DSRIP

In 2014, New York received CMS approval to implement a Delivery System Reform Incentive Payment (DSRIP) program as part of its Section 1115 Waiver. This $8 billion program represents an aggressive continuation of New York’s Medicaid reform efforts to create a “high-performing State-wide health system” under the leadership of Governor Andrew Cuomo and the vision of Medicaid Director Jason Helgerson. The primary objectives of New York’s DSRIP program are to reduce unnecessary hospital admissions by 25 percent over five years; measure infrastructure transformation and community population health project domain progress against agreed-upon goals; and maintain progress on the MRT’s 70 initiatives. As the mechanism for achieving these ambitious goals, New York’s DSRIP program establishes Performing Provider Systems (PPSs), an ACO-like network of providers assembled at the community level.

DOH recognized from the outset that democratization of its wealth of Medicaid data would be indispensable to the success of the DSRIP program. Providers would need access to data to form networks, determine community health needs, develop their program applications, and formulate project plans for DOH approval. Yet at the same time, the sensitivity of healthcare information made data security and integrity paramount considerations. DOH turned once again to Salient, its trusted partner in Medicaid reform, to help it facilitate this groundbreaking initiative.

In the first phase of the DSRIP PPS formation and application process, Salient created a public-facing dashboard portal with a subset of the Medicaid Enterprise Management dataset to give providers the insights they needed to identify networks and begin assessing community health needs in their regional catchment areas. These public-facing dashboards, utilizing cleansed and de-identified data as well as other technical means to maintain HIPAA compliance, afford providers and the general public unprecedented insight into the performance of the healthcare system for Medicaid beneficiaries. Salient embedded documentation and use aids directly into the dashboards to realize a user-friendly, zero-training environment.

In the second phase, PPSs in the process of formation and project plan development obtained access to the full Medicaid Enterprise Management solution through Salient’s robust no-PHI security capability, ensuring that no sensitive protected data would be compromised while still giving analysts the deep access to Medicaid data they needed to formulate effective strategies and plans to serve the local population.

The third phase, now under development, integrates the DSRIP performance measures into the Medicaid Enterprise Management application and embeds PPS performance dashboards into the Medicaid Analytics Performance Portal. The data used to formulate these measures includes Medicaid claims as well as Potentially Preventable Events, risk stratification data, quality measures, survey data, and features innovative technical means to overcome claims lag to make the data more up-to-date and actionable.