More than $335M was spent to cut Medicaid costs in WNY. Did it work? – Buffalo Business First

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Curator summary

The impact of NY DSRIP in Western New York is examined, and found to have decreased preventable hospital admissions by 35%, but the impact on ER visits was not quantified.

 
 

Clipped from: https://www.bizjournals.com/buffalo/news/2020/11/11/medicaid-costs-western-new-york.html

It’s been five years since state health officials announced New York would pump $335 million into Western New York to help area hospitals and health care providers cut Medicaid costs.

The goals were clear: reduce unnecessary emergency department visits and the number of readmissions within 30 days of discharge. Groups of providers had no choice but to work together if they wanted to reap the financial benefits of the Delivery System Reform Incentive Payment (DSRIP) program.

Statewide, health care officials called the $8 billion program a success. Preventable hospital admissions dropped by 21%, and readmissions went down by 17% through June 2018.

Though emergency department visit reductions didn’t quite reach the same threshold in Western New York, local health care leaders say hospital readmissions dropped by 34.5% over the five years. While they can’t estimate how much was saved on events that never took place, it’s clear there were savings.

“It’s hard to say, because we know there are different reimbursement models that pay at different rates, but when you’re avoiding an ER visit, you’re saving thousands of dollars,” said Amy White Storfer, director of Community Partners Western New York which is affiliated with Catholic Health and one of two provider systems that organized providers and distributed the DSRIP funds. The other is Millennium Collaborative Care, affiliated with Erie County Medical Center Corp.

Just before the Covid-19 pandemic hit New York, the federal government rejected a state request for a four-year extension. Though the program expired March 31, providers are required to continue to measure outcomes March 31, 2021.

Ann Monroe, one of two co-chairs overseeing the DSRIP program and the state’s Medicaid reform effort, said five years wasn’t enough.

“My concern now is that while collaboration was made much stronger, that was in a time of resource plenty and we are now moving into a time of resource scarcity,” Monroe said. “Maintaining the progress made between and among organizations will be much harder in the next few years. I think the temptation is to hunker down and defend one’s organization during a dark time and that would be the antithesis of what we will really need in the next few years.”

ECMC’s COO Andy Davis is interim executive director at Millennium. He said financial savings were important, but the new, strong relationships between hospitals and community-based organizations are invaluable. Many executives had never spoken to each other before the DSRIP meetings.

“We saw that particularly during the height of Covid in the spring when we were able to flow some of those dollars to testing with community partners,” he said. “If we didn’t already have that community collaboration, we wouldn’t have been able to do that.”