What is DSRIP?

On April 14, 2014 Governor Andrew M. Cuomo announced that New York had finalized terms and conditions with the federal government for a groundbreaking waiver that will allow the state to reinvest up to $6.42 billion in federal savings generated by Medicaid Redesign Team (MRT) reforms.

The funds are to 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.

The Centers for Medicare & Medicaid Services (CMS) is changing the way Medicare and Medicaid pay for hospital care by rewarding hospitals for delivering services of higher quality and higher value.  With pay-for-performance, hospitals, nursing homes, and other providers are required to demonstrate that patients receive the most effective care possible, with fewer re-admissions, appropriate emergency room utilization, good follow-up care and efficient use of electronic medical records.

DSRIP Funds are intended to support qualified providers with more money over the next five years, through a period during which fee-for-service revenue will decline, but financial rewards based on performance will not yet be fully developed.

 

Goals of DSRIP

1. Transformation of the healthcare safety net at both the system and state level

2. Reducing avoidable hospital use and improve other health and public health measures at both the system and state level

3. Ensure delivery system transformation continues beyond the waiver period through leveraging managed care payment reform

4. Near-term financial support for vital safety net providers at immediate risk of closure.

 

What was a PPS Expected to Manage?

By 2020, New York State Medicaid wanted to fully transition from Fee-for-Service to a Value-based Payment methodology that will put payment at risk based on performance.

The ability to manage risk will require existing Medicaid safety net providers to:

  • Create a care delivery network structure for a region that has enough Medicaid covered lives to manage risk based payments.
  • Organize the provider network to effectively and efficiently deliver care to Medicaid beneficiaries.
  • Develop the analytical and financial core competencies for population health management.

 

DSRIP Partners Received the Following Benefits

Care Compass Network’s goal was to assist partner organizations through the DSRIP transition period. We offered assistance at no charge and provided them with:

  • Education and training to help them successfully implement Medicaid’s new performance-based payment structure
  • Resources to train workforce in the new system
  • Information about additional resources and services in the community, such as transportation assistance or support groups
  • Workforce assistance – we provided support with recruitment and trainings, such as Cultural Competency and Health Literacy
  • Funding for services and programs that benefitted Medicaid Members

If you have any questions, please contact your representative: