to Rochester to encourage the team to prioritize preventive care.
“If you prevent things on the front end, you don’t pay for them on the back end. So, that’s a person who’s not going to end up with a heart attack. Not going to end up on dialysis for kidney disease,” Fox said.
“A small expense in the short term can get you substantial savings in the future.”
Monroe County Executive Adam Bello told the panel that he wants to work with the state to find ways to save money.
Last month, Cuomo proposed a cap on state reimbursements to county Medicaid expenditures if those county expenses rose by more than 3% in a year. The state association of counties is urging Cuomo to reconsider.
Bello said the cap would cost the county just under a million dollars.
To bring costs down, Bello suggested a local Medicaid fraud unit to ferret out illegitimate claims and increased use of telemedicine to connect people with less costly forms of health care.