NYS DSRIP: Investing in Health Care Collaboration

Last month, the Center for Health Care Strategies (CHCS) hosted a webinar entitled “The New York State DSRIP Program: A Model for Reforming Medicaid Delivery System” for entities across the country that are looking to transform their Medicaid system through DSRIP-like initiatives. NYS is moving forward with the implementation of its Delivery System Reform Incentive Payment (DSRIP) program, which is set to be implemented beginning on April 1, 2015.  As per NYSDOH, DSRIP funds will invest in system wide reform in health care delivery by promoting community-based collaboration, where providers are jointly accountable as Performing Provider Systems (PPS) to offer population based health care. This includes improving clinical performance and achieving a 25% reduction in avoidable hospital use over the next five years.

So how was this investment made possible?

After years of exponential cost growth, the NYS budget could no longer afford to continue to support its current Medicaid infrastructure. And so, in 2011, Governor Cuomo created the Medicaid Redesign Team (MRT) in an effort to reduce costs while focusing on improving quality and reforming New York’s Medicaid System. MRT launched numerous initiatives simultaneously to generate immediate cost savings, while also launching multiple systemic reforms designed to generate future cost savings. To date, the MRT fiscal impact has been tremendous, with $17.1 billion dollars saved.

CMS approved NYS’s Medicaid Waiver request in April of 2014, allowing the state to reinvest $8 billion of the $17.1 billion in federal savings generated by MRT reforms. DSRIP funding is spread out over 5 years, and includes:

  • $500 Million for the Interim Access Assurance Fund (IAAF) – Time limited funding to ensure current trusted and viable Medicaid safety net providers can fully participate in the DSRIP transformation without unproductive disruption;
  • $6.42 Billion for Delivery System Reform Incentive Payments (DSRIP) – Including DSRIP Planning Grants, performance payments, and state administrative costs; and
  • $1.08 Billion for other Medicaid Redesign purposes – This funding will support Health Home development, and investments in long term care workforce and enhanced behavioral health services.

The achievement of project metrics and milestones will determine the portion of DSRIP funds that are allocated to each PPS. During the webinar, CHCS was clear that the key to success would be to focus on collaboration and coordination amongst providers. In order to move the needle in transforming the current system and moving toward the achievement of the Triple Aim of better care for lower cost resulting in improved population health, providers must work together to ensure Medicaid and Non-Medicaid consumers can access integrated cross sector services, including medical and behavioral health providers, community-based organizations, specialists and hospitals, using a single system of effective care management.

For more information and to access a recording from this informative webinar, visit the CHCS website here.