DELIVERY SYSTEM REFORM INCENTIVE PAYMENT PROGRAM (DSRIP)

We successfully led the implementation of the very complex DSRIP Program. The program improved the design and delivery of healthcare for the Medicaid population by reducing avoidable hospitalization and improving population health, while lowering the cost of healthcare.

Innovation Fund, CBO VBP Readiness Program, and Medicaid Accelerated eXchange Programs

The FLPPS partnership is a diverse network of hundreds of Partner organizations across many provider types and an expansive geography. Prior to DSRIP, most partner organizations operated in their own silo and did not have the tools or processes to enable an integrated network approach to care delivery.

We organized Partners into geographical regions refer to as Naturally Occurring Care Networks or NOCNs and developed a process for these individual agencies to come together and begin to understand the value of an integrated delivery system for patients in their region.

The Partners in each of the NOCNs are stronger together because of our support in developing high-performing networks.

Innovation Fund Projects

Through the Innovation Fund program, we began by supporting quality improvement activities at 12 partner organizations. These Innovation Projects focused on prioritized FLPPS pay-for-performance clinical outcomes intended to drive quick results.

In 2019, we supported the NOCNs in performing a root cause analysis to identify the cause of poorly performing outcomes and supported the implementation of projects to address needs in those areas. The NOCNs developed solutions and identified high-impact data driven interventions to address underperforming clinical outcomes specific to each NOCN region.

Value Based Payment Program

This program engaged twelve high impact community based organizations who provide food, clothing, emergency housing, and homeless prevention services. Six of these agencies were in the City of Rochester and six were in the FLPPS rural counties. All of the organizations served more than 2,500 individuals per year.  We co-developed this program with the United Way and also utilized organizational development consultants to work with partners one on one. We provided educational workshops and leveraged our expertise in facilitation, system transformation, and value-driven solutions to support Partners in the development of their value proposition statements.  

Medicaid Accelerated Exchange Program

The Medicaid Accelerated eXchange (MAX) Program redesigned the way healthcare is delivered to a specific patient population by utilizing a rapid cycle continuous improvement methodology. The key objective of the MAX program was to support an interdisciplinary team to accelerate their ability to achieve sustainable reductions in hospital admission and emergency department use.

The MAX program supported the goal of transforming healthcare by strengthening care collaborations and getting patients the right care at the right time. By understanding the drivers of high utilization, patients are directed to appropriate community providers and resources while promoting the more efficient use of hospitals for emergent and acute level services.

We facilitated and led four action teams over two years partnering with Arnot Ogden Medical Center, St. Joseph’s Behavioral Health Science Unit, Geneva General Hospital, and Noyes Hospital.

We also facilitated a mini-MAX series with Jones Hospital in 2018 which established a structure for the hospital and community-based organizations to coordinate care and address social determinants of health for identified high utilizers.

The results were impressive:
Februrary – May 2017
Arnot Ogden Medical Center

58% reduction
in inpatient utilization

September 2017 – February 2018
St. Joseph’s Behavioral Health Science Unit

86% reduction
in inpatient utilization

November 2017 – March 2018
Geneva General Hospital

75% reduction
in inpatient utilization

July 2018 – February 2019
Noyes Hospital

89% reduction
in inpatient utilization