Creating a Primary Care Road Map for DSRIP

More than 20 years ago, around the time that the Primary Care Development Corporation (PCDC) started out, Barbara Starfield, a pediatrician and primary care advocate, defined primary care as first-contact, long-term, person-focused (not disease focused), comprehensive, and coordinated care. Even then, U.S. and international public health evidence was clear: countries with strong primary care had lower overall costs, generally healthier populations, and greater health equity.

Yet, despite this evidence, less than 10 percent of the $3 trillion spent annually on health care in the United States goes toward ensuring that primary care is well funded, with a sufficient provider supply, and easy access for all. It is a costly and underperforming system.

But with DSRIP’s enormous challenge, it’s possible to lose focus on what “transformation” means at its core: a robust, accessible, person-centered, high-quality, and cost-effective state-wide primary care system.

Across the country, innovative delivery and payment system reforms are being tested by states, insurance companies, and the federal government to address deficiencies in quality, cost, and accessibility of care. In recognition of its unique ability to improve health outcomes and equity while simultaneously reducing costs, primary care is being called on to shoulder much of the weight of this transformation.

Take, for example, New York State’s Medicaid Delivery System Reform Incentive Payment program (DSRIP), which aims to reduce avoidable health care costs by creating new integrated provider systems (mostly headed by hospitals) to collaborate on system transformation, clinical quality, and population health improvement. This $8 billion enterprise is complex, and, if successful, a game changer for the over 6 million Medicaid beneficiaries and 1.2 million uninsured people served by the New York State health care safety net.

But with DSRIP’s enormous challenge, it’s possible to lose focus on what “transformation” means at its core: a robust, accessible, person-centered, high-quality, and cost-effective state-wide primary care system.

That’s why PCDC called for – and New York State is now requiring – DSRIP health care systems to develop and implement “Primary Care Plans.” These plans should include primary care performance, capacity, workforce, and adequate resources.

More than two years in, the New York State DSRIP program is at a critical juncture — each of the 25 integrated systems is required to submit its Primary Care Plan to the state’s Medicaid authority by the end of August 2016. PCDC will be watching closely to ensure that these plans will truly form the foundation for a high performing primary care system. We hope that you will join us.

Read more about PCDC’s Principles for Primary Care, and DSRIP Primary Care Plans.

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