[NYAPRS Enews] Crain's: PPS' Prepare 'Mini-Bergers'

[Briana Gilmore]

NYAPRS Note: The below article nicely highlights the difficulties in pulling together Performing Provider Systems in DSRIP. As providers who are continuously seeking new ways to emphasize recovery know, asking these questions of yourself and internal to your own agency are difficult enough. Asking how your agency can change to be more effective at a table in front of your oldest competitors is another challenge altogether.
In the end, there is a lot to win. Not only financially, but for the system as a whole. If hospitals can repurpose existing-but ultimately unnecessary-facilities into housing, crisis respites, or even a medical village as one of the proposed projects indicates<http://www.health.ny.gov/health_care/medicaid/redesign/docs/strategies_and_metrics_menu.pdf>, community members stand to benefit more from DSRIP than from any single other transition the state is currently facing.
As the article notes, the financial implications for systems transformation are tremendous. Risk and loss are on the minds of every major system in emerging DSRIP partnerships. Progressive agencies will seize the enormous opportunity; others will try to game the new system and eventually lose.
If you're still wondering where you stand and how DSRIP will continue to play out in your community, join state agency leads Greg Allen, Bob Myers, and Rob Kent for a workshop on 9/17 at the Annual Conference to learn more and partake in meaningful dialogue. Still not registered? Hurry! Only a few days left!<https://rms.nyaprs.org/event/?page=CiviCRM&q=civicrm/event/info&reset=1&id=13>

New Networks Prepare 'Mini-Bergers'
Crain's New York Business; 9/10/2014


Over the coming months, performing provider systems will be feverishly working on community needs assessments for their nascent networks. These assessments are critical, and not just because they are the basis on which providers will choose DSRIP projects for their PPSs. Providers must also use these assessments to nail down which New York hospitals will close, downsize, restructure or be transformed into community housing. If that isn't a tough enough task, the state wants competitors to work together to make those difficult decisions by mid-December.

In essence, the state "is asking each PPS to do a mini-Berger and come up with a plan," said a consultant, who asked not to be identified, referring to the Berger commission on hospital restructuring.

The state gave specific instructions on its expectations in a webinar recently posted on the state Department of Health website, the second of two webinars<http://www.health.ny.gov/health_care/medicaid/redesign/dsrip_webinars_presentations.htm> on community needs assessments.

The state directed PPS applicants to understand the financial implications of the changes they proposed to make. PPSs must specify reductions in bed capacity and how they plan to trim excess tertiary-care services.

"How will PPS facilities address the expected reduction in hospital service use [emergency department and inpatient services, including reduction in excess bed capacity] and financially maintain appropriate tertiary care services?" the state asked in its presentation to DSRIP applicants, online here<http://www.health.ny.gov/health_care/medicaid/redesign/docs/dsrip_community_needs_assessment_webinar_slides_part2.pdf>. "What is the potential for repurposing redundant facilities? What would be required to repurpose? Are there other community nonhealth needs that could be addressed, such as housing?"

Answering such questions is a tall order in the few months left before the applications are due; the Berger commission studied communities in depth over months before making its recommendations. It also had power to force downsizing, while the PPS networks must cooperate if they hope to access DSRIP funding. Many in the health care industry say that it is proving very difficult for providers to work together, let alone decide soon which institutions must close, downsize or restructure.

"We are asking hospital systems in competition forever to put aside their fundamental distrust and work together," continued the consultant. "That is asking a lot."
http://www.crainsnewyork.com/article/20140910/PULSE/140909834/new-networks-prepare-mini-bergers
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