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Medicaid Managed Care and DSRIPs: Current Approaches, Future Considerations

September 19, 2016
Erin O'Malley

A new policy brief by America’s Essential Hospitals provides an overview of the current landscape and future considerations for Medicaid managed care and Delivery System Reform Incentive Payment (DSRIP) programs.

DSRIP and Medicaid managed care programs have been used in recent years to drive cost savings and efficiencies, but so far the two have largely not been coordinated.

The Centers for Medicare & Medicaid Services (CMS) is seeking to further align these policy approaches to drive delivery system reform. Early efforts to integrate DSRIP programs with managed care focused on increasing the sustainability of reforms.

Meanwhile, approved and pending DSRIP programs are beginning to require shifts of managed care  patients into alternative payment models, including waivers in California, New Hampshire, and
New York. Managed care pathways might serve as a potential complement to waiver-based delivery system reform.

Contact Director of Policy Erin O’Malley at eomalley@essentialhospitals.org or 202.585.0127 with questions.

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