Medicaid Delivery System Reform Incentive Payment waivers, unleashed by the Affordable Care Act and other Obama administration initiatives, sought to foster a greater focus on value in the delivery of health care.  Medicaid DSRIP waivers typically provided new Medicaid funds to health care organizations that met performance goals for improving the quality of care, improving health care outcomes, and improving health care infrastructure in ways that improved care quality and outcomes.  To a significant extent, early DSRIP programs helped protect Medicaid payments to hospitals that were jeopardized by hospital-specific and state-wide upper-payment limit problems.

State DSRIP initiatives are now moving in another direction – away from supplemental funding and toward different approaches and objectives.  The latest generation of DSRIP waivers:

  • are less hospital-oriented and more focused on broader partnerships of different types of providers and not just hospitals;
  • place a greater emphasis on behavioral health; and
  • seek to spread value-based purchasing to a larger portion of Medicaid services, such as those covered by Medicaid managed care organizations and accountable care organizations.

Learn more about how DSRIP programs have evolved in the article “Medicaid Delivery System Reform Incentive Payments: Where Do We Stand?,” which can be found here, on the Health Affairs blog.