In December 2011, the Center for Medicare and Medicaid Services approved Texas for a Section 1115 Medicaid waiver.
The waiver allows health care providers to collaborate on innovative solutions to improve patient care, increase efficiency and reduce cost through the use of experimental, pilot or demonstration projects. The state is divided into 20 regions, with multiple counties in each region working together on ways to better serve Medicaid and uninsured patients.
UTMB serves as the anchor for Region 2, which includes the counties of Galveston, Brazoria, Jefferson, Hardin, Liberty, Orange, San Jacinto, Polk, Tyler, Jasper, Newton, Angelina, San Augustine, Sabine, Nacogdoches and Shelby.
Katrina Lambrecht, vice president of Institutional Strategic Initiatives and lead contact for Region 2, recently explained the Delivery System Reform Incentive Payment facet of the waiver, in a presentation titled “DSRIP by the Numbers.”
According to CMS, through the waiver, DSRIP is designed to incentivize activities that support hospitals’ collaborative efforts to improve access to care and the health of the patients and families they serve.
To date, Region 2 has 75 approved and active DSRIP projects aimed at improving health outcomes and/or costs.
UTMB has 27 projects in the works related to increasing access to care, improving transitions of care, chronic disease management and hospital re-admission reductions among others.
Lambrecht explained that demonstration projects were submitted to Texas Health and Human Services and CMS for approval with a measurable goal or metrics before the projects began implementation. Compensation is granted only if each project’s goals are met.
“This is an opportunity to play a significant role in improving the delivery of health care for some of our most vulnerable populations,” said Lambrecht. “It’s an exciting time to be in health care.”