Delivery system innovation and collaboration: A case study on influencers of preventable hospitalizations

ABSTRACT

The fiscal pool that funds Delivery System Reform Incentive Payment (DSRIP) projects has four interlinking categories, Categories I – IV. DSRIP that was adopted in nine counties of southeast Texas detected a decrease in Preventable Hospitalization (PH) rates formulating the problem statement: What were the proposed factors that influenced the detected decrease? The article is a delineation of the presumable influencers within DSRIP that may have resulted in decrease in PH rates, those likely being physician-hospital collaboration, mechanisms of reimbursements, types of measures leveraged to report quality initiatives and interplaying healthcare externalities within the implemeted counties. The paper explains functioning of the four aforementioned influencers, examines how those may have impacted DSRIP and thereafter elucidates mechanisms these influencers in a detailed discussion. Physician-hospital collaboration propagated relationship centered care geared towards patients. State reimbursements provided a fiscal ballast to initiate and continue DSRIP activities. DSRIP’s Categories itself were designed in a systematic way so as to procure health outcomes in a continual process. And lastly, interplaying healthcare externalities such as the presence of Medicaid Managed Care/Health Maintanence Organizations may have impacted patient health in the implemented areas. At large, DSRIP may have exemplified coordination of physicians, administrators and the state so as to likely procure outcomes in healthcare quality as described herewith.

KEYWORDS:

• Delivery System Reform Incentive Payment (DSRIP) program
• provider-hospital collaboration
• outcome reporting measures in healthcare quality
• state reimbursement for healthcare initiatives
• physician-management collaboration
• influencers of a policy program
• mechanisms of policy influencers

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes on contributors

Dr. Amrita Shenoy is Assistant Professor of Healthcare Management at the University of Minnesota Crookston and the Winner of the 2011 McGraw-Hill/Irwin Distinguished paper Award. Her research areas spotlight topic in public health and public policy with a broad emphasis in healthcare management. She leverages econometric techniques to analyze policy impact.

Dr. Charles Begley is Professor of Management, Policy, and Community Health at the University of Texas School of Public Health and Co-Director of the Center for Health Services Research. His research interests include performance of healthcare safety new systems, the economics of chronic disease prevention, and healthcare reform.

Dr. Lee Revere is Associate Professor of Management, Policy and Community Health at the University of Texas School of Public Health and the Director of the George McMillan Fleming Center for Healthcare Management. Her research focuses on applied managerial methods in the fields of healthcare quality, process improvement and quantitative decision-making.

Dr. Stephen Linder is the UT System Distinguished Teaching Professor in the Department of Management Policy and Community Health and the founding Director of the Institute for Health Policy at UT Health School of Public Health in Houston. He is also the Associate Director of the TMC Health Policy Institute.

Dr. Stephen P. Daiger is the Matney Professor and Johnston Distinguished Chair, School of Public Health and Ruiz Dept. of Ophthalmology, The Univ. of Texas, Houston. His research is in the genetic epidemiology of Mendelian Diseases and he directs a CLIA Certified DNA Diagnostic Laboratory for inherited eye diseases.