Why, how and what is DSRIP? Delivery System Reform Incentive Payment - - PowerPoint PPT Presentation

Delivery System Reform Incentive Payment (DSRIP)

Why, how and what is DSRIP?

Delivery System Reform Incentive Payment (DSRIP)

You know this...

• A fragmented delivery system is

incredibly difficult to navigate and prevents patients from receiving the full continuum of care they deserve.

• Providers, health care workers and

community based organizations are frustrated that fragmentation inhibits them from concentrating on their passion: to help people!

• Health care costs are enormous in a

system that incentivizes volume over

• utcomes.

Delivery System Reform Incentive Payment (DSRIP)

Federal and state efforts have aligned to address growing and unsustainable health care costs.

• Medicaid Redesign Team (MRT) established by

Governor Cuomo in 2011 as a response to the high cost of New York State Medicaid – Medicaid enrollment and expenditure nearly doubled from 2000-2013

• Centers for Medicare and Medicaid Services

1115 Waiver – Federal funds to support state initiatives to improve outcomes and reduce costs for Medicaid

Delivery System Reform Incentive Payment (DSRIP)

What is DSRIP?

• Delivery System Reform Incentive Payment, organized by the NYS Medicaid

Redesign Team (MRT)

• $6.4 billion statewide incentive program to redirect Medicaid funds to

projects that radically transform the Medicaid delivery system

• Collaborative effort that brings together health care and community-based
• rganizations to implement innovative system transformation
• Designed to improve the quality of patient care, improve the health and

wellness of our communities and reduce avoidable hospital use by 25%

• ver five years

Delivery System Reform Incentive Payment (DSRIP)

Performing Provider Systems (PPS):

• A Performing Provider System (PPS) is a network of health care and

community-based organizations that have agreed to work together to transform the health care system in their region, using the DSRIP program.

• New York State is divided into 25 Performing Provider Systems, based on

geography and regional care delivery.

• Alliance for Better Health Care, LLC and the Center for Health Systems

Transformation at Albany Medical Center are Performing Provider Systems serving Albany and beyond.

Alliance: Who We Are

• 2,000 providers and community based
• rganizations
• Serving
• 125,000 Medicaid members
• 94,000 uninsured and low utilizers
• 5 members:
• 3 health systems with group practices
• 2 FQHCs
• 6 county service area:

Albany Rensselaer Fulton Saratoga Montgomery Schenectady

Alliance: Projects

• 1. Integrated Delivery System Development
• 2. Emergency Department Triage for At-Risk Populations
• 3. Care Transition to Reduce 30 Day Readmissions
• 4. Hospital-Homecare Collaboration
• 5. Patient Activation for Uninsured, Under-Insured and Low Utilizers of

Health Care

• 6. Integration of Behavioral Health and Primary Care
• 7. Ambulatory Detoxification
• 8. Asthma Self-Management
• 9. Palliative Care Integration Into Primary Care
• 10. Strengthen the Mental Health and Substance Use Disorder Infrastructure
• 11. Tobacco Cessation

Alliance: Community engagement Taking care of our communities requires collaboration. Improving the health and wellness of the neediest members of our community requires more than collaboration:

• Shared Sense of Purpose
• Connectivity
• Innovation

We must work together at an unprecedented level.

Alliance: Project involvement

• Non-clinical support services to ensure patients receive necessary assistance in order to

remain in a home or non-hospital setting upon discharge from the hospital.

• Better understanding of cultural competency and health literacy standards for providing

appropriate care.

• Providing guidance to individuals with chronic illness, beginning conversations about

advance care planning, or assisting individuals and families in completing healthcare proxies.

• Facilitating referrals to NYS Smokers’ Quit line, Opt-to-Quit (www.nysmokefree.org) or

helping to establish smoke-free grounds at your workplace.

• Connecting individuals with unmet psycho-social or medical needs to appropriate medical

appointments, transportation and social support services through new or existing roles including community navigators.

• Awareness of behavioral health and substance abuse supports such as trauma-informed care

training, peer support programs and primary care integration.

Alliance: Building the partnership

• Self-identify that your agency has a service that you can contribute to

support the projects

• Capacity and value
• Personnel- knowledgeable, trained and experienced
• Sound understanding of Federal and State requirements
• Electronic access to who you are
• Sustainability plan

Alliance: Supporting best practices

• Engagement of unreached population
• Training strategies
• Community information sessions
• Naturally occurring collaborative partners

Alliance: End game

• Developed and implemented an improved integrated health care delivery system

in our service area that will replace the fragmented one currently in place.

• Developed new partnerships and collaboration among hospitals, physicians, long

term and home care programs, social service agencies and community

• rganizations.
• Improved the quality of care delivered to Medicaid and uninsured individuals.
• Patient’s care will be tailored to his/her individual needs, both medically and

socially, and that the right care is delivered at the right time and in the right place.

• High-need individuals will receive coordinated care at an earlier stage, resulting in

healthier individuals and lower health care costs.

Alliance: Who We Are

Linda.Austin@AllianceforBetterHealthCare.com www.AllianceForBetterHealthCare.com Let’s Talk…