Finger Lakes Region Receives $565 million to Transform Medicaid Healthcare Delivery

May 11, 2015
Rochester, NY – New York State Department of Health announced Thursday that the Finger Lakes Performing Provider System (FLPPS) is eligible to earn up to $565,448,177 over 5 years to transform the way healthcare is delivered to more than 300,000 Medicaid beneficiaries in the Finger Lakes region.

The Finger Lakes Performing Provider System, headquartered in Rochester, NY, is one of 25 Performing Provider Systems in New York State (NYS). FLPPS is comprised of 28 hospitals, 3000 healthcare providers and more than 600 healthcare and community-based organizations in a 13 county region.

“With the many changes in health care, we recognized the importance of regional collaboration to support this important transformation.” says Kathy Parrinello, Chief Operating Officer, Strong Hospital and FLPPS Board Chair. “Our region shares a history of healthcare innovation and we look forward to our collective success in developing this integrated network.”

The $565 million, allocated by the Centers for Medicare and Medicaid Services (CMS) and dispersed by New York State Department of Health, is a maximum possible award which can be earned primarily by achieving performance metrics within the Delivery System Reform Incentive Payment (DSRIP) program. DSRIP is part of a Medicaid reform model which, in NYS, has a goal of improving clinical outcomes and reducing avoidable ED use and hospitalizations by 25% over five years. Following a comprehensive community needs assessment, FLPPS chose 11 DSRIP projects to focus their work. Each project addresses a current shortfall in the healthcare system such as the role of behavioral health in primary care and skilled nursing facilities, triage practices in Emergency Department, patient care transitions, chronic disease management and integrating healthcare services across multiple care settings.

“It is too hard for patents with complex health conditions and limited resources to maintain their health using the current system” says Dr. Bridgette Wiefling, Chief Quality Clinical Innovations Officer, Rochester Regional Health System and FLPPS Board vice-chair. “Our existing system reflect silos that focus on individual aspects of healthcare delivery. Our region is building an Integrated Delivery System that will break down those silos and make it easier for patients to navigate and more useful for providers who are sharing information, identifying resources and ultimately developing treatment plans that can be successful.”

The five-year implementation period, which began April 1, 2015, followed six months of implementation planning and PPS development. The initiative focuses on system transformation, clinical care management and population health. For safety net providers, such as the Federally Qualified Health Centers whose patient volume is at least one-third Medicaid, uninsured or dual eligible members, DSRIP aligns with the care they currently provide.

“When providing healthcare services, we cannot separate a patient's economic and social issues from personal health issues. To help our patients achieve better health outcomes, we need to understand the complexity of their lives and connect them with a multitude of resources within their communities. Closer coordination with trusted partners and resources will help us to serve our patients and support our clinicians." says Mary Zelazny, Chief Executive Officer, Finger Lakes Community Health in Penn Yan, NY. For the patient who relies on Medicaid to support the health of their family, the new system promises to improve access to care and create a reliable single source to coordinate their care.

For more information about this award, DSRIP or the Finger Lakes Performing Provider System, contact Meredith Rutherford, FLPPS Communications Director at 585.455.0414, FLPPS leadership, patients and subject matter experts available for interview.

The NYS Medicaid Redesign Team (MRT) is redirecting Medicaid funds to projects that radically transform the Medicaid delivery system. These projects are part of the Delivery System Reform Incentive Payment (DSRIP) program. DSRIP will incentivize healthcare and community-based providers to form regional collaborations and implement innovative system transformation. The overarching objective of DSRIP in NYS is to improve clinical outcomes and reduce avoidable ED use and hospital admissions by 25% over five years.

The Finger Lakes Performing Provider System (FLPPS) is one of 25 Performing Provider Systems in NYS who have applied for Medicaid 1115 waiver amendment funds to transform the Medicaid healthcare delivery system. A performing provider system is a network of healthcare providers and community-based organizations that have agreed to work together to change the healthcare system in their region using the DSRIP program.

The Finger Lakes Performing Provider System (FLPPS) was formed under the sponsorship of Rochester Regional Health System (RRHS) and UR Medicine who co-lead DSRIP implementation across Allegany, Cayuga, Chemung, Genesee, Livingston, Monroe, Ontario, Orleans, Seneca, Steuben, Wayne, Wyoming and Yates counties.