Amount Expected to Exceed $1 Billion over Five Years
May 28, 2015 – Millions of dollars earmarked for improving the health of those who live in the Bronx, the least healthy county in New York State, arrived today.
The four Performing Provider Systems (PPSs) who have been tasked with improving quality, expanding access, lowering costs and transforming the healthcare delivery system of the Bronx, received their first installments in payments that are likely to exceed $1 billion dollars over the next five years.
This marks the first time that competing healthcare systems are coming together to coordinate resources, align goals and collaborate on projects with the goal of changing the health of the Bronx, which ranks 62 out of New York State’s 62 counties when it comes to lifestyle and health outcomes.
These consortiums are comprised of hospitals, nursing homes, community-based organizations, ambulatory health care facilities, home care agencies, physician groups, behavioral health/ substance abuse organizations, and health insurance plans. They have been collaborating since their establishment a year ago to help align project selection and implement strategies that will allow them to drive change and achieve outcomes.
The four countywide PPSs are Bronx Partners for Healthy Communities, with SBH Health System (St. Barnabas Hospital) as the designated lead applicant; Bronx-Lebanon Hospital Center; “OneCity Health,” the New York City Health and Hospitals Corporation-led PPS; and Advocate Community Providers, the only physician-led PPS in New York State.
Initial payments to the PPSs are based on numbers of Medicaid beneficiaries and their use of the system. Later payments will be based on demonstrated patient engagement and improved outcomes for beneficiaries.
The allocation is part of the Delivery System Reform Incentive (DSRIP) program, which was established to provide funding for public and safety net providers. With the mission of “Better Health, Better Health Care, Lower Cost,” DSRIP’s overall goal is to reduce avoidable hospital admissions by 25 percent by 2019. The program intends to do this by transforming the healthcare delivery system from one that is based on volume in terms of the number of patients seen, to one of value, which is based on care management, primary care and systems-wide collaboration in order to improve patient outcomes.
The infusion of DSRIP monies into the Bronx to transform its healthcare system is also likely to have a positive effect on the county’s economy. Implementation of the projects developed by the PPSs is expected to result in the creation of thousands of additional jobs throughout the Bronx.
“The infusion of these cost saving dollars into The Bronx is exciting,” said Bronx Borough President Ruben Diaz Jr. “Our county has become the model of collaboration and cooperation with regards to our healthcare system and status. I am proud of our hospitals, health centers, healthcare plans, community based organizations, neighborhood doctors, and most importantly, of our constituents who have all joined our #Not62 campaign aimed at improving the overall health status of our borough by addressing the social determinants of health. This funding speaks directly to the goals of the #Not62 campaign, and will play a key role in our continuing efforts to make The Bronx a healthier place.”
Projects were determined and approved by the state based on an assessment of the needs of the communities conducted jointly by the PPSs. They focus on better integration of the healthcare delivery system, the integration of primary care and behavioral health, chronic care management, and population health.
The four PPSs cover different regions of the Bronx, which has a population of close to 1.5 million residents. One third of the county’s population lives in poverty and its unemployment rate is 12 percent. It has the highest rates of Medicaid coverage in the state, as well as the highest rates of pre-term births, HIV infection and premature death.
The Bronx has a high rate of chronic disease, including diabetes, and cardiovascular and respiratory disease, as well as obesity. It accounts for 22% of asthma hospitalizations and the county’s diabetes mortality rate is 60% higher than the state’s rate. Close to a third of Bronx residents are immigrants, resulting in language and cultural barriers. The Bronx is a medically underserved area, with almost half of its residents living in a federally designated Health Professional Shortage Area, and 16% lacking health insurance (pre-Affordable Care Act implementation).