Action Teams Working to Improve Healthcare and Provision of Interdisciplinary Services

Medicaid Accelerated eXchange (MAX)

By Saralin Tiedeman, MS, OTR/L, Post-Acute Project Manager

As part of the Delivery Service Reform Incentive Program (DSRIP), the New York State Department of Health launched the Medicaid Accelerated eXchange (MAX) Series Program.

This program was developed to redesign the way care is delivered for NYS’s most vulnerable patients. High healthcare users drive a disproportionate amount of inpatient admissions and annual costs, with less than five percent of the patient population accounting for more than 50 percent of total readmissions. This group of patients tends to have distinct clinical, social, and behavioral needs that require an adaptation in traditional care delivery.

The MAX Series is a rapid cycle continuous improvement (RCCI) methodology, which aims to “do something different”. MAX brings together community care providers from across the healthcare continuum into action teams to improve healthcare and the provision of interdisciplinary services. Through highly structured workshops and action periods, change is implemented and results are driven at the local level.

The MAX Series program objectives are as follows:

  1. Decrease high utilizer 30-day readmissions and/or hospital utilization
  2. Improve provider quality of life
  3. Increase integration across the care delivery system
  4. Develop and build rapid cycle continuous improvement capability

The MAX series methodology uses data to measure and drive performance. Using PDSA (Plan, Do, Study, Act) cycles and periodic workshops, action teams brainstorm drivers of utilization, discuss potential improvement ideas, prioritize ideas based on patient need, and create action plans to systematically improve care and facilitate multidisciplinary integration.

This methodology does not need to be used solely for high utilizer specific programs. The concepts and methods of PDSA and MAX can be adapted and applied to any quality improvement program.

As we enter DSRIP Year 3, Millennium’s focus is going to shift towards population health specific metrics and the programs that will enable us to achieve our New York State targets.

The use of the MAX methodology is a tool that is available for providers, to develop sustainable programs, achieve goals, and make a true impact in our communities.

In future updates, we will be highlighting the progress of individual Millennium MAX programs. Currently, the Erie County Medical Center (ECMC) and Niagara Falls Memorial Medical Center (NFMMC) are active participants in on-going MAX initiatives.


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The Erie County Medical Center Corporation (ECMCC) is the parent organization of Millennium Collaborative Care

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