Established in New York and six other states, the Delivery System Reform Incentive Payment Program (DSRIP) is a major initiative, intended to transform the way Medicaid health care delivery and payments are handled. More specifically, DSRIP aims to push the health system to become more integrated and proactively focused on patients, Health Affairs Blog reported. DSRIP was first implemented in some states in 2010, and approximately $30 billion have been dedicated to this program across the participating states thus far. After nearly five years, it is now fair to ask how well or poorly the program is performing.
According to a recent report from the Medicaid and CHIP Payment and Access Commission (MACPAC), the results have been impressive. As Healthcare Finance News reported, MACPAC’s annual report to Congress went so far as to suggest that the Medicaid program at large would benefit by expanding DSRIP usage across the country.
DSRIP Success
The MACPAC report focused heavily on DSRIP and its success, according to Healthcare Finance News.
“The DSRIP approach, if taken to scale, has the potential to fundamentally change Medicaid’s role from financing medical care to driving system change toward value and improved health outcomes,” wrote Diane Rowland, Chair of MACPAC and Executive Vice President of the Henry J. Kaiser Family Foundation, the source reported.
The report highlighted the preventative benefits championed by DSRIP.
A big part of this potential depends on the ability of DSRIP to deliver treatment and medical care earlier, cutting down on preventable hospitalizations and health care efforts. In New York, for example, DSRIP’s primary goal is to reduce avoidable hospital readmissions by 25 percent, as Health Affairs Blog noted.
DSRIP Disconnect
At the same time, though, it’s important to note that the MACPAC report emphasized that there is a disconnect between how the program is viewed at different governmental levels, according to Healthcare Finance News.
“Although CMS describes DSRIP programs as a tool primarily intended to assist states in transforming their delivery systems in order to fundamentally improve care for beneficiaries, states have been candid that DSRIP programs have been pursued as a means to make supplemental payments,” the MACPAC report asserted.
What’s more, the report noted that DSRIP should only be seen as one piece of these broader efforts to cut down on hospitalization rates. Improved infrastructure development will be essential to achieve broad progress in this capacity.
“DSRIP should be seen as one piece of broader efforts to cut down on hospitalization rates.”
Mandates Needed?
Another key factor to consider in this arena is the nature of DSRIP’s incentives. Essentially, DSRIP is entirely dependent on incentives. Participating health care organizations have the potential to earn major financial rewards if they are able to achieve goals established by the program.
Yet this alone may not be enough to fully shift Medicaid’s focus from acute care to preventative efforts, as Stephen Berger, Chairman of Odyssey Investment Partners, recently explained. Speaking at the Crain’s New York Business health care summit, Berger noted that health care professionals have long discussed the need of focusing more on preventative efforts, but progress has been far less common. DSRIP, with its incentive-based program, is certainly having an effect, and will continue to do so, but it won’t sway every health care provider to embrace new strategies and tools.
“DSRIP is the carrot, and it’s a big one, but without a mandate it will not be enough,” Berger said, according to Crain’s New York Business.
If the current DSRIP programs continue to yield significant results, though, then it’s very possible that Berger’s claims will prove exaggerated – or, alternatively, DSRIP’s goals will become mandates for Medicaid participants. Whatever the case, it seems very likely that DSRIP will continue to expand and grow, putting more pressure on health care providers to embrace health IT solutions that will enable them to meet all of DSRIP’s objectives and requirements.