Case study

The Client

A nonprofit Performing Provider System (PPS) created as part of a New York State Medicaid redesign. The Client works with partner organizations to implement Delivery System Reform Incentive Payment (DSRIP) programs that enhance population health services to nearly 300,000 people in eight counties across New York State.

Location

Upstate New York

Category

DSRIP

Employees

35

The Situation

The Client needed to develop resources that would maximize its partner organizations’ Medicaid reimbursement plans. Specifically, The Client’s goal was to implement value-based payment options, enhance population health services, and deliver performance metrics.

The Challenge

As a newly formed PPS in Upstate New York, The Client was still in the process of adopting and adapting to New York State-sanctioned programs and guidelines. Without much experience as an official PPS, The Client needed input from a third-party team of experts that could consult with its leadership team, develop implementation plans, and support the progress of its newly formed organization.  

The Solution

The Client sought expert consultation services from Blount Consulting Services (BCS). As partners in DSRIP implementation, we led the development of value-based payment assessments and initial strategies, supported the development of population health strategies, and optimized performance payments—all in compliance with New York State guidelines. 

 

Additionally, we collaborated with The Client’s leadership team to create hospital and behavioral health programs that led to a total system transformation. In conjunction with the executive team, we developed and implemented a sustainability strategy for continued transformation of the delivery system for Medicaid patients

 

 The Client’s network of 11 DSRIP programs.

The Result

The Client’s PPS soon entered the high-performing pool for payment. With a newly strengthened position to become a management services organization (MSO), The Client is now capable of transforming Medicaid payment and reimbursement plans for a growing community of healthcare partners and their patients. 

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