Creating a Primary Care Road Map for DSRIP

Categories: Policy
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Louise silo

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.

About the author:

Louise Cohen, MPH, Chief Executive Officer

Phone: 212-437-3917Email: Louise Cohen is the Chief Executive Officer of the Primary Care Development Corporation (PCDC), a not-for-profit community development financial institution dedicated to expanding and strengthening the primary care safety net in the United States. PCDC provides capital and technical assistance to a wide variety of primary care providers, and advocates for improved and increased primary care access, capacity, quality, reimbursement, and capital resources in order to improve health outcomes, create healthier communities, increase health equity, and reduce overall health care system costs. Prior to assuming leadership of PCDC, she was Vice President for Public Health Programs at Public Health Solutions in New York City (2011-2015), where she oversaw a variety of programs to improve community health through food access and nutrition, women’s reproductive health, tobacco control, and child development. Ms. Cohen held successive leadership positions at the New York City Department of Health and Mental Hygiene (DOHMH) from 1998-2011, including as Deputy Commissioner of the Division of Health Care Access and Improvement. Among her accomplishments at DOHMH, Ms. Cohen led the development and execution of Take Care New York, New York City’s first comprehensive health policy agenda. She also oversaw the Primary Care Information Project, which brought a public health and prevention-oriented ambulatory care electronic health record system to more than 2,500 primary care providers. Before her tenure at DOHMH, Ms. Cohen was Director of the Park Slope Family Health Center (now part of the NYU Lutheran Family Health Centers network). She served on PCDC’s Board of Directors from 2011 until she became CEO.