An OPEN MINDS Market Intelligence Report
Delivery System Reform Incentive Payment (DSRIP) programs are an effort by state Medicaid programs to contain costs while delivering quality care and preserving safety-net funding. Authorized as part of a state’s Section 1115 demonstration waiver, DSRIP programs utilize the waiver’s savings to implement a variety of delivery system and payment reform projects, such as the expansion of primary care services or implementation of telehealth. These projects and DSRIP funding levels are established by the state Medicaid program and the federal Centers for Medicare and Medicaid Services (CMS).
The DSRIP program originally focused on hospital-based system reform, but more recently, the program has been expanded to include projects implemented by other types of safety-net providers. The types of provider organizations that are eligible to participate vary from state to state. The types of projects that are included as part of DSRIP programs also vary from state to state. Some states include behavioral health as part of their planning, while others do not. Projects include everything from integrated health homes for the seriously mentally ill, to the expansion of patient care navigation programs. Payment for these projects is contingent upon meeting specific metrics linked to planning, reporting, and clinical outcomes established by the state and CMS.
As of November 2015, no state has released a full analysis of their DSRIP program, and only two states (Massachusetts and California) have completed a full DSRIP cycle. At this time, most states are reporting on the amount of money awarded to participating provider organizations, but they are not reporting on money that was forfeited due to missed metrics/milestones.
This report gives a comprehensive explanation of what a DSRIP is and which states have DSRIP programs. It details how the program is funded, the types of providers that can participate in DSRIP, and what kinds of projects have been implemented under DSRIP. The report lists the states that have behavioral health DSRIP projects and the results of the programs, along with outlining the future of DSRIP.