With medical expenses among the nation's highest, New York has begun cutting Medicaid costs by replacing pay-as-you go services with managed care for prescription drugs. It also is planning to extend that approach to other medical services.
The goal is pushing treatment ``upstream'' into lower-cost primary care and prevention.
Nearly half the $53.5 billion Medicaid budget for 5.3 million low-income New Yorkers goes for fewer than 700,000 chronically ill, elderly patients.
The Kaiser Foundation says the state's annual health care spending averaged $8,341 per person in 2009, fifth highest among states, following two decades of 5.9 percent annual increases.
Experts say chronic illness and end-of-life interventions remain major cost drivers also affecting privately insured New Yorkers, including 1.1 million expected to enroll under a new federal mandate.