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DSRIP

Improving care management is at the heart of our Delivery System Reform Incentive Payment (DSRIP) solution.

Achieving Success in NY DSRIP

Crain’s New York Ask the Expert

Related Resources:

 

Insights from the NY DSRIP Mid-Point Assessment: Areas of Focus, Improvement, and the Path Forward

 

Catholic Health Serivces of Long Island Selects xG Health Solutions

 

Components of the DSRIP Workforce Training Strategy

 

Should a PPS Set Up a Hybrid Care Management Organization (CMO)?

 

Amplifying DSRIP Care Manager Productivity and Effectiveness

 

 

The Delivery System Reform Incentive Payment (DSRIP) program is a federally sponsored, pay-for-performance initiative designed to achieve the Triple Aim.

 

DSRIP programs provide incentive payments for providers who undertake transformation projects that achieve predefined performance metrics and outcomes. Many states are implementing these programs, and our DSRIP team has an established track record of helping providers succeed under DSRIP.

 

Effective care management is integral to success under DSRIP because it drives reduced inpatient and emergency department use while improving quality of care. Your DSRIP program depends on having a well-trained, well-staffed care management team, empowered by tested tools, workflows, and analytics to achieve DSRIP metrics.

 

Our DSRIP interventions are powered by decades of experience and proven outcomes achieved at Geisinger. We have replicated Geisinger success with other clients nationwide, accelerating their journey to deliver better care at reduced costs. With this experience, we can help you meet the robust data collection and reporting requirements imposed on performing provider systems (PPS).

 

We also understand the challenges associated with setting up your PPS team.

 

A PPS needs a team of its own, but how should it be staffed? What is the optimal staffing mix and ratios? What caseload should each case manager carry? Should the PPS develop an internal care management organization to complement what exists in the county? Where should RNs and social workers be embedded? What workflows are needed to manage patients collaboratively with medical homes and MCOs?

 

We help our DSRIP clients address these issues with a design blueprint for care management that accounts for structure, process and standards, technology interfaces, and culture change. We then help you establish your PPS team—we know what makes a good care manager and can accelerate the hiring and training processes.

 

We can screen, interview, hire, manage, train, evaluate, and optimize your care management team. We also can provide Geisinger-trained care management leadership services to supervise or help your PPS team deliver a steady-state care team.

 

Training

 

Our care management training addresses the hard and soft skills your care team needs, but our support goes deeper than any other available in the market today. We provide on-the-job training for your case managers at Geisinger, where they experience immersion in successful medical home sites while working with an experienced Geisinger case manager who shows them how to get the job done. Care managers can get this real-world experience only by sitting shoulder-to-shoulder with a seasoned professional.

 

Workflow

 

After you redesign your care plan and staff and train your care management team, you need to ensure that your plan is productive. Our workflow solutions increase case manager efficiency and effectiveness using xGCare, our intuitive care management workflow and documentation tool for care managers.

 

Clinical Strategy

 

Once your care management blueprint is in place, success requires strong engagement for your practice staff to function at the highest level. We help you get there with strategies such as the following:

 

  • Our advanced medical home model: Developed by Geisinger and tested and refined over many years, with proven effectiveness.
  • Transitions of care strategies: Based on years of experience, we can help you implement strategies such as discharge timeouts, direct communication on discharge by physician/nurse/case manager for high-risk patients, follow-up appointment scheduling with PCP, post-discharge phone calls, and medication reconciliation.

For more information about our DSRIP services, contact Meg Horgan.

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Rocky Edmondson RN, BSN, MBA, CCRN
Senior Director, Bundled Payments, Care Redesign and Management Advisors, xG Health Solutions

Rocky Edmondson is the Senior Director of Bundled Payments for Care Redesign and Management Advisors at xG Health Solutions. Rocky has been involved in workflow redesign, program implementation, and analytic evaluation of Bundled Payment Programs across the country, and he coaches Hospitals, Health Systems, Post-Acute Providers, and Physician Groups on how to successfully implement care redesign in the Bundled Payment for Care Improvement (BPCI) and CJR Programs.

Rocky’s passion is helping people to understand the intricacies of Bundled Payment Programs. He has a talent for teaching people how to cut through all the noise and just do the things that matter to be successful in these programs.

Rocky holds an Associate’s Degree in Nursing from the University of Hawaii Maui, and a Bachelor’s Degree in Nursing and a Master’s Degree in Business Administration (MBA) from Boise State University.

Prior to joining xG Health Solutions, Rocky was the Southeast Region Director of Clinical Operations for Remedy Partners, overseeing program design, implementation and analytic evaluations for Bundled Payment Programs. Prior to embarking on a career in Bundled Payments, Rocky was a Registered Nurse for 18 years, working in a number of positions within Critical Care. Before becoming a Nurse, Rocky was an Institutional Broker at Merrill Lynch and advised a number of healthcare systems and large corporations on cash management strategies. In addition, Rocky has started several businesses and provided consulting for small business startups. Rocky served in the U.S. Marine Corps as a Recon Marine.

Janet Comrey RN, BSN, MHSA
Director, Population Health Solutions, Geisinger Health System

Janet Comrey, RN, BSN, MHSA has over 30 years of diversified nursing and leadership experience at Geisinger Health system and currently serves as Director of a small department embedded within Population Health. One of her key roles is managing the Bundle Payment for Care Improvement (BPCI) program since January 2014 earning an overall positive net payment reconciliation to date. Janet also serves as the coordinator for Project Achieve at Geisinger which is a national PCORI funded study related to patient’s perceptions of transitions of care.

Janet received her nursing education through Geisinger’s diploma program, her BSN through Bloomsburg University, and later earned her graduate degree from Marywood University. During her tenure at Geisinger she taught quality improvement methodology and facilitated improvement teams the Geisinger Quality Institute. She is currently enrolled in the Institute for Healthcare Improvement Advisory program.

Professional memberships include Sigma Theta Tau, Phi Kappa Phi, American Society for Quality.

Andrew Blackmon, MBA, MHS
Chief Sales and Business Development Officer

Chief Sales and Business Development Officer Andrew Blackmon, MBA, MHS, has more than 18 years of experience in healthcare product sales, marketing, and strategy.

Before joining xG Health, Andrew was vice president of sales for population health and risk management solutions at McKesson. He came to McKesson through acquisition of MedVentive, an early population health vendor. Before MedVentive, he served as vice president of enterprise solutions development at MedAssets. He is a past president of the Georgia chapter of HIMSS, and he has held strategy and planning positions at PricewaterhouseCoopers and Orlando Health.

Andrew has an MBA and a Master’s of Health Science from the University of Florida Warrington, College of Business, and a Bachelor of Arts degree in Psychology from Rollins College.

Holly Barbella, RN, MBA

Risk Coordinator, Geisinger Health System

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Earl P. Steinberg, MD, MPP
Chief Executive Officer

Earl P. Steinberg, MD, MPP, is a nationally recognized expert in healthcare quality improvement and serves as xG Health’s chief executive officer. Earl also is an adjunct professor of Medicine and of Health Policy and Management at Johns Hopkins University and a member of Blue Cross/Blue Shield Association’s National Medical Advisory Panel.

Before joining xG Health, Earl was executive vice president of Innovation & Dissemination, and chief, Healthcare Solutions Enterprise at Geisinger Health System.

Before joining Geisinger, he was senior vice president for Clinical Strategy, Quality & Outcomes at WellPoint, Inc., the largest commercial health insurer by membership in the US, and president and CEO of Resolution Health Inc. (RHI), a leading healthcare data analysis company that provides innovative quality improvement and cost reduction services to health plans, employers, pharmacy benefit managers, and disease management companies.

Before joining RHI, Earl spent six years as vice president of Covance Health Economics and Outcomes Services Inc., director of its Quality Assessment and Improvement Systems Division, and co-director of its Outcomes Studies Group. He also spent 12 years on the full-time faculty at Johns Hopkins University, where he was professor of Medicine and of Health Policy and Management and director of the Johns Hopkins Program for Medical Technology and Practice Assessment, and four years on the Federal Physician Payment Review Commission. He co-chaired the Institute of Medicine’s panel on Standards for Development of Trustworthy Practice Guidelines.

Earl has received many awards, including the Henry J. Kaiser Family Foundation Faculty Scholar Award in General Internal Medicine (1984), the “Outstanding Young Investigator” Award from the Association for Health Services Research (1988), and a Special Presidential Visionary Award from the National Kidney Foundation (NFK) (2004) for his work as the scientific director of the NKF’s landmark Kidney Disease Outcomes and Quality Initiative, which produced more than 250 clinical practice guidelines for management of patients with end-stage renal disease. He also is a fellow of both the American College of Physicians and AcademyHealth, and he has published more than 125 articles in peer-reviewed journals.

Earl received his AB from Harvard College (summa cum laude), his medical degree from Harvard Medical School, and a Master of Public Policy from the Kennedy School of Government. He performed his residency training in internal medicine at Massachusetts General Hospital.