Tag Archives: DSRIP

Planning Your DSRIP Implementation


Post by Vicki Harter


Clinical Product Manager, Caradigm

We are in the middle of a broad and dynamic effort to reform Medicaid. In 2014, 30 states reported having some delivery system reform initiatives underway with that number increasing to 40 states in 2015.[1] Delivery System Reform Incentive Payment (DSRIP) programs are one example of Medicaid reform that is top of mind for provider organizations because of the significant funding available to support the transformation of care to Medicaid beneficiaries. Nine states (California, Illinois, Kansas, Massachusetts, New Hampshire, New Jersey, New Mexico, New York, and Texas) have indicated that they plan to implement or expand DSRIP programs in FY 2015, so for providers in those states, it is the right time to strategize how to implement a successful DSRIP project supported by health information technology (HIT).

The following are a few recommendations to consider in order to get your DSRIP Year 1 off to a strong start.

A Key First Win is Integrated Health IT (HIT)

In order to truly transform how healthcare organizations meet the needs of the Medicaid population, silos of care must be brought together. Healthcare collaboration has been challenging across the healthcare community due to the lack of interoperability of IT solutions, which prevents the aggregation and sharing of information across a diverse team of care givers. Integrated HIT across a health system should be one of the first goals of a PPS (Performing Provider System) because it enables the longitudinal information required to accomplish DSRIP projects including care coordination and population health management. When evaluating solutions, keep in mind that the integration of HIT is outside the scope of many population health solution providers that focus on a specific area of population health such as analytics or workflow efficiency. The ability to aggregate and share all data within a diverse PPS is a capability that few solution providers are executing on today.

Factor in Speed of Results with Performance-Based Payments

DSRIP waiver funds are allocated with the achievement of specific performance metrics. Initially, those metrics will be process based, but they will become performance based for the majority of the program. In order to receive full funding amounts, implementation plans should consider the scale, speed and scope of deployment. As PPS’ are committing to take on a number of different projects, it’s important to identify synergies and efficiencies that can accelerate clinician processes and results across multiple projects. Without those efficiencies, clinicians can become bogged down by the amount of change management and new processes being introduced. Examples of new efficiencies that are possible include:

  • Identifying patients that are most impactful in order to achieve faster results from targeted interventions.
  • Enabling an interoperable, longitudinal patient record across the PPS so clinicians don’t have to log into many different systems for the information they need.
  • Team-based care with clear roles and responsibilities assuring “top of license” activity.
  • Enabling quality analysts and other clinicians to see performance analytics and gaps in care in real-time so those gaps can be closed quickly and even while still in the presence of a patient.
  • Automatically generating personalized care plans, task lists and interventions for care team members to enhance efficiency and reduce variations in care.
  • Utilizing those personalized care plans to generate self-management action plans for patients so they can engage in self-care.

Take An Enterprise Approach to Transform Care

The goals of DSRIP align very closely with population health approaches as both seek to transition from fee-for-service, episodic care to value-based care for a population across a community of providers. The ultimate goal is health delivery transformation, which can’t be accomplished with a narrow, point solution approach. Point solutions for population health can be counter-productive to DSRIP goals because they sustain the silos and inefficiencies that DSRIP was intended to address. The difference with an enterprise population health approach is that it integrates all of the core capabilities needed for population health and true care delivery transformation: integrated information systems, health care analytics, care coordination and patient engagement. An enterprise approach is also extensible, which allows providers to support today’s needs while planning for the initiatives of tomorrow.

Caradigm is the leading enterprise population health company that can help organizations succeed with their DSRIP initiative. To learn more about how Caradigm can help you plan your DSRIP implementation, please visit our DSRIP page, see our recent DSRIP press release or send a note here.


[1] Smith, Vernon K. Ph.D., Gifford, Kathleen, Eileen Ellis Health Management Associates and Rudowitz, Robin and Snyder, Laura Kaiser Family Foundation. National Association of Medicaid Directors. Medicaid in an Era of Health & Delivery System Reform: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2014 and 2015. October 2014.

DSRIP Leads to Population Health Management


Post by Vicki Harter


Clinical Product Manager, Caradigm

It’s challenging to provide care for the patients most in-need – the homeless, those with untreated, chronic health and mental illness. These patients often lack consistent primary care, and often only receive treatment when they go to the emergency room during an acute episode. It’s a lose-lose situation because the patients don’t sustain the improved health after leaving the ER, and costs are unsustainable for providers and U.S. taxpayers.

The federal government saw the need for better coordinated care of Medicaid and uninsured patients, resulting in the creation of the Delivery System Reform Incentive Payment (DSRIP) program to help healthcare organizations transform how they deliver care to those patients. At its highest level, DSRIP is intended to advance the Institute for Healthcare Improvement “Triple Aim” of improving the health of the population, enhancing the experience and outcomes of the patient and reducing the per capita cost of care. DSRIP is also ultimately about Medicaid reform, moving to a system of care that promotes wellness rather than just manage sickness and promotes value of care over volume of care.

DSRIP points people in the right direction by emphasizing certain goals such as the “Triple Aim,” collaboration with community providers, avoiding preventable hospitalizations and clinical improvement for chronic diseases. What DSRIP does not do is specify how providers are going to accomplish those goals, which requires organizational change and new technologies. To complete the picture, healthcare organizations need a population health management strategy and solutions to enable that strategy.

Population health management solutions can reduce silos of care by sharing data and analytics across the community at the point-of-care. Patients are given a single plan of care focused on prevention and wellness that is then executed by a care team across the continuum efficiently and without redundancy. The result is an integrated community of providers that delivers better coordinated care to make patients healthier and keep them out of the ER and hospital settings.

The DSRIP program represents a great opportunity for eligible organizations to jumpstart a population health strategy. To learn more about the DSRIP program, you can watch this short video or contact us to discuss further.