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DSRIP: An Opportunity to Implement Recommendations of the North Country Health Systems Redesign Commission

The emerging Performing Provider System’s (PPS) vision is to realize the primary recommendation of the North Country Health Systems Redesign Commission (NCHSRC), “to ensure that New Yorkers in the North Country achieve high quality care, better health outcomes, and lower costs, both now and into the future”. When New York State DOH Commissioner, Nirav R. Shah, M.D., M.P.H., announced the formation of the NCHSRC, he charged the Commission with a goal “to create an effective, integrated health care delivery system for preventative, medical, behavioral, and long term care services to all communities throughout New York’s North Country.” This is the same overarching goal of the emerging PPS.

The Commission points to an integrated approach that “emphasizes prevention, increases primary care, builds more community-based options, strengthens coordination and communication, supports critical safety net providers, monitors and rewards quality, and builds affiliations and partnerships that achieve these goals in a cost efficient and fiscally sound way”. The PPS proposes a set of DSRIP projects that will make real the integrated approach to delivery system redesign that the Commission recommends.

The main objective of DSRIP is to reduce avoidable hospital use by 25%. To get there, the emerging PPS will create the appropriate infrastructure and care processes needed to promote efficiency and to support prevention and early intervention. Goals include: (1) expand primary care, (2) integrate care through the cooperation of inpatient, outpatient, institutional, and community-based providers, (3) improve communication and coordination across settings of care, and (4) expand community-based options, and (5) educate providers, patients, and communities about palliative care and hospice options.

To date, over 100partners are involved in the planning; AHI cast a wide net and invited all public and private health care organizations to the planning table. The breadth and depth of partners at the planning table lends itself to formation of a sustainable new network.

The PPS will work to leverage, and reconfigure where needed, existing infrastructure to support the DSRIP plan. This includes hospital and nursing home infrastructure, as well as health information technology. HIT readiness for performance based contracting will be assessed, and the PPS will seek to build on existing HIT infrastructure as part of a long-range regional HIT plan. Similarly, the PPS will work closely with the Hudson-Mohawk Area Health Education Center to ensure a long view of workforce development is paired with short-term needs for training. The PPS will be sustainable in part because it will be grounded in long-range strategic planning for facilities, HIT, and workforce. Another key facet of sustainability will be the ability of the PPS to negotiate contracts with Managed Care Plans.