A new analysis of Medicaid Delivery System Reform and Incentive Payment (DSRIP) demonstrations concludes that a strong working partnership between Medicaid and community health centers will prove central to successful reform. DSRIP programs, carried out under the demonstration authority of Section 1115 of the Social Security Act, enable states to test new approaches to health care delivery and payment aimed at improving health care quality and cost effectiveness. Ten states have ongoing DSRIP projects and each is unique; this study focuses on Massachusetts and New York, two national leaders in delivery and payment reform. While it is too early to fully evaluate these projects and their impact on health care cost, quality, and health outcomes, this study provides valuable insight for other states as well as for national policymakers involved in the effort to attain deep and lasting health systems change. The analysis was conducted by researchers at the Geiger Gibson/RCHN Community Health Foundation Research Collaborative at the George Washington University Milken Institute School of Public Health and Viaduct Consulting, LLC.

Several lessons can be drawn from the ambitious DSRIP Implementation experiences in the two states:

• Medicaid and community health centers share a mission and are mutually dependent. Because delivery and payment reform turn on high-value primary care integrated with social services, health centers play a central role.
• Local conditions and circumstances influence the ways in which health centers become part of DSRIP experiments. In each state, community health centers have assumed leadership roles, although in distinctly different ways.
• A strong working partnership between Medicaid and community health centers can produce important benefits relevant to payment reform, since a carefully designed policy partnership creates an opportunity to strengthen health center performance while also testing alternative payment models.

Successful health care delivery transformation hinges on a strong base of comprehensive primary care. While New York and Massachusetts differ in approach, the DSRIP experiences in each state illustrate the singular importance of health centers in advancing health care quality and improving population health.

The report, “Community Health Centers and Medicaid Delivery and Payment Reform: A Closer Look at Massachusetts and New York” is now available on our website.

Read the full report here.