A recent research project by the National Academy of State Health Policy (NASHP) and the Medicaid and CHIP Payment and Access Commission (MACPAC) explored the evolution of Delivery System Reform Incentive Payment (DSRIP) programs.

DSRIPs and similar programs allow states to direct Medicaid payments toward provider-led efforts to improve quality and outcomes while reducing costs. Since 2010, 12 states have implemented such programs. DSRIP programs are authorized through section 1115 waiver authority and require approval from the Centers for Medicare & Medicaid Services.

As part of the project, NASHP and MACPAC released reports exploring trends that set recently approved DSRIPs apart from earlier demonstrations, including:

  • shifts in program goals, from preserving supplemental payments to further delivery system reform goals;
  • increased use of statewide performance milestones;
  • leveraging provider partnerships;
  • different financing methods, including designated state health programs;
  • increased standardization in monitoring and evaluation; and
  • development of plans to sustain DSRIP activities through managed care.

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