Hot Topics / Priority Issues

A new report published by United Hospital Fund and funded by the New York State Department of Health found that the State’s Medicaid reform efforts can improve health care outcomes well beyond 2020 if New York continues to expand on practices implemented to date.

New York State launched the Delivery System Reform Incentive Payment (DSRIP) program in 2014 to invest in system transformation, clinical improvement, and population health projects that promote community-level collaborations, with the goal of achieving a 25 percent reduction in avoidable hospital use over five years. Under this initiative, health care and social service providers formed collaborative networks called Performing Provider Systems (PPSs) to implement a series of improvement projects.

To help inform discussions on next steps when the current DSRIP program ends on March 31, 2020, the Department of Health asked UHF’s Medicaid Institute to review the first four years of the effort to identify important lessons and promising practices.

The resulting report, DSRIP Promising Practices: Strategies for Meaningful Change for New York Medicaid, identified several key takeaways:

• Substantial investments in infrastructure, such as coordinated provider networks and robust information technology systems, are required to support efforts to improve health outcomes across large populations.

• Projects targeting small populations of complex, potentially costly patients with multiple medical conditions can improve outcomes and generate valuable models for other projects and populations. Substantial care management and coordination are important for the most complex populations.

• DSRIP has greatly accelerated the focus on social determinants of health, such as food insecurity or poor housing, by facilitating partnerships between health care providers, community-based social service organizations, and other community partners.

• Given the prevalence of individuals in Medicaid with behavioral health needs, some of the most promising practices focused on expanding patients’ access to treatment and their ongoing engagement with those services.

The report includes case studies of DSRIP projects across the state and an appendix of specific DSRIP measures, sorted by the outcomes that the promising practices sought to affect. It can be downloaded from UHF’s website here.