What does the future hold for DSRIP?

As New York’s five-year, $7.4 billion Delivery System Reform Incentive Payment program nears its midpoint, the election of Donald Trump as president has caused some providers to worry about whether the federal government will honor its commitment to fund the Medicaid reform effort.

Some members of the Healthcare Association of New York State have already expressed their concerns about the fate of DSRIP to the trade group’s leadership, said HANYS President Bea Grause. The New York state Department of Health said it’s confident the federal government will maintain its commitment to DSRIP, which runs through 2020.

“The change in the administration will not affect the federal DSRIP waiver,” DOH said in an emailed statement to Crain’s.

Grause said that Gov. Andrew Cuomo’s administration views the federal waiver as a contract that binds the federal government to honor its commitment.

What is less clear is whether a Trump administration would be willing to extend DSRIP beyond its first five years, as the Centers for Medicare & Medicaid Services did for California at the end of 2015, Grause noted.

The concept of DSRIP, which grants states a finite pool of money that is earned based on performance incentives, could prove palatable to a Trump administration, which has expressed interest in turning Medicaid into a block-grant program, said Michael Sparer, chair of health policy and management at Columbia’s Mailman School of Public Health.

“The waivers are designed to give flexibility, which is in line with block grants,” he said.—J.L.



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