Common use of Delivery System Reform Incentive Program (DSRIP Clause in Contracts

Delivery System Reform Incentive Program (DSRIP. Section 5.1 Contractor Responsibilities and Reporting Requirements under DSRIP A. DSRIP Participation Plan The Contractor shall at all times during the Contract Term maintain an EOHHS-approved DSRIP Participation Plan in a form and format specified by EOHHS and as described in this Section. 1. The Contractor’s Preliminary Participation Plan as approved by EOHHS shall satisfy this requirement until the start of Performance Year 1 or as otherwise defined by EOHHS; 2. The Contractor’s DSRIP Plan shall be in a form and format specified by EOHHS and shall provide, at a minimum, the following information: a. The Contractor’s 5-year business plan, including the Contractor’s goals and identified challenges under this Contract; b. The providers and organizations (including but not limited to Affiliated Providers) with which the Contractor is partnering or plans to partner for the purposes of this Contract, including descriptions of how these partnerships will support the Contractor’s planned activities and proposed investments under this Contract; c. A population and community needs assessment, including: 1) The population of Enrollees the Contractor serves and the communities in which they live; 2) The health and functional needs of such population and communities; 3) How the Contractor’s planned activities and proposed investments will promote the health and wellbeing of Enrollees; 4) How the Contractor plans to engage Enrollees and their communities; and 5) The community resources that currently exist for Enrollees, and how the Contractor is partnering or plans to partner with such resources for the purposes of this Contract; d. As further specified by EOHHS, the Contractor’s planned investments and spending plan, including: 1) Specific investments or programs the Contractor will support with DSRIP funds. Such investments and programs may include but are not limited to: a) Care coordination or Care Management programs, including any programs to manage high-risk populations or other population health initiatives and including the Contractor’s Transitional Care Management program as described in Section 2.3.C.2; b) Efforts to address Enrollees’ health-related social needs, including expanding community linkages between the Contractor and providers, CPs, or other social service organizations, and including any spending on allowable Flexible Services to address health-related social needs; c) Ensuring appropriate workforce capacity and professional development opportunities to meet increased expectations for care coordination, management, and integration; d) Investments in the Contractor’s and Affiliated Providers’ data and analytics capabilities; e) Programs to shift service volume or capital away from avoidable inpatient care towards outpatient, community based primary and preventative care, or from institutional towards community-based LTSS, including capital investments to downsize or re-purpose inpatient or institutional capacity, investments in expanding outpatient and community capacity, and costs associated with piloting new care delivery models, such as those involving alternate settings of care and the use of telehealth or home-based services; f) Investments in Culturally and Linguistic Appropriate Services, including hiring translators and providers fluent in Enrollees’ preferred languages, or in medical and diagnostic equipment that is accessible to members with disabilities; and g) Other investments or programs identified and proposed by the Contractor that meet the other requirements of this Contract; 2) Estimates of the amount and structure (e.g., one –time vs. annual) of costs associated with each investment or program the Contractor identifies in its DSRIP Participation Plan; 3) Descriptions of how each such investment or program will support the Contractor’s performance of the requirements of this Contract and EOHHS’ goals of improving the quality and efficiency of Enrollees’ care; 4) Specific goals, evaluation plans, measurable outcomes, and performance management strategies the Contractor will apply to each investment or program to demonstrate effectiveness and inform subsequent revisions;

Delivery System Reform Incentive Program (DSRIP. Section 5.1 4.1 Contractor Responsibilities and Reporting Requirements under DSRIP A. Under DSRIP DSRIP Participation Plan The Contractor shall at all times during the Contract Term maintain an EOHHS-approved DSRIP Participation Plan in a form and format specified by EOHHS and as described in this Section. 1. The Contractor’s Preliminary Participation Plan as approved by EOHHS shall satisfy this requirement until the start of Performance Year 1 or as otherwise defined by EOHHS; 2. The Contractor’s DSRIP Plan shall be in a form and format specified by EOHHS and shall provide, at a minimum, the following information: a. : The Contractor’s 5-year business plan, including the Contractor’s goals and identified challenges under this Contract; b. ; The providers and organizations (including but not limited to Affiliated Providers) with which the Contractor is partnering or plans to partner for the purposes of this Contract, including descriptions of how these partnerships will support the Contractor’s planned activities and proposed investments under this Contract; c. ; A population and community needs assessment, including: 1) : The population of Enrollees Attributed Members the Contractor serves and the communities in which they live; 2) ; The health and functional needs of such population and communities; 3) ; How the Contractor’s planned activities and proposed investments will promote the health and wellbeing of Enrollees; 4) Attributed Members; How the Contractor plans to engage Enrollees Attributed Members and their communities; and 5) and The community resources that currently exist for EnrolleesAttributed Members, and how the Contractor is partnering or plans to partner with such resources for the purposes of this Contract; d. ; As further specified by EOHHS, the Contractor’s planned investments and spending plan, including: 1) : Specific investments or programs the Contractor will support with DSRIP funds. Such investments and programs may include but are not limited to: a) : Care coordination or Care Management programs, including any programs to manage high-risk populations or other population health initiatives and including the Contractor’s Transitional Care Management program as described in Section 2.3.C.2; b) Efforts to address Enrollees’ health-related social needs, including expanding community linkages between the Contractor and providers, CPs, or other social service organizations, and including any spending on allowable Flexible Services to address health-related social needs; c) Ensuring appropriate workforce capacity and professional development opportunities to meet increased expectations for care coordination, management, and integration; d) Investments in the Contractor’s and Affiliated Providers’ data and analytics capabilities; e) Programs to shift service volume or capital away from avoidable inpatient care towards outpatient, community based primary and preventative care, or from institutional towards community-based LTSS, including capital investments to downsize or re-purpose inpatient or institutional capacity, investments in expanding outpatient and community capacity, and costs associated with piloting new care delivery models, such as those involving alternate settings of care and the use of telehealth or home-based services; f) Investments in Culturally and Linguistic Appropriate Services, including hiring translators and providers fluent in Enrollees’ preferred languages, or in medical and diagnostic equipment that is accessible to members with disabilities; and g) Other investments or programs identified and proposed by the Contractor that meet the other requirements of this Contract; 2) Estimates of the amount and structure (e.g., one –time vs. annual) of costs associated with each investment or program the Contractor identifies in its DSRIP Participation Plan; 3) Descriptions of how each such investment or program will support the Contractor’s performance of the requirements of this Contract and EOHHS’ goals of improving the quality and efficiency of Enrollees’ care; 4) Specific goals, evaluation plans, measurable outcomes, and performance management strategies the Contractor will apply to each investment or program to demonstrate effectiveness and inform subsequent revisions;in