Delivery System Reform Incentive Payment

The Delivery System Reform Incentive Payment (DSRIP) Program is a “demonstration program” under New Jersey’s Comprehensive Medicaid Waiver. DSRIP represents a new funding model for hospitals with financial incentives tied to the achievement of quality metrics. It is sponsored by the Centers for Medicare and Medicaid Services (CMS).

The NJ DSRIP program is transitioning as of July 2021 to the Quality Improvement Program (QIP)-NJ. Healthcare Innovation Solutions (HCIS), NJII’s for-profit-subsidiary, will offer services to help hospitals make this transition. The HCIS team is well qualified to help hospitals optimize their performance having helped 16 hospitals improve the lives of more than 300,000 patients and earn millions in incentives during the 2019 reporting year.

As stated on the New Jersey Department of Health Website, in order to support continued population health improvement across New Jersey, the Department of Health (DOH) has developed a hospital performance initiative called the Quality Improvement Program-New Jersey (QIP-NJ). QIP-NJ will be administered by DOH in conjunction with the Department of Human Services as a Medicaid pay-for-performance initiative open to all acute care hospitals in the state. 

The focus of the planned program is to advance statewide quality improvements in maternal health and behavioral health. All acute care hospitals in New Jersey will be eligible for QIP-NJ performance payments. Hospitals will earn QIP-NJ incentive payments through the achievement of performance targets on state-selected quality measures that demonstrate:

• Improvements in maternal care processes
• Reductions in maternal morbidity
• Improvements in connections to behavioral health services, and
• Reductions in potentially preventable utilization for the behavioral health population

The New Jersey Department of Health (DOH) has decided to delay the start date for the Quality Improvement Program - New Jersey (QIP-NJ), which will not start on July 1, 2020 as originally planned. DOH is instead intending to start QIP-NJ on July 1, 2021.  

DOH and the Department of Human Services are proposing to implement a Medicaid payment for acute care hospitals for State Fiscal Year 2021. Hospitals will be provided with information regarding the payment as soon as possible. The payment methodology is contingent upon CMS approval.  Source:  NJ DOH Website 

Our team will help you:

• Successfully make submission deadlines
• Maximize your financial incentives and minimize any penalties
• Identify your beneficiary population via claims and quality data
• Collect quality metric data
• Aggregate quality measures data to produce organization, practice, provider and even patient-level reports
• Translate aggregate reports to a standard reporting workbook