Delivery System Reform Incentive Payment program promotes population health
FIVE, TWO, ONE, ZERO—team members of various UTMB pediatric clinics want their patients and their patients’ guardians to remember these numbers when it comes to nutrition and exercise for children.
“We tried to keep the message simple,” said Dr. Helen Paradise, clinical assistant professor and Internal Medicine physician with UTMB’s Community-Based Clinics, referring to the advice that for optimal health, each day children should strive to have five servings of fruits and vegetables, no more than two hours of screen time, one hour of physical activity and zero sugary drinks.
To ensure these practical recommendations were reaching all UTMB patients, regardless of condition or insurance coverage, a standardized note highlighting the “five, two, one, zero” guidelines was recently incorporated into after-visit summaries for all ambulatory pediatric patients across the UTMB Health System.
Paradise, who also serves as medical director for DSRIP and Population Health initiatives at UTMB, said the move was a strategic one that simultaneously allowed for consistent awareness about the topic while ensuring UTMB reaches its performance target for nutrition and physical activity counseling for children and adolescents. Such counseling is one of the 30 metrics in place within DSRIP, which stands for “delivery system reform incentive payment”—a funding program of the larger Texas Medicaid Transformation 1115 Waiver that incentivizes hospitals and other providers to improve care for uninsured patients and those on Medicaid.
“While DSRIP is technically a Medicaid-focused program, we at UTMB like to look at it instead as an incubator for larger population health initiatives,” said Craig Kovacevich, associate vice president for Community and Population Health. “What we want to do is take the ideas, pilots and initiatives we have in place to meet our DSRIP goals and see where we can apply those to our overall patient population.”
The various DSRIP metrics cover a total of five care areas: diabetes care, heart disease care, adult preventative primary care, cancer screening and pediatric primary care. Metrics include blood pressure control, hemoglobin A1c testing for diabetes, cervical cancer screening and many more.
In an effort to help providers meet goals and provide better care for their patients, the DSRIP and population health team at UTMB has recently launched a population health internal website http://intranet.utmb.edu/population-health, which includes links to tips, tricks and resources clinicians can incorporate into their practices every day.
The website also has a section reserved for celebrating the teams who have made significant strides in achieving DSRIP and population health goals overall at UTMB. Kovacevich and Paradise, along with other members of the DSRIP team, not only publish the progress and performance reports online to celebrate the groups’ successes. They also present the teams with certificates and other goodies to recognize their achievements. They also ensure that all members of the team—patient services specialists, medical assistants, nurses, physicians and others—are invited to celebrate, because they all play a role in providing best care.
Seven years into the waiver and DSRIP, folks at UTMB know there’s still much work to be done, but they’re excited and energized about the task at hand and are keeping their focus on the big picture.
“Since day one, we have looked at the 1115 waiver and DSRIP first and foremost as an opportunity to provide better care for our patients,” said Kovacevich. “If we prioritize better patient outcomes, we’ll be able to meet the metrics and continue supporting the health of the full patient population.”