What was the DSRIP Program?
New York State (NYS) worked with the Federal Government to initiate the Delivery System Reform Incentive Payment (DSRIP) program, which allowed NYS to reinvest over six billion dollars over five years to improve healthcare for Medicaid recipients. The DSRIP program promoted community-level collaborations with a focus on system reform and aims to reduce avoidable hospital use by twenty-five percent by 2020.
Community Care of Brooklyn PPS
Performing Provider Systems, or PPSs, were regional entities responsible for the health of the population in their service area during the DSRIP Waiver. CCB was the largest PPS in New York State and the biggest PPS in Brooklyn, with a network comprised of over 800 participant organizations, more than 3,000 clinical providers (including 1,100 PCP’s), and over 448,000 attributed Medicaid lives. Today, CCB remains active as a coalition of over 1,000 Brooklyn-based health providers and community partners.
CCB Under DSRIP
At the onset of the DSRIP program, the New York State Department of Health created dozens of projects for PPSs to choose from. CCB’s choices were informed by a Community Needs Assessment, which identified the main health and health service challenges facing communities in Brooklyn. The projects for which CCB saw the greatest opportunities for growth were:
- Creating an integrated delivery system
- Addressing drivers of potentially preventable ED utilization
- Improving care transitions to reduce 30-day readmissions
- Proactively supporting high-risk patients
- Integrating behavioral health services into primary care
- Designing and implementing evidence-based strategies for adults with cardiovascular disease
- Expanding asthma home-based self-management programs
- Integrating palliative care into primary care
- Strengthening mental health and substance abuse infrastructure across systems
- Increasing access to and retention in HIV care
- CCB utilized DSRIP funding to further leverage clinical and technological infrastructure to establish an integrated system of care across a broad range of medical, behavioral and social sectors and to improve care coordination and communication among providers throughout the borough and enhance population health management for the most complex patients.
- Serving as the largest PPS in Brooklyn for the duration of DSRIP, with a scalable governance model and 4,600 physicians, including 1,600 primary care doctors, and 650,000 attributed patients
- Expanding the reach of the Department of Population Health and clinical and transitional care programs at Maimonides
- Providing technical assistance for 138 primary care sites and 400 PCPs to achieve PCMH recognition
- Reducing avoidable hospitalizations by 30%+ over 5-year period
- Implementing programming to improve patients’ quality of care in palliative care, asthma, and cardiovascular disease
- Reducing ED and inpatient utilization through the implementation of transitional care teams
- Engaging the healthcare workforce by training over 1,500 staff from 156 organizations in over 50,000 hours of training.
- Studying and addressing social determinants of health in Brooklyn with over 170 students conducting participatory action research, with findings that resulted in the creation of fitness and education programs and a hydroponic farm, in addition to other community programs
- Helping partners access tens of millions in Capital Restructuring Financing Program funds for critical projects
- Generating revenues of more than $336 million for reinvestment in Brooklyn
- Supporting provider network’s transition to value-based contracting