Crain's Health Care Summit: New York After DSRIP – What Comes Next?

Bryan Madden, Esq., Long Island Chapter President, HCP Guest columnist

The New York Delivery System Reform Incentive Program (DSRIP) 1.0 was a $12.8 billion federal investment enacted in 2014 established to redesign the New York Medicaid program.  The goal of DSRIP 1.0 was to bring together hospital systems, doctors, and community-based organizations into Performing Provider Systems (PPS) to encourage collaboration rather than competition, with a common goal to reduce avoidable hospitalizations, and increase the quality of care.  New York is seeking a second round of $8 billion in DSRIP funding in order to further focus on Value Based Payment programs and reach spending reduction goals that were not achieved in the current DSRIP.

The Crain's Summit brought together many of the leaders of the New York State DSRIP in order to discuss and review the program, in terms of what was working and what was not working, particularly in light of the current growing Medicaid budget gap.  Prominent speakers included Jason Helgerson, former Director of NY Medicaid.  

A recurrent theme of the 4-hour discussion was the missed opportunity and failure of utilizing the DSRIP funds and infrastructure to effectively bring in home health care as a key player to improve community-based patient outcomes and quality of care.  This theme was repeated throughout the presentation, and explicitly detailed by Helen Shaub of SEIU 1199.  

Another major discussion point and regret was the failure to utilize the Medicaid Managed Care Organizations (MCOs) as an organizational body to administer DSRIP, rather than investing in hospital systems to create the infrastructure which led to time and conflict of interest issues.  

All in all, this was a good opportunity to position home care as part of the solution with the people who set or influence Albany budget policy; however, with a very challenging budget year, it seems that all providers should prepare for some type of reimbursement strain within the foreseeable future. 

NOTE: Earlier this month, HCP sent a comment letter to a range of State officials regarding DSRIP 2.0. 
The letter stressed the importance of ensuring that any continuation of DSRIP must more fully incorporate home care providers.