Description

This report examines New York’s experience implementing its DSRIP waiver to identify emerging issues enabling or impeding Medicaid transformation. Findings are informed by two rounds of interviews: the first with federal and state officials and thought leaders from national health care organizations, and the second with New York stakeholders involved in on-the-ground implementation efforts, including leaders from provider entities, health care trade organizations, and health plans. This report focuses on five areas that have broad implications for stakeholders pursuing Medicaid-driven delivery system reform, with or without a DSRIP waiver: organization, governance and market transformation; care model and social determinants of health; data-sharing and analytics; measurement and accountability; and value-based payment (VBP) arrangements and sustainability. Across each of these topics, the authors describe the New York approach, assess early successes and challenges, and identify how New York’s experiences can influence new state payment and delivery system reform initiatives.