Rural Challenges: DSRIP & VBP Greg Allen Director, Division of Program Development & Management Office of Health Insurance Programs September 2017

DSRIP: Preparing for VBP September 2017 DSRIP: Preparing for VBP Performance on DSRIP measures can be a good indicator for the relative readiness and expected performance in VBP arrangements VBP contract arrangements will not mirror PPS formation, but PPSs can be a strong incubator and convener of willing providers Where your potential VBP contracting network is strong, consider how continued performance can be an asset to your MCO partner in strengthening their overall performance Where your potential VBP contracting network has room for improvement, consider the opportunity for potential shared savings Do not ignore areas of care for which you may not have participated in relevant DSRIP projects

September 2017 Rural County Analysis For the purposes of analysis, NYS counties were divided into 4 groups: New York City Bronx Queens Kings New York Richmond Upstate Urban Albany Broome Chautauqua Chemung Dutchess Erie Monroe Niagara Oneida Onondaga Orange Rensselaer Saratoga Schenectady Tompkins Warren Upstate Rural Alleghany Montgomery Cattaraugus Ontario Cayuga Orleans Chenango Oswego Clinton Otsego Columbia Putnam Cortland Saint Lawrence Delaware Schoharie Essex Schuyler Franklin Seneca Fulton Steuben Genesee Sullivan Greene Tioga Hamilton Ulster Herkimer Washington Jefferson Wayne Lewis Wyoming Livingston Yates Madison Suburban NYC Nassau Rockland Suffolk Westchester

Systemwide KPIs Upstate Rural Counties perform well on PPRs … September 2017 Systemwide KPIs Upstate Rural Counties perform well on PPRs … … But PPVs show room for improvement

Strengths in Rural Medicaid Performance September 2017 Strengths in Rural Medicaid Performance Among projects commonly selected by rural PPSs Statewide Goal Statewide Goal Takeaway: Investigate whether strong performance on BH measures would position potential VBP contractor well for HARP arrangement

Strengths in Rural Medicaid Performance September 2017 Strengths in Rural Medicaid Performance Among projects NOT commonly selected by rural PPSs Takeaway: Investigate whether strong performance on maternity measures would position potential VBP contractors well for Maternity arrangement Statewide Goal

Opportunities for Improvement September 2017 Opportunities for Improvement Revisiting PPV Performance Takeaway: Unnecessary utilization of ED might indicate strong potential for Shared Savings in IPC or TCGP arrangements

Questions on DSRIP or VBP? dsrip@health.ny.gov vbp@health.ny.gov