Texas is just one of many states currently implementing more innovative programs that are helping reform the way healthcare is delivered and paid for, especially for Medicare and Medicaid reimbursements. Delivery System Reform Incentive Payment (DSRIP) Waivers are one of these payment programs.

Part of the Section 1115 Waiver programs, DSRIP initiatives give states more comprehensive funding to support hospitals and other providers that have a higher number of uninsured or underinsured patients. Texas was one of the first states to approve and implement DSRIP initiatives, which are currently in place for many key programs at Seton Healthcare Family.

Care Based on Quality

One of the primary ways that DSRIP initiatives change the healthcare system is by tying funds to performance metrics rather than patient volume. Although specifics differ for each provider, the process follows four stages:

  1. Infrastructure development is the first step toward better healthcare. Infrastructure that will properly support the desired changes must first be planned and developed.
  2. System redesign is the second process that must be planned out. With the right infrastructure already in place, providers can then look for a more efficient way to deliver the best care.
  3. Clinical outcome improvement is a metric that can be measured to show positive impacts as the first two stages take effect and cause patient outcomes to improve.
  4. Population focused improvements look at the broader milestone that ties back into the big picture: keeping people healthier through end-to-end care.

Seton first had to define the solutions and services that would be best for meeting the unique needs of those who benefit most from the DSRIP program. Robust data collection is an essential part of meeting these milestones.

However, more than simply reporting on outcomes, Seton uses data collection to both track the way care management is coordinated, and improve those methods when needed. Over time, these metrics can see steady improvements as the changes that were put into action take full effect, as seen in our DSRIP case studies.