A key component of the American Health Care Act (AHCA) being debated in Congress is a reduction in Medicaid spending. The ACHA aims to cut back the Medicaid enrollment expansion that resulted from the passage of the Affordable Care Act (ACA) in 2010. Whether an eventual new health care law includes such cutback provisions, one thing is clear: controlling Medicaid costs will be an ongoing area of concentration for federal and state governments.
The focus on cost-saving will put more emphasis on programs like the Delivery System Reform and Incentive Payment program (DSRIP) now in place in six states. According to the Centers for Medicare and Medicaid Services (CMS), the goal of DSRIP is to “promote community-level collaborations and focus on system reform, specifically to achieve a 25 percent reduction in avoidable hospital use over five years.” Accomplishing the goal means providers must collaborate to implement “system transformation, clinical improvement, and population health improvement.”
Meeting these aggressive targets is going to be challenging and will require providers to rely heavily on technology. Here are three areas where technology will be a key factor in meeting the goals of DSRIP.
One of the most important programs in the New York State DSRIP and one that will be replicated in other states is the development of Integrated Delivery Systems. These networks of health care organizations reduce the reliance on hospitals as the primary care location. Instead, patients are directed to other facilities such as walk-in clinics that are more appropriate for their immediate need. The result is reduced overall costs.
Technology is key to establishing these networks since it requires an IT infrastructure that integrates the members’ systems. The group needs to be able to share EHR data and other crucial information to ensure proper, effective and safe care throughout the network.
To measure improvements and track the effectiveness of DSRIP programs, organizations need to be able to collect, analyze, and report on detailed performance data. This requires data management and reporting capability that may not be available in legacy systems. Providers must conduct an assessment of their IT infrastructure to ensure they have the hardware and software required to meet these requirements.
For DSRIP to be effective, organizations are going to have to view technology not simply as a requirement, but as a key driver of success in the program. Organization leaders must understand that technology is not simply a cost, but is instead an investment that will help ensure DSRIP can accomplish its goals. Automating workflows and eliminating time consuming manual processes through advanced technology will provide significant payback that will justify the expense in the long term.
DSRIP offers a solid pathway to better manage and reduce Medicaid costs. However, true success of the program requires the proper implementation and use of healthcare technology.
CTEK can support your DSRIP initiatives through our healthcare technology solutions, which are designed to support DSRIP domains and enhance integrated delivery systems. Our solutions can help DSRIP PPS organizations create the backbone they need for their key systems and drive usability and performance from administrative and support staff to doctors and nurses.
Whether it’s upgrading a communication system or modernizing a hospital’s network infrastructure, CTEK has experience in all stages of healthcare IT – from purchasing to implementation.