Predicting the Future: Bigger Systems and Dissolving DSRIP Networks

Crain’s Health Pulse
February 10, 2016
Jeffrey Kraut, Executive VP, Strategy and Analytics, Northwell Health

Consolidation will strengthen health care delivery in New York during the next few years, and the networks created through DSRIP will fall apart once the money dries up. Those were two of the controversial predictions made during a panel discussion Tuesday. The conference, co-sponsored by the United Hospital Fund and the New York State Health Foundation, pondered what health care will look like in New York in 2021.

Speakers from Kingsbrook Jewish, an independent community hospital in Brooklyn, and Northwell Health, a huge system, agreed that consolidation is the key to future success.

"We've known for a while—probably since 2007—that the way of independent hospitals was the way of the dinosaur," said Dr. Linda Brady, president and chief executive of Kingsbrook Jewish, one of 28 hospitals on the state Department of Health's watch list of financially struggling institutions.

After searching for a regional health system to join for years, Brady said, the hospital now has a glimmer of hope. She expressed confidence the facility will be around in five years but didn't offer any additional details about potential partners. She added that she was grateful for Gov. Andrew Cuomo's proposal of $195 million in capital funding to help health systems take on struggling safety-net hospitals.

The number of systems in New York will likely shrink to just four or five in the future, predicted Jeffrey Kraut, executive vice president of strategy and analytics at Northwell Health. In many ways, he said, that's a good thing.

"Scale has material benefits," said Kraut. These include increased economic sustainability, innovation and access to care, he said.

Keeping care affordable is not necessarily one of those benefits, said Karen Ignagni, president and chief executive of EmblemHealth.

"As someone who gets the bills, it results in significant cost increases," she said.
Ignagni said she's excited about new value-based contracts EmblemHealth is negotiating with Northwell Health and other providers, but emphasized that new payment models are insufficient for guaranteeing better outcomes and lower costs.

When it comes to DSRIP, panelists said, the reform program is a much-needed platform for discussing what kind of care should be reimbursed. They agreed DSRIP funding likely would be extended beyond the initial five years.

But Kraut suggested that the new spirit of cooperation displayed by providers as they work together in performing provider systems will evaporate when the funding pool dries up—especially if they are competitors otherwise.

"The PPSs have created wonderful venues to discuss common health care issues and problems," he said, but predicted many contracts created through PPSs would not outlast DSRIP.

Topics: DSRIP, News

Focus onHealth TV

Watch Focus onHealth, Northwell Health's TV show. It's the healthy way to stay informed!