On April 14, 2014, Governor Andrew Cuomo announced that New York has finalized terms and conditions with the federal government for a waiver that will allow the state to reinvest $8 billion in federal savings, generated by Medicaid Redesign Term (MRT) reforms.  More specifically, the waiver allows the state to reinvest over a five-year period $8 billion of the $17.1 billion in federal savings generated by MRT reforms.  The waiver amendment dollars will address critical issues throughout the state and allow for comprehensive reform through a Delivery System Reform Incentive Payment (DSRIP) program.  The DSRIP program will promote community-level collaborations and focus on system reform, specifically a goal to achieve a 25 percent reduction in avoidable hospital use over five years.  Safety net providers will be required to collaborate to implement innovative projects focusing on system transformation, clinical improvement and population health improvement; single providers will be ineligible to apply.  Under the plan, all DSRIP funds will be based on performance linked to achievement of project milestones.  Governor Cuomo indicated that this multi-year plan will improve health outcomes for many New Yorkers and will also bend the state’s Medicaid cost curve.  Public comment on the MRT waiver amendment will be solicited through the MRT website, webinars, and public hearings that will take place over the next several weeks.