DSRIP OVERVIEW

What is DSRIP? 2

 DSRIP = Delivery System Reform Incentive Payment  An effort between the New York State Department of Health (NYSDOH) and the Federal government to improve the health of the Medicaid population and for people who do not have health insurance.  Goal: Provide incentives to healthcare providers to build infrastructure and programs to improve population health.  Performance based – must achieve goals before payment is made  Must choose from a list of approved DSRIP projects  Community-level partnerships are key to making DSRIP work.  Need to look beyond the medical system  Community-level organizations are important in keeping people healthy 3

Why is DSRIP Happening?  Ultimate goals:  Improve the way care is accessed and delivered so patients receive the right care, in the right place, at the right time.  Reduce preventable hospital visits statewide by 25% over the next five years.  To improve the health care system so Medicaid and uninsured populations spend less time in hospitals, and more time in their homes and communities.  The DSRIP funds will go towards infrastructure development – this program is working to transform the system! 4

Who Will Be Impacted by DSRIP?  Everyone! Including, but not limited to the following:  Medicaid beneficiaries  The uninsured population  Hospitals  Doctors  Community based organizations  Social services  Nursing facilities  Mental health & substance use providers  Community coalitions  Patient’s access to care and where they receive services will remain as it is today.  Goal is to expand access so patients can get care at the right place and at the right time to maintain their health. 5

How will DSRIP work?  Providers must partner together to develop networks.  These networks of providers will work together to implement 5-11 projects.  These projects must be new or significantly different initiatives that do not currently have a funding stream.  It can’t supplement existing programs  It can’t replace existing program funding  These projects must be detailed in a project plan that include specific goals (metrics and milestones).  Payment is contingent upon providers meeting these goals in the timeline they’ve committed to. 6

DSRIP Program Structure 7

DSRIP Lead Entity  Performing Provider System (PPS): the entity responsible for creating and implementing a DSRIP program.  Providers must form partnerships and join a PPS to participate in DSRIP  Participating providers should include, but are not limited to the following: Hospitals Health homes Skilled nursing facilities/Nursing homes Clinics & FQHCs Behavioral health providers Community based organizations  Each PPS must have a designated lead entity.  Most lead entities are public hospitals or private safety net hospitals 8

DSRIP Projects  For a PPS to receive DSRIP payments, it must implement projects.  The State provided 44 potential projects, each PPS could select between 5 and 11 projects.  These projects must be new or significantly different initiatives that do not currently have a funding stream.  It can’t supplement existing programs  It can’t replace existing program funding  These projects must be detailed in a project plan that include specific metrics and milestones.  Payment is contingent upon providers meeting these metrics and milestones. 9

DSRIP Incentive Payments  Payments are based on meeting specific milestones.  This is a separate stream of money from what providers receive for the services they provide today  Payment for services will remain the same as it is today  These dollars are incentives for building the right infrastructure and programming to support population health  Pay for Reporting:  Some payments will be based on the PPS submitting required reports and process outcomes  Pay for Performance:  Other payments will be based on meeting specific performance measurements and outcome targets 10

DSRIP Planning Timeline 11

Timeline for Duration of 2014  DSRIP Project Plan applications are due December 16,  November until December 16th  Submit the finalized list of provider NPIs to the state for attribution calculations  Work with internal PPS partners to finalize the project plan application  Continuous  Work with internal PPS partners as well as external stakeholders in refining the network and project plan 12

Timeline for 2015  January – February 2015  DSRIP Project Plans are reviewed by NYSDOH and open for public comment.  Early March 2015  DSRIP awards are made to selected PPSs.  April 1, 2015  Start of DSRIP implementation!  The next 5 years are when DSRIP projects are implemented and when DSRIP money begins to flow.  December 31, 2019  The beginning of capitation 13

How Can I Learn More? 14

Ways to Stay Involved  We want to learn from you about the healthcare resources and needs in your community.  We value your ideas and want to keep you in the loop.  There are many ways to stay involved:  Visit the PPS website at  Join the list to get weekly updates and information on upcoming events  In addition to Town Halls there will be many more ways to stay involved  us at 15

Thank You! the Bronx-Lebanon PPS Team at Visit the Bronx-Lebanon PPS website at Official CMS and State DSRIP documentation & guidance is posted on the New York State Department of Health website 16