Implications of the Latest Round of Delivery System Reform Incentive Payment Waivers

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September 2017

Delivery System Reform Incentive Payment (DSRIP) programs, first implemented in 2010 under Section 1115 waiver authority, provide incentive payments to providers that take on value-based delivery system reform projects. They are currently approved in 13 states. MACPAC reported on DSRIP programs in its June 2015 Report to Congress on Medicaid and CHIP, and conducted a follow-up study between August 2016 and August 2017.

This presentation reports on MACPAC’s follow-up study, which finds that newer DSRIPs do not rely as heavily on supplemental payments. Instead, the newer programs increasingly use state health program funds that cover broader public health needs.  In addition, new waivers have had a greater focus on statewide delivery system reform goals and on social determinants of health. The DSRIP experience raises questions about how states could support delivery system reform efforts in managed care, and how Medicaid could align with other payers.

Publication Type: Presentations

From: September 2017 MACPAC Public Meeting

Tags: delivery system reform, financing, hospitals, managed care, payment, supplemental payments, waivers