The Delivery System Reform Incentive Payment Program: A Model for Reforming Medicaid

Kozick, D
Publication Year: 2014
Population Focus: Medicaid beneficiaries
Intervention Type: Service redesign
Type of Literature: Grey


Insights Results

Overview of article

  • This article provides an overview and explores the key domains of Medicaid DSRIP programs

Key takeaways/implications

  • Since 2010, 7 states have established DSRIP programs (California, Kansas, Massachusetts, New Jersey, New Mexico, New York, and Texas). Earlier approaches focused on reallocating funding to safety net hospitals only, while more recent models have advanced wider-scale payment and delivery system reform by expanding the definition of eligible safety net providers to encourage community-wide collaboration
  • New York’s DSRIP program holds comprehensive networks of providers accountable as Performing Provider Systems for delivering population-based healthcare. The state’s primary goal under DSRIP is to reduce avoidable hospital use by 25% (i.e., preventable hospital readmissions, inpatient admissions that can be avoided with proper preventive care services)
  • Under California’s renewal efforts, the state is exploring topics such as, patient safety, complex patients, and prevention by rewarding 21 safety net hospitals with more than $3 billon for achieving quality benchmarks associated with specific projects. The state is also exploring how it might use DSRIP to advance the integration of behavioral health and substance use disorder services with medical care, promote care coordination across delivery systems, and potentially include a broader set of safety net providers
  • DSRIP programs generally address 4 key domains: 1) Infrastructure development; 2) System redesign; 3) Clinical outcomes improvements; and 4) Population-focused improvements