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Medicaid Incentive Programs: Hospital Perspectives from Three States

Part of the association’s comprehensive Section 1115 Medicaid waivers program, Essential Hospitals Institute has summarized the in-depth perspectives of leaders from three hospitals working with waivers: Boston Medical Center in Massachusetts, Santa Clara Valley Medical Center in California, and UT Health Northeast in Texas.

Research Brief – Medicaid Incentive Programs: Hospital Perspectives from Three States


  • Section 1115 Medicaid waiver incentive programs provide essential hospitals with vital resources for initiating delivery system transformation.
  • Engaged leadership is crucial to navigating culture change, promoting the importance of waiver programs across the organization, and laying the groundwork for ongoing improvement efforts.
  • Collaboration among clinicians and community-based organizations is critical to the success of DSRIP/DSTI programs.
  • Despite the challenges of having to report on new metrics, DSRIP/DSTI programs have encouraged hospitals to better integrate their data systems.
  • Delivery system transformation can be accelerated by leveraging existing infrastructure to create new systems and processes.
  • Waiver transformation often transcends specific projects to further the overall improvement of system processes and patient care.


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