A key element of the Medicaid Redesign Team 1115 Waiver amendment is the Medicaid Hospital Global Budget Initiative (GBI), a reimbursement model tied very closely to the States Advancing All-Payer Health Equity Approaches and Development (AHEAD) model proposed by the Center for Medicare and Medicaid Innovation. A summary of the waiver can be found here. The New York waiver, and in particular the GBI, seeks to provide financial stability to financially stressed hospitals serving disproportionately large numbers of Medicaid beneficiaries while also driving delivery reform to advance accountability and health equity. The GBI can be viewed as a global capitated reimbursement model, in which hospitals are guaranteed a certain revenue for a certain group of services but, of course, must manage operations within that budget. A similar effort in Maryland has shown promising results.
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