The Role of Family Planning Providers in the DSRIP Program

The Delivery System Reform Incentive Payment (DSRIP) program, announced in April 2014, aims to reduce preventable hospitalizations by 25% over five years. To achieve this loft goal, safety-net providers must employ innovative approaches in infrastructure development and system redesign to achieve clinical and population health improvements. Specifically, 25 Performing Provider Systems (PPS) statewide are seeking to improve patient experiences with health care, working alongside community partners to coordinate care for patients and integrate health care delivery systems.

In order to successfully coordinate care for Medicaid beneficiaries of reproductive age and reduce preventable hospitalizations among those with significant medical and behavioral health care needs, it is critical to consider the role that family planning providers play in the overall health care of women of reproductive age. Approximately 55% of New York State Medicaid beneficiaries are women.6 Six in 10 women consider their sexual and reproductive health care provider to be their primary source of healthcare, while 4 in 10 receive health care services exclusively in family planning settings.7 These statistics speak to the importance of family planning providers in women’s health care utilization patterns. Accordingly, DSRIP strategies to identify and engage low-income women of reproductive age must consider that a majority of women in this age group receive the primary and preventive care services from family planning providers.

In addition to providing sexual and reproductive health services, family planning agencies have evolved to provide their clients with a comprehensive set of services, including referrals for chronic disease management, behavioral health services, and social services. In order to effectively lead clinical and population improvement for Medicaid beneficiaries, particularly women of reproductive age, family planning providers are positioned to fill a role that most health care providers have struggled to fill for years. Family planning providers are adept at providing comprehensive health screenings and referrals to necessary medical and social services.

As DSRIP programs are implemented across New York State, it is likely that there will be more conversations around the sexual and reproductive health care needs of women at greatest risk for negative health outcomes. Family planning agencies are an intrinsic part of initiatives to improve women’s health and improve population health outcomes. With the adoption of the Quality Family Planning (QFP) guidelines, family planning agencies are making great strides to integrate reproductive health and primary care services. PPS’s seeking to improve women’s health and birth outcomes stand to benefit from partnering with family planning providers in their efforts to improve the patient experience and lower per capita health care costs.

6 The Henry J. Kaiser Family Foundation. Medicaid Enrollment by Gender, FY2010, http://kff.org/medicaid/state-indicator/medicaid-enrollment-by-gender/?state=NY
7 Guttmacher Institute, Moving Forward: Family Planning in the Era of Health Reform, 2014, http://www.guttmacher.org/pubs/family-planning-and-health-reform.pdf