DSRIP Program: Transforming the Healthcare Delivery System in New York State

1. DSRIP & Bronx Partners for Healthy Communities: An Overview Developed by the BPHC Project Management Office 1

2. Overview New York State (NYS) received federal approval to implement a Delivery System Reform Incentive Payment (DSRIP) program that will provide funding for public and safety net providers to transform the NYS health care delivery system. Goals: (1) Achieve the Triple AIM :Better Health, Better Health Care, Lower cost (2) Transform Delivery and payment system to incentivize value over volume (3) Ensure delivery system transformation continues beyond the waiver period through managed care payment reform Key Program Components: Statewide funding initiative for public hospitals and safety net providers Only coalitions of community/regional health providers are eligible DSRIP projects based on a menu of interventions approved by CMS and NYS Payments to providers based on their performance in meeting outcome milestones and state achieving statewide metrics Additional information about the NY State DSRIP program can be accessed here: https://www.health.ny.gov/health_care/medicaid/redesign/delivery_system_reform_incentiv e_payment_program.htm 2

3. What is Bronx Partners for Healthy Communities (BPHC)? BPHC is an emerging Performing Provider System in the Bronx led by SBH Health System. This PPS currently consists of: 3 160 Unique Organizations 780 Total Locations/Sites 5 Assisted Living Facility Locations 19 Certified Home Health Agency Locations 33 Diagnostic & Treatment Center Locations 32 Federally Qualified Healthcare Center Locations 10 Long Term Home Health Care Provider Locations 13 Nursing Home Locations 23 OASAS (Article 32) Provider Locations 78 OMH (Article 31) Provider Locations 8 OPWDD (Article 16) Provider Locations 19 Skilled Nursing Facility Locations 9 Sole Community Provider Locations 2 Voluntary Hospitals (33 Locations) 501 Other (i.e. Housing, Hospice, Community Based Organizations, LHCSA, etc.)

4. SBH As Lead Applicant SBH Health System has received the support and approval to serve as the lead applicant from founding members and the BPHC Steering Committee. Founding Members Acacia Network Bronx United IPA Institute for Family Health Montefiore Medical Center Morris Heights Health Center Puerto Rican Family Institute SBH Health System Union Community Health Center BPHC Steering Committee 1199 SEIU Healthcare Workers East Acacia Network Bronx United IPA Centerlight Health System Institute for Family Health Montefiore Medical Center Morris Heights Health Center Puerto Rican Family Institute SBH Health System Union Community Health Center Visiting Nurse Service of New York 4

5. BPHC Geographic Region The Entire Bronx Borough Population: Culturally vibrant community with population of ~1.5 million Medicaid Coverage: Highest rates of Medicaid coverage in the State (59% of Bronx residents over the course of a year) Population Health: Though the Bronx represents only 7% of the States population, it accounts for 22% of asthma hospitalizations and the diabetes mortality rate is 60% higher than the States rate Social Factors: Poorest county in New York State with approximately 30% of residents living in poverty, and a 12% unemployment rate. Over a third of the population has unaffordable or inadequate housing.

6. Project Advisory Committee Structure and Processes Steering Committee Business Operations Committee (BOC) IT & Analytics Finance Workforce Development Clinical Delivery and Program Planning (CDPP) Committee Care Management and Care Transitions CVD/Asthma/Diabetes Primary Care/Behavioral Health Integration Population Health SBH acts as the fiduciary to the State SBH Steering Committee approves all plans brought forward by BOC and CDPP Clinical work groups draft project plans to be reviewed by CDPP Together, the Steering, BOC, and CDPP Committees form the PAC Business O perations work groups* draft plans for the development of centralized services support and infrastructure The Project Advisory Committee acts as the planning governance for BPHC. *45 organizations are represented on work groups. There is a total of 113 members across the 7 work groups. 6

7. Clinical Work Groups and DSRIP Project Assignments Clinical Work Group DSRIP Projects ED care triage for at-risk populations Health home at-risk intervention program Care transitions intervention model to reduce 30 day readmissions for chronic health conditions Care Management & Care Transitions Integration of primary care and behavioral health services Primary Care/ Behavioral Health Integration CVD/Asthma/Diabetes Evidence-based strategies for disease management for cardiovascular health Evidence-based strategies for disease management for diabetes Population Health Expansion of asthma home-based self-management program Strengthen mental health and substance abuse infrastructure across systems Increase early access to and retention in HIV care 2.a.i 2.a.iii 2.b.iv 3.a.i 3.b.i 3.c.i 3.d.ii 4.a.iii 4.c.ii

8. May 15 Letter of Intent due June 26 Design Grant Application due December 16 DSRIP Project Plan Application due DSRIP Project Planning Timeline (Year 0) May 2014 August 2014 December 2014 August 6 Design Grant Awards made November 14 State releases final electronic DSRIP Project Plan Application Project Planning April 2015 April 1 DSRIP Year 1 begins Early March DSRIP Project Plan Awards made January 20 Public comments due on DSRIP Project Plan applications NOTE: Timeline may change at States discretion. September 22 State releases draft DSRIP Project Plan Application and Application Review Tool August 31 State makes baseline data for DSRIP measures available Early Sept. Initial PPS Attribution Logic Run for PPS* Mid-Nov. PPS to submit final Network Lists Late Nov.-Early Dec. Final attribution will be made available to PPS Red text=Pending State deliverables *Date likely to be delayed October 22 Public comments due on draft DSRIP Project Plan application