Region 10 Health Partnership (RHP)

   for the Texas 1115 Medicaid Waiver

                      Representing the counties of:

Tarrant

Ellis

Erath

Hood

Johnson

Navarro

Parker

Somervell

Wise

 

 

Information & Resources: HHSC & Anchor Updates

Texas Health and Human Services Commission (HHSC) administers programs designed to improve health and human services in Texas. As the Waiver process continues, HHSC will post important updates and valuable information and tools on their website, including protocols and DSRIP menus.
August 22, 2016
DSRIP

Good Morning Region 10 Providers,

 

I have some very important updates for you below. Please be sure to read them in their entirety.

 

 

Category 3

Alternate Achievement Requests for DY6

  • The Alternate Achievement Request Form (attached) for DY6 has been posted to the waiver website (http://www.hhsc.state.tx.us/1115-Waiver-Guideline.shtml, under the Category 3 section halfway down the page) . Providers with a currently approved alternate achievement request must submit an updated request for DY6 goals. Providers with a P4P QISMC outcome with a baseline below the MPL may also submit an alternate achievement request to change DY6 goals to a 12.5% gap closure towards perfect, similar to a P4P IOS outcome. HHSC will take into account achievement reported as of April DY5 when reviewing these request.
  • The form will indicate eligibility to submit an alternate achievement request based on the above criteria. If a provider believes an outcome should be eligible, but is not showing as eligible in the form, please contact HHSC. One form should be completed for each alternate achievement request.
  • Alternate Achievement Requests should be submitted to the RHP 10 Mailbox (RHP_Region_10@jpshealth.org) by COB, Tuesday, September 6th, along with responses to HHSC comments regarding the DY6 Participation Form.
    • The Stretch Activity DY6 Selection template is attached. This template should be completed by Anchors as it is organized at an RHP level. HHSC is extending the submission deadline for the Stretch Activity Selection Template to September 30th, pending submission of the RHP Planning Protocol updates for DY6. The deadline is being extended so that providers will have a chance to review the PFPM and Stretch Activity menu in the RHP Planning Protocol as submitted to CMS prior to making final selections. Prior to submission to CMS, HHSC has updated the Draft Category 3 operational details document with the detailed PFPM and Stretch Activity menus. This document must be return to the RHP 10 mailbox (RHP_Region_10@jpshealth.org) by 12(noon) September, 27th.
      • HHSC has completed reviews of Category 3 Interim corrections that were submitted to HHSC by August 11th . HHSC will be notifying providers of approval or any needed follow up the week of the 22nd.
      • HHSC has also completed reviews of PFPM Baseline templates hat were submitted August 15th. HHSC will be notifying providers of approval or any needed follow-up the week of the 22nd.

 


Stretch Activity Selections for DY6

  • The Stretch Activity DY6 Selection template is attached. This template should be completed by Anchors as it is organized at an RHP level. HHSC is extending the submission deadline for the Stretch Activity Selection Template to September 30th, pending submission of the RHP Planning Protocol updates for DY6. The deadline is being extended so that providers will have a chance to review the PFPM and Stretch Activity menu in the RHP Planning Protocol as submitted to CMS prior to making final selections. Prior to submission to CMS, HHSC has updated the Draft Category 3 operational details document with the detailed PFPM and Stretch Activity menus. This document must be return to the RHP 10 mailbox (RHP_Region_10@jpshealth.org) by 12(noon) September, 27th.


Category 3 Interim Corrections and PFPM Baselines

  • HHSC has completed reviews of Category 3 Interim corrections that were submitted to HHSC by August 11th . HHSC will be notifying providers of approval or any needed follow up the week of the 22nd.
  • HHSC has also completed reviews of PFPM Baseline templates hat were submitted August 15th. HHSC will be notifying providers of approval or any needed follow-up the week of the 22nd.

DY6 DSRIP Rule Set #2

  • Just a reminder that the public comment period for the second set of DY6 DSRIP rules, which closely mirror the DY6 Program Funding and Mechanics (PFM) protocol language, ends August 29, 2016.   These rules were published as proposed in the July 29, 2016, issue of the Texas Register, and are available here - http://www.sos.state.tx.us/texreg/pdf/backview/0729/0729prop.pdf
  • Please note that the public hearing date listed in the initial Texas Register posting is inaccurate.  The public hearing on these rules will be held on August 26, 2016, at 9:00 AM at HHSC, Brown Heatly Building, Public Hearing Room, 4900 N. Lamar Blvd., Austin, TX.   The public hearing will be webcast.  

2016 Statewide Learning Collaborative

  • The Statewide Learning Collaborative is right around the corner!  Thank you to all of the anchors for facilitating reservations for all of your providers.  Attached is the final agenda!
    • HHSC has arranged for the Statewide Learning Collaborative Summit to be available for viewing on-line, in real time, in order to allow all interested individuals to watch the proceedings.  To access the Summit via webcast on August 30th and/or 31st , please click on the Summit Webcast link: https://player2.streamspot.com/?playerId=92a4a38d. The webcast will only stream the sessions that are occurring in the Grand Ballroom.  A test stream will be available on August 22 - 24 each day between the hours of 8:00AM and 10:00PM at the same link (https://player2.streamspot.com/?playerId=92a4a38d) in order for viewers to troubleshoot any firewall issues prior to the Summit.  If issues are encountered during the test stream, we recommend facilities wanting to watch the Summit open up the ability to offer streaming through their firewall and test again to make sure it is working. When you access this site during the test period or the Summit hours, please press play to begin watching on-going sessions. If at any time a participant leaves the webcast and returns later, you will need to click on the same link and press play to re-join. During the webcast, participants may submit questions through an online chat function. Questions will be answered after the Summit concludes.
  • HHSC will send the SLC agenda and livestream link to their provider distribution list and post on the website.

Waiver Extension

  • Friday, the Health and Human Services Commission sent a letter (attached) to the Centers for Medicare and Medicaid Services (CMS) to facilitate discussions on the longer term extension of the Medicaid 1115 Demonstration Waiver, the Texas Healthcare Transformation and Quality Improvement Program. The current 5-year period ends September 30, 2016. CMS granted an initial temporary 15-month extension requested by HHSC on May 1, 2016. The initial extension period continues the existing program at current funding levels through December 31, 2017.
    • The letter specifies that HHSC is on track to submit the required independent report analyzing the Uncompensated Care pool and Delivery System Reform Incentive Payment (DSRIP) program on August 31, 2016. The letter also states that HHSC seeks a clear understanding of CMS' vision for DSRIP integration into Medicaid managed care and HHSC's vision for the longer term extension. The HHSC proposal that is in development includes both a glide path for the integration of DSRIP into managed care for Medicaid beneficiaries and the continued support of locally directed interventions for the continued transformation of the health care system for all Texans. HHSC is looking forward to engaging with CMS for the longer term extension.

 

 

Please let me know if you have any questions.




August 5, 2016
DSRIP


Good Afternoon Region 10 Providers,

 

Attached you will find the Anchor Call Notes. I have included a brief summary of the notes below but please be sure to read them in their entirety.

 

DY 5 April Reporting

 

  • HHSC has completed April DY5 Reporting Review for milestones and metrics that needed more information (NMI). Updated metric workbooks were distributed to providers and anchors on Thursday, August 4th.
  • Please note that only providers who received NMI requests and/or "Incomplete" semi-annual reporting signoffs were sent updated workbooks.

Compliance Monitoring

 

  • With regard to outstanding Category 1 and 2 - Round 1 for projects where additional work was requested by HHSC - we are finalizing the review of these projects and metrics.


Category 3

 

  • Category 3 Interim Correction Templates were due on July 29th. Providers who need more time can submit their template to HHSC by August 9th. HHSC has sent confirmation receipts to providers who submitted a Category 3 Interim Correction Template and will notify providers of their interim correction status by the end of August.
  • Providers who had not yet submitted a baseline for a Population-focused Priority Measure (PFPM) were required to submit a baseline by August 2nd. HHSC has sent confirmation receipts to providers who submitted a PFPM baseline template and will provide feedback to providers by the end of August.

Waiver Renewal Planning

 

  • HHSC is currently reviewing the completed DY6 DSRIP Participation Templates. HHSC will remind anchors/providers in the feedback process that funds associated with projects that providers elect not to continue in DY 6 will not be available to providers in DY 6 - 10.
    • August 26, 2016 - HHSC will begin providing approval of requested MLIU reporting exceptions, required QPI/MLIU changes, and submitted next steps or request additional information. HHSC will also provide the updated Project Descriptions and Target Populations that were noted as incorrect by providers.
    • September 9, 2016, 5:00pm - Anchors submit responses to HHSC requests for additional information, and Category 3 stretch activity selections and alternate achievement requests.
      • Templates for Category 3 stretch activity selections and alternate achievement requests will be distributed in mid-August.
    • September 30, 2016 - HHSC will approve or deny the additional information submitted in response to HHSC comments.
    • October 1, 2016 - Approved DY6 projects are effective.

Statewide Learning Collaborative

 

  • HHSC requests your assistance to provide information on the impact of DSRIP to highlight in the Summit. HHSC would like specific information related to Medicaid or uninsured populations for the benefits to your communities.
  • HHSC also sent some questions to help the "Value Based Contracting: Perspectives from National, State, MCO and Provider Levels" panel provide information on what participants would like to learn about. HHSC would love to have your feedback as soon as possible.

Please let me know if you have any questions.



July 22, 2016
DSRIP

Good Morning Region 10 Providers,

 

Attached you will find the Anchor Call Notes. I have included a brief summary of the notes below but please be sure to read them in their entirety.

 

UC Update

  • HHSC submitted the draft Independent Evaluation of Uncompensated Care Costs (UC Study) to CMS on July 15, 2016 as required in the Special Terms and Conditions of the 15-month extension.
    • April DY5 Reporting Timeline:
      • July 29, 2016 - April reporting DY3 and DY4 DSRIP payments processed for all providers and DY5 DSRIP payments processed for remaining providers that were not paid on July 15, 2016.
      • August 5, 2016 – HHSC will complete NMI Reporting Review and distribute reporting results.
        • HHSC has several providers who did not submit timely responses during the Category 3 baseline review. These measures will be automatically included in the Round 2 Category 3 Performance review, during which the baseline and the performance will be reviewed at that time.
        • Category 3 Baseline Review is completed by MSLC, and any changes to reported baselines are reflected in the Cat 3 Summary Workbook that is posted online.
        • Work for Category 1 and 2 - Round 1 for projects where additional work was requested by HHSC is completed by MSLC, and HHSC is reviewing final documents. Providers should hear from HHSC in the next 10 days.
          • IOS - Survey Goals: HHSC has received confirmation from CMS on a goal setting methodology for DY6 for outcomes designated as IOS - Survey (Survey/Tool based outcomes in Outcome Domains 10 and 11 like the PedsQL, AQoL, and PHQ screeners). DY6 goals for IOS - Survey outcomes using goal setting scenario 2 or scenario 3 will be set as a 12.5% gap closure towards the best possible score, in line with other IOS outcomes. DY6 goals for IOS - Survey outcomes using goal setting scenario 1 will be a 12.5% improvement relative to the change observed between baseline pretest and baseline posttest scores. These goal setting formulas will be included in an update to the RHP Planning Protocol for DY6A.
          • As the currently approved goal setting methodology for some IOS - Survey outcomes resulted in unreasonable goals for a number of projects, HHSC has also received approval from CMS to revise the goal setting methodology in DY5 for IOS - Survey outcomes using goal setting scenario 2 or goal setting scenario 3 to a 10% gap closure towards the best possible score, rather than an improvement equal to 10% of the total available point value. This will result in lower DY5 goals.
            • There is no change in DY5 for outcomes using Scenario 1.
            • HHSC will be reaching out to individual providers with an approved alternate achievement request that may be impacted by this change in DY5 goals.
  • Updated Summary Workbook: HHSC has updated the Category 3 Summary Workbook & Goal Calculator to reflect these changes to DY5 and DY6 goals, as well as to correct a few errors identified in the previous version of the Category 3 Summary Workbook (PY2 and PY3 measurement periods displaying incorrectly for some outcomes, October DY5 reporting eligibility for outcomes approved to us a DY4 baseline milestone structure).
  • Updated RHP Summary: HHSC has also updated the RHP Summary Workbook with new DY5 and DY6 goals, as well as additional details on DY6 project IDs if changed, and reporting history for Population Focused Priority Measures.
  • Category 3 Interim Corrections: The Category 3 interim correction forms are due back to HHSC July 29th. HHSC has updated the interim correction template to reflect the new goal calculations for IOS - Survey outcomes in DY5. Providers who have already completed a template do not need to complete a new template.
    • July 22, 2016 5:00pm - Anchors submit the completed DY6 DSRIP Participation Templates to HHSC. HHSC will send confirmations of received templates and request any missing templates.
    • August 26, 2016 - HHSC will begin providing approval of requested MLIU reporting exceptions, required QPI/MLIU changes, and submitted next steps or request additional information.
    • September 9, 2016 5:00pm - Anchors submit responses to HHSC requests for additional information, and Category 3 stretch activity selections and alternate achievement requests.
      • Templates for Category 3 stretch activity selections and alternate achievement requests will be distributed in early August.
  • September 30, 2016 - HHSC will approve or deny the additional information submitted in response to HHSC comments.
  • October 1, 2016 - Approved DY6 projects are effective.
    • Rule packet #2 pertains to requirements for the DSRIP program for DY6. The rules in this packet closely mirror the DY6 PFM language.
    • These rules will be published as proposed in the July 29 issue of the Texas Register.
    • A public hearing on these rules is scheduled for August 26, 2016, at 9:00 am at the Brown-Heatly Building, Public Hearing Room, located at 4900 N. Lamar Blvd. in Austin. . This hearing will be webcast.
      • HHSC is in the final stages of having a final SLC agenda. Currently HHSC is notifying projects selected for highlighting during a panel or breakout session, and getting confirmation of their willingness to attend. HHSC will let all of the projects who submitted a template know by early this week if they are not selected.

 

April DY 5 Reporting

 

Compliance Monitoring

 

Category 3

 

Waiver Renewal

The estimated timeline for the DY6 DSRIP Participation Template is the following.

 

DY 6 Rule Packet #2

 

2016 Statewide Learning Collaborative Summit - August 30-31

 

Please let me know if you have any questions.



June 10, 2016
DSRIP

Good Afternoon RHP 10 Providers,

 

HHSC has provided the below updates on our recent Anchor Call. Please be sure to read them in their entirety.

 

Waiver Renewal Updates

 

  • HHSC recently had a call with CMS and stated that CMS is amenable to the attached PFM. If you have any major changes to the PFM please let me know by Thursday, June 16th at 5PM.
  • In the second attached document you will find additional detail on what HHSC has proposed Category 3 look like in DY 6.

Category 3

 

Updated MPL for IT-12.2 Cervical Cancer Screening

  • HHSC has identified that the Minimum Performance Level for IT-12.2 Cervical Cancer Screening was incorrectly seeded into the Category 3 reporting companion. The MPL has been changed from .6837 to .6137. For most providers, this results in lowered goals in DY4 and DY5. HHSC has updated their internal database with the corrected MPL and adjusted DY4 and DY5 goals for impacted providers. 

 

Category 3 DY5 R2 Interim Corrections

  • HHSC will have another Category 3 Interim Correction period this summer. Currently, HHSC anticipates an interim correction period template being released at the end of June, with a target due date back to HHSC of July 20th
  • As a reminder the interim correction period is intended for making corrections to: 
    • The DY5 R2 interim correction period will allow corrections to previously reported and approved baseline, PY1, PY2, and PY3 due to errors in measure interpretation or data collection. The October DY5 Category 3 reporting template will still allow corrections to prior reporting for P4R outcomes and P4P outcomes that have not yet reported performance and do not have a custom goal. The interim correction period is not intended for outcomes that need to make corrections to DY5 R1 reporting due to a "Needs More Information" determination. 

- P4P outcomes that have previously reported performance 

- Outcomes that have a custom goal

- P4P outcomes that have not been reviewed by MSLC. 


Updated Category 3 Summary Workbook

  • HHSC will be releasing an updated Category 3 Summary Workbook & Goal Calculator prior to the interim correction period. This update will include DY5 R1 reporting. 
    • HHSC will be reviewing baselines newly reported or corrected through the April DY5 reporting template in June and contacting providers individually if any follow up TA is needed. HHSC hopes to have this review complete by mid-July. 
      • Just a reminder that registration for providers and anchors for the SLC is open.  HHSC has received some inquiries from providers, and are directing them to contact their anchor to coordinate registration.
      • HHSC is hoping to finalize the agenda soon so they can get it out to participants sooner than in prior years. 
      • As in years past, HHSC would like to showcase DSRIP success stories that represent the breadth and depth of projects across the state. This year, HHSC would particularly like to highlight the specific impact on the uninsured population and on those in the Medicaid program. This could also include projects that impact both Medicaid and uninsured with explanations of the benefits for both. Given where HHSC is with the waiver extension and ongoing negotiations over a new five-year waiver, HHSC believes that focusing on outcomes specifically for these two populations will be most beneficial.
        • HHSC would like to gather information from hospitals and other providers in RHP10. Specifically, HHSC would like:

 

New Baselines and Baseline Corrections submitted in the April DY5 Reporting Template

 

  • Just a reminder that registration for providers and anchors for the SLC is open.  HHSC has received some inquiries from providers, and are directing them to contact their anchor to coordinate registration.
  • HHSC is hoping to finalize the agenda soon so they can get it out to participants sooner than in prior years. 
  • As in years past, HHSC would like to showcase DSRIP success stories that represent the breadth and depth of projects across the state. This year, HHSC would particularly like to highlight the specific impact on the uninsured population and on those in the Medicaid program. This could also include projects that impact both Medicaid and uninsured with explanations of the benefits for both. Given where HHSC is with the waiver extension and ongoing negotiations over a new five-year waiver, HHSC believes that focusing on outcomes specifically for these two populations will be most beneficial. 


Statewide Learning Collaborative

 

  1. Video submissions focusing on DSRIP outcomes. These video stories should be no more than 2 minutes. HHSC prefers not to have patient narrative stories. Videos should discuss a particular DSRIP project and its impact on the uninsured and/or Medicaid enrollees.
  2. For hospitals and other providers that do not have the capability of submitting a video, the other option is to submit two PowerPoint slides. The first slide should give a brief project description and the second slide should detail outcomes for the uninsured and/or those in the Medicaid program.  


Please let me know if you have any questions.






April 18, 2016
DSRIP

Good Morning Region 10 Providers,

 

HHSC has provided a few updates below.

 

April DY5 Reporting

  • The April DY5 reporting deadline has been extended to Wednesday, May 4th at 11:59 PM. The DSRIP Online Reporting System will remain open to accept ALL April DY5 reporting submissions until this time.
  • Based on previous reporting periods, we've had significant issues with providers sending multiple complicated requests regarding reporting templates on the reporting deadline. Please encourage providers to review the information in their reporting templates. If the provider finds that their information is incorrect, they should notify HHSC as soon as possible. HHSC will determine if an update to the template is needed and provide a new template to the provider as soon as we can.
  • Just a reminder that the updated Category 3 template was posted on Monday, 4/11/16. The new template says Version 2 at the top.  Providers should make sure they are using Version 2 of the template.

 

Community Needs Assessment Update Reporting Form

  • As requested, attached is a draft form to give you an idea of what the CNA reporting template would look like.  Please let us know if you have any feedback, concerns or suggestions.  Reporting on the updated CNA would be required by the end of October 2017 (DY6 second reporting period).

 

Transition Year (DY6) Rules

  • HHSC will be presenting the second set of transition year rules at the following upcoming meetings:
    • Hospital Payment Advisory Committee (HPAC) - May 5, 2016
    • Medical Care Advisory Committee (MCAC) - May 12, 2016
    • HHSC Council - May 20, 2016
    • The HHSC Council meeting will be webcast.  Additional details regarding these meetings will be forthcoming.
    • These rules describe the transition year policies to be effective by September 30, 2016, including, but not limited to:
      • The definition of Medicaid and Low-income or uninsured (MLIU) - an individual can be either low-income or uninsured to qualify as LIU.
      • Category 1 and 2 milestones, including:
        • Total QPI
        • MLIU QPI
        • Core component reporting
        • Sustainability planning
  • Category 3 requirements
  • The conversion of Category 4 to the Performance Bonus Pool (PBP) and PBP requirements
  • Combining projects
  • Uncompensated care only hospital requirements
  • Uses of remaining DSRIP funds
  • Anchor requirements
  • They also specify that compliance monitoring is an ongoing process that will be happening during the current waiver period, as well as in the transition year.  In addition, they clarify providers’ responsibility to provide any requested documentation to the independent assessor and HHSC, and that a provider's failure to provide supporting documentation of metric or milestone achievement may result in recoupment of DSRIP payments.
  • Timeline
    • June 27, 2016: Proposed rule submitted to the Texas Register
    • July 8, 2016:  Proposed rule published in the Texas Register
    • August 8, 2016: Public comment period ends
    • September 9, 2016: Adopted rule submitted to the Texas Register
    • September 23, 2016: Adopted rule published in the Texas Register
    • September 30, 2016: Rule effective date

 

Please let me know if you have any questions.

April 8, 2016
DSRIP

Good Morning Region 10 Providers,

 

HHSC has released all of the reporting documents for April DY 5 Reporting. You will find in the attached zip file the below documents:

 

  • April DY5 Reporting Companion Document
  • Updated User Guide for the DSRIP Online Reporting System
  • DY3-DY5 Reporting Coversheet
  • Learning Collaborative Participation Template
  • April DY5 QPI Reporting Companion (The RHP 10 Anchor Office would like to encourage providers to pay special attention to the QPI MLIU section)
  • April DY5 QPI Template
  • Category 3 April DY5 Reporting Template
  • Category 3 April DY5 Population Focused Priority Measure (PFPM) Reporting Template
  • Category 4 Template
  • April DY5 DSRIP General Reporting (Updated version)
  • April DY5 DSRIP Category 3 Reporting

 

RHP 12 recorded the webinar on April 6th and has graciously shared the Reporting Webinar with us.

 

If you would like the Anchor office to review any information that is being submitted for April reporting please send an email to RHP_Region_10@jpshealth.org

 


March 3, 2016
DSRIP

Good Morning Region 10 Providers,

 

I have a few very important updates for you below.

 

Reporting

  • October DY4 NMI Review Results were distributed on Friday, February 26 to providers who received NMIs during the October DY4 Initial Review. Due to technical difficulties with software upgrades, we had to resend some emails on Thursday, March 3rd.
  • HHSC sent an Active Users Report to each Anchor to collect any changes to user status or contact information to ensure that providers and their IGT entities have access to the reporting system for April DY5. This update is due back to the RHP Mailbox (RHP_Region_10@jpshealth.org) by Monday, March 21st. After this deadline, changes must be submitted using an RHP Contact Change Form to the waiver mailbox.
  • Preparations for April DY5 reporting are underway, including updating the Companion and developing a new Category 3 reporting template.  If HHSC has any reporting webinars it will likely be to go through the new Cat 3 template, but HHSC will let us know soon.

 

Category 3 Update:

  • Partial Payment: HHSC has received a number of questions in the waiver box asking about carryforward for outcomes that reported partial achievement in DY4. HHSC has attached an example from previous reporting webinars that clarifies partial payment calculations. As a reminder, reporting partial achievement of a Category 3 DY4 milestone does not change your Category 3 measurement periods. Unlike QPI, Category 3 measurement periods are not extended if a goal is not fully achieved during the measurement year. The Performance Year 1 measurement period is the twelve months immediately following baseline. Performance Year 1 is associated with DY4 achievement milestones. The Performance Year 2 measurement period is the 12 months immediately following Performance Year 1.  Performance Year 2 is associated with DY5 achievement milestones and DY4 milestones carried forward due to partial achievement.
  • Stretch Activities: Providers will report Stretch Activity milestones in October DY5. For Stretch Activity 3 (Program Evaluation), HHSC will be providing a template to summarize your final report for reporting purposes. The template will be similar to a cover page. This template will be available prior to the October reporting period.
  • Interim Corrections: HHSC has started review of Interim Corrections submitted in February and will notify providers of approval or any needed follow up by March 11th.
  • PFPM Baseline Submissions: HHSC has started review of Population Focused Priority Measure baselines submitted in February and will notify providers of approval or any needed follow up by March 11th.
  • Category 3 Summary Workbook Update: HHSC will be updating the Category 3 Summary Workbook currently posted to the waiver website. The current target date is March 14th. This update will include any changes made through the NMI reporting period, baseline TA for baselines reported in October DY4, approved interim corrections, approved PFPM baselines, and baselines under review by MSLC that have been reported to HHSC. This update will also include April DY5 reporting eligibility. HHSC will send anchors a regional Category 3 summary of selection and reporting details included in the Category 3 Summary Workbook.

 

Statewide Events Calendar

 

March 2016

RHP

Date

Topic

Contact

19

3/23

RHP 19 Learning Collaborative

Rebecca McCain

 

8 & 17

3/24

RHP 8 & 17 Joint Learning Collaborative

Jennifer LoGalbo

 

16

3/29

RHP 16 Learning Collaborative

To register: RHP 16 LC

Kathy Lee

 

 

April 2016

RHP

Date

Topic

Contact

4

4/14

RHP 4 Learning Collaborative

To register: RHP 4 LC

Jonny Hipp

 

May 2016

RHP

Date

Topic

Contact

12

5/4

RHP 12 Learning Collaborative

 

Sandra James

 

August 2016

RHP

Date

Topic

Contact

HHSC

8/30-31

2016 Statewide Learning Collaborative

 

Transformation Waiver

 

September 2016

RHP

Date

Topic

Contact

2

9/15

RHP 2 Behavioral Health Learning Collaborative

 

Susan Seidensticker

Please let me know if you have any questions.

February 23, 2016
DSRIP

Good Afternoon Region 10 Providers,

 

HHSC has released a few clarifications (below) on the DY 6 Transition Year Proposal.

 

Clarifications on Proposed Transition Year (DY6) Policy

 

  1. Project Eligibility to Continue - HHSC has already notified those projects that are not eligible to continue.

 

  1. Project Valuation Reductions - HHSC has already notified those projects that may have a DY6 project valuation that is lower than their DY5 project valuation. 

 

  1. Non-QPI Milestones (core component reporting and sustainability planning) - These milestones are pay-for-reporting.  Providers will need to complete a standardized template for each of these two milestones to demonstrate achievement of the milestone. 
    1. The core component reporting template questions for DY6 will be the questions from the current "Project Summary" tab in the DSRIP Online Reporting System (i.e., "Project Overview: Accomplishments", "Project Overview: Challenges", etc.) 
    2. HHSC is working to develop the sustainability planning template questions.

 

  1. Deciding Whether to Discontinue or Continue/ Replace a Project - Providers will have to decide by Summer 2016 whether to: 1) discontinue their project; or 2) continue/ replace their project.  If they decide in Summer 2016 to continue/ replace, they will have until March 2017 (immediately prior to April DY6 reporting) to change their mind without financial penalty. 
    1. HHSC Timeline for development of DY 7 protocols:
    2. 10/1/2016 -- Protocol information on Replacement Projects that would start in DY 7; Protocols for funds not dedicated to projects (leftover funds)
    3. 1/1/2017 -- Draft Protocols for continuing projects to finalize by Spring 2017

 

  1. Performance Bonus Pool
    1. HHSC plans to provide CY2015 data for baseline measurement as soon as it is available during DY6 for regional planning purposes, pending confirmation of this timeframe by ICHP.
    2. In order to finalize the list of performance bonus pool measures, HHSC needs feedback from Anchors and providers on the proposed list of measures (currently posted on the waiver website), specifically any additional measures or removal of currently proposed measures. We would appreciate your feedback by March 23, 2016.
    3. The draft DY6 PFM states that prior to a region selecting PBP measures, the region must redo/update the community needs assessment.  HHSC does not plan to prescribe the format for the CNA or how it is administered. 

 

Please let me know if you have any questions.


January 25, 2016
DSRIP

Good Morning Region 10 Providers,

 

I have a few brief updates for you this morning. As always a summary of the Anchor Call Notes is below and I ask that you please read the attached Anchor Call Notes in their entirety.

 

 

October DY 4 Reporting

 

  • On January 29, 2016, October reporting DY3 DSRIP payments will be processed for all providers and DY4 DSRIP payments processed for remaining providers that were not paid on January 15, 2016. Note that there are separate transactions for each payment for each DY.

 

Category 3

 

  • HHSC has also posted an Interim Category 3 Correction Template to the waiver website for outcomes that will make corrections during the interim correction period, if corrections are needed. The Correction Template will indicate if an outcome is eligible to make corrections during the interim correction period, or if the outcome can be corrected at the time performance is reported. The final due date for submitting interim corrections is Sunday, February 14th. Providers do not need to submit a correction template if no corrections are needed, even if the template shows them as eligible to submit an interim correction.
  • HHSC will be posting a revised Population Focused Priority measure (PFPM) baseline reporting template early this week. All providers with an alternate achievement outcome (AM-3.1 in DY5) will be asked to submit a baseline for their selected measure. This is to prepare for reporting in April DY5, if eligible. The deadline for returning the PFPM baseline template is tentatively scheduled for Sunday, February 14th.

 

Waiver Renewal Planning

 

  • In addition, HHSC plans to share the following waiver renewal planning information with stakeholders in January that are specific to the transition year (DY 6):
    • Combining Projects: Template and companion document for combining projects have been posted on the HHSC waiver website on the Tools and Guidelines page under Combining DSRIP Projects.
    • Draft Transition Year (DY6) Proposal: HHSC plans to post the draft language for the Program Funding and Mechanics Protocol (PFM) relating to the transition year (DY6) during the week of January 25, 2016.
      • HHSC also plans to post a survey for stakeholder feedback on this information during the week of January 25, 2016 -- we will be looking at information received by Feb. 2nd as a first look prior to the Executive Waiver Committee, but will continue to keep the survey open after that date for additional feedback.
  • Draft list of Performance Bonus Pool and Statewide Analysis Plan measures that builds on the information presented at the Statewide Learning Collaborative is scheduled to be sent out for feedback by the week of January 25th.
  • A list of best practice models HHSC has identified for project options on the Transformation Extension Menu for replacement projects is also scheduled to be sent out for feedback by the week of January 25th.

 

Please let me know if you have any questions.


January 18, 2016
DSRIP

Good Morning Region 10 Providers,

 

I have a lot of information to share with you this morning. Please see the information below from HHSC.

 

HHSC has not yet received feedback from CMS on the draft Transition Year plan. CMS understands the urgency of HHSC and DSRIP entities being able to plan for the next year, and HHSC hopes to receive feedback by the end of this month or early February.  In the meantime, HHSC is proceeding as planned with the Transition Year documents and processes as outlined. They are still finalizing the draft Transition Year PFM language so that is now planned for this week. Information on the draft performance bonus pool measures, and the best practices models for the Transformation Extension Menu for replacement projects is still planned for this week, along with survey links for stakeholder feedback. 

 

Combining Projects

  • Attached is the companion document and template for combining projects.  The companion document outlines the criteria, requirements and timeline for requesting to combine projects. 
  • Please note the deadline for template submissions to HHSC is February 1, 2016 at 5:00pm.

 

Category 3

  • Providers were sent their summary review file for outcomes that reported baselines during October DY4 reporting, and notified of any flags for technical assistance last Friday.  HHSC will be sending Anchors a regional baseline review summary early this week.
  • Attached is a Cat 3 Reporting Summary and Goal Calculator.  This file will enable providers to confirm current reporting information and determine new goals if corrections are anticipated. It will also be posted on the waiver website.
  • Also attached is the Interim Category 3 Correction Template, which will also be posted on the website. The 1/8/15 Anchor Call Notes described which outcomes are able to submit needed corrections during the interim baseline correction period. The Correction Template will indicate if an outcome is eligible to make corrections during the interim correction period, or if the outcome can be corrected at the time performance is reported. The final due date for submitting interim corrections is scheduled for Friday, February 12th.

 

Deadline Extension for Provider Re-enrollment

  • The Centers for Medicare and Medicaid Services (CMS) recently announced that the previous March 24, 2016 deadline for Medicaid provider re-enrollment is extended to Sept. 25, 2016. Though this extension gives states additional time to ensure providers comply with Patient Protection and Affordable Care Act (PPACA) requirements, Texas Medicaid encourages all providers who have not yet submitted a re-enrollment application to begin this process immediately to avoid potential payment disruptions. Additional information will be announced by HHSC Medicaid/CHIP in the coming weeks to assist providers who are working on the re-enrollment process. 

 

The attached files will also be posted as soon as possible on the waiver website. As always, let us know if you have any questions



January 11, 2016
DSRIP

Good Afternoon Region 10 Providers,

 

I hope that everyone had a safe and happy new year. I have a lot of information to share with you this morning, especially about Waiver Renewal. I have provided a summary below but I ask that you read the (attached) Anchor Call Notes in their entirety.

 

General Communication

 

  • Attached you find the reporting and payment data used to populate the table in the Anchor Report.

 

October DY 4 Reporting

 

  • The additional reporting period for metrics that need more information (NMI) is now open and will close at 11:59 p.m. on Friday, January 15, 2016.
  • Any questions regarding submission of NMI documentation should be sent to the waiver mailbox at TXHealthcareTransformation@hhsc.state.tx.us by noon on Tuesday, January 12th in order for staff to respond to all of the questions by the Friday deadline. Please remember to include RHP, Project ID, and Metric ID with your questions.
  • On January 15, 2016, October reporting DY4 DSRIP payments will be processed for transferring hospitals and top 14 IGT Entities.
  • On January 29, 2016, October reporting DY3 DSRIP payments will be processed for all providers and DY4 DSRIP payments processed for remaining providers that were not paid on January 15, 2016. Note that there are separate transactions for each payment for each DY.
  • A note on findings for DY4 QPI reporting and moving toward Waiver extension: There were a number of providers who are falling more than 20% below the Medicaid/Low-Income Uninsured (MLIU) QPI target. For those projects where MLIU is not required, this does not impact achievement of the metric. However, as HHSC looks towards waiver renewal, HHSC is planning to strengthen the MLIU component of QPI milestones, as this is the target population for the Waiver. HHSC strongly  encourages providers, especially those falling short of their MLIU targets, to work toward increasing the number of MLIU patients served.

 

Monitoring IGT

 

  • Attached you will find the DY5 Monitoring IGT amounts. HHSC plans to request $5M for DY5 Monitoring IGT.
  • HHSC is reviewing actual MSLC costs compared to the $4M collected for DY3 Monitoring IGT. HHSC estimates that IGT refunds for unused DY3 Monitoring IGT will be processed in early 2016. HHSC does not expect to process DY4 Monitoring IGT refunds.

 

Category 3

 

  • HHSC is currently finalizing reviews of Category 3 baselines submitted during the October DY4 reporting period that were not flagged as Needing More Information. This week HHSC will send providers a summary of reported baselines and goals, as well as any notes regarding needed technical assistance.
  • HHSC will be posting an Interim Category 3 Correction Template to the waiver website within the next two weeks.
    • Pay for Performance outcomes that are not under review by MSLC that have already reported DY4 performance, or are approved for an alternate achievement level or maintenance or P4R due to small volume will submit any needed corrections during the interim baseline correction period.
    • All other outcomes will be able to make corrections to the reported numerator/denominator when performance is next reported. T
    • he Correction Template will indicate if an outcome is eligible to make corrections during the interim correction period, or if the outcome can be corrected at the time performance is reported.
    •  The final due date for submitting interim corrections is tentatively scheduled for Friday, February 12th.
    • For outcomes not eligible to submit corrections during the interim correction period, HHSC will also be posting a Cat 3 project specific reporting summary and goal calculator so that providers can confirm current reporting information and determine new goals if corrections are anticipated.
    • The DY5 goals currently included in the online reporting system are out of date and will be removed prior to the April DY5 reporting period.
    • In mid-January, HHSC will distribute a revised Population Focused Priority measure (PFPM) baseline reporting template and provide guidance on submitting a DY3 or DY4 baseline for the selected alternate achievement outcome. All providers with an alternate achievement outcome will be asked to submit a baseline for their selected measure, regardless if a baseline was previously submitted.

 

Waiver Extension Application

 

  • Based on the discussions thus far with CMS, HHSC believes an initial 1-2 year extension is probable to enable more time for more detailed negotiations for the later years in the extension.
  • HHSC has not received formal written feedback from CMS, but anticipate getting some initial feedback from CMS on the transition year proposal and the initial extension request later this month.
  • For DSRIP, CMS asked Texas to explore further financial integration of DSRIP into Medicaid managed care (i.e., running some DSRIP payments through the managed care plans, similar to NAIP). We explained at a high level the operational complexities of this (300 varying providers) and also that one of the DSRIP target populations is low income uninsured. CMS understands these considerations, and asked HHSC to explore potential options to move in this direction. HHSC is analyzing internally and will share more with stakeholders as we have more information.

 

Waiver Renewal Planning

 

  • HHSC is continuing to review projects to determine if a project is eligible to continue or requires changes for the waiver extension period. HHSC reviewed additional projects based on October reporting submissions and will notify the projects that need to submit additional information.
    • HHSC will begin notifying individual providers of the results and required changes for the extension period the week of January 19th.
    • In addition, HHSC plans to share the following waiver renewal planning information with stakeholders in January that are specific to the transition year (DY 6):
    • Combining Projects: Template and companion document for combining projects will be posted this week.
    • Draft Transition Year (DY6) Proposal: draft language for the Program Funding and Mechanics Protocol (PFM) relating to the transition year (DY6) will be posted this week.
      • The waiver renewal survey will be updated for stakeholder feedback on this information this week – HHSC will be looking at information received prior to Feb. 5th for the Executive Waiver Committee, but will continue to keep the survey open after that date for additional feedback.
      • Draft list of Performance Bonus Pool and Statewide Analysis Plan measures that builds on the information presented at the Statewide Learning Collaborative is scheduled to be sent out for feedback by the week of January 25th.
      • A list of best practice models HHSC has identified for project options on the Transformation Extension Menu for replacement projects is also scheduled to be sent out for feedback by the week of January 25th.

 

Medicaid Provider Re-Enrollment

 

  • To participate in DSRIP, each DSRIP provider must be an enrolled Medicaid provider. Based on federal requirements, tens of thousands of Texas providers must re-enroll by March 2016to remain active providers for Texas Medicaid.
  • HHSC encourages all DSRIP providers who enrolled in Texas Medicaid prior to January 1, 2013, and have not yet re-enrolled, to do so as soon as possible.
  • Please see the Anchor Call Notes for further information on how to re-enroll.

 

Please let me know if you have any questions.


DECEMBER 15, 2015
DSRIP

Good Morning Region 10 Providers,

 

I have a lot of very important information to share with you this morning. Below is a brief summary of the Anchor Call notes but I ask that you please take the time to read them through in their entirety.

 

October DY 4 Reporting

 

  • HHSC has completed its October DY4 reporting review. Reporting results were sent out to providers on Friday, December 11, 2015. If providers did not receive a summary file of their October DY4 Reporting Results, please have them contact the waiver mailbox at TXHealthcareTransformation@hhsc.state.tx.us. Please note HHSC will not re-review metrics that received a “Needs More Information” determination between the Initial and Needs More Information (NMI) review periods. Providers should upload their additional documentation to DSRIP Online Reporting System during the additional reporting period.
  • As indicated in the Initial Review Results email sent to providers, HHSC may have made corrections to the initially selected achieved by status and percent of goal achieved selection in the online reporting system for Category 3 milestones. In places where the online reporting system and the October DY4 Category 3 Template did not match, HHSC corrected the online reporting system to match the reporting status indicated in the Category 3 template. HHSC has attached a summary of October DY4 Category 3 Reporting Template achievement status. This summary includes milestone level reporting and achievement status for each Category 3 outcome as indicated in the submitted Category 3 Reporting Template.
  • The additional reporting period for NMIs is now open and will close at 11:59 p.m. on Friday, January 15, 2016. Any questions regarding submission of NMI documentation should be sent to the waiver mailbox at TXHealthcareTransformation@hhsc.state.tx.us. Please remember to include RHP, Project ID, and Metric ID with your questions.
  • HHSC Rate Analysis will send out the notice for IGT requests for January 2016 DSRIP payments this week. Please follow the instructions within the email to ensure timely DSRIP payments and contact Rate_Analysis_DSRIP_Payments@hhsc.state.tx.us if you have questions regarding IGT processing. If you have questions regarding payment calculations or reporting review results, then please contact the waiver mailbox TXHealthcareTransformation@hhsc.state.tx.us.
  • IGT for October reporting DSRIP payments will be due on January 4, 2016.
  • On January 15, 2016, October reporting DY4 DSRIP payments processed for transferring hospitals and top 14 IGT Entities.
  • On January 29, 2016, October reporting DY3 DSRIP payments processed for all providers and DY4 DSRIP payments processed for remaining providers that were not paid on January 15, 2016. Note that there are separate transactions for each payment for each DY.

 

Compliance Monitoring

 

  • Cat 1&2 Validation – MSLC has notified providers of the metrics that were selected for review and has starting reaching out to providers to request additional data and sample documentation.

 

Monitoring IGT

 

  • A reminder that the DY5 Monitoring IGT will be calculated based on IGT commitments as of January 1, 2016. HHSC may request up to $5M for DY5 Monitoring IGT. If IGT Entities have changes in funding DSRIP projects, please submit an IGT Entity Change Form prior to January 1, 2016. The form is located on the waiver website at: http://www.hhsc.state.tx.us/1115-docs/DY3-Templates/April2014/IGT-Entity-Change-Form.xlsx.
  • HHSC is reviewing actual MSLC costs compared to the $4M collected for DY3 Monitoring IGT. HHSC estimates that IGT refunds for unused DY3 Monitoring IGT will be processed in early 2016. HHSC does not expect to process DY4 Monitoring IGT refunds.

 

Category 3

 

  • HHSC has previously stated that interim baseline corrections will resume in January. Given the volume of baseline corrections and the success of updating baselines through the DY4 performance reporting template, HHSC will only be accepting interim corrections for a small selection of baselines. Specifically, outcomes that have already reported DY4 performance in either April or October of DY4 will be able to submit corrected baseline and performance rates in January. Outcomes with a current HHSC approved alternate achievement request, in maintenance mode, or utilizing Scenario 1 will be able to submit corrected baselines in January. All other outcomes will correct their baselines at the time of DY4 performance reporting. HHSC will be releasing a Category 3 goal calculator so that providers can confirm their goals prior to reporting, and determine if technical assistance is needed prior to performance reporting or if baselines can be corrected during the interim correction period.
  • In early 2016, HHSC will distribute a revised Population Focused Priority measure (PFPM) baseline reporting template and provide guidance on submitting a DY3 or DY4 baseline for the selected alternate achievement outcome. All providers with an alternate achievement outcome will be asked to submit a baseline for their selected measure, regardless if a baseline was previously submitted. This is to prepare for possible reporting in DY5. All providers who were approved by HHSC to select an alternate outcome measure (PFPM or P4P Cat 3 outcome measure) as a result of being transitioned to maintenance mode for high performance should inform HHSC of their selected alternate outcome measure as soon as possible.
  • HHSC has attached an updated list of Stretch Activity and Population Focused Priority measure selections. This list is current as of September 30th, 2015. HHSC recently released additional guidance for providers reporting Stretch Activity 3. As the volume for other stretch activities is fairly small, HHSC will not be producing additional guidance for other Stretch Activities. At this time, providers may only change a current selection to Stretch Activity 3, and may not switch to any other stretch activity if not currently selected.
  • A number of providers have expressed concern to MSLC about the compendium specifications for the following outcomes: IT-1.10 HbA1c poor control, IT-1.11 BP control, IT-1.21 Adult Body Mass Index (BMI) Assessment, IT-1.7 Controlling high blood pressure, and IT-12.4 Pneumonia vaccination status for older adults. Specifically, providers are concerned about the denominator requirement for a clinic visit in the 12 months prior to the measurement period. Based on input from MSLC and providers, HHSC has determined that providers may waive the requirement for an encounter in 12 months prior to the baseline measurement period for these outcomes. Providers should report with consistent specifications across baseline and performance reporting periods. Going forward, providers who waive this encounter requirement will not need written approval from HHSC. Providers should note this deviation from specification when reporting or correcting prior reporting for these outcomes. Myers and Stauffer will be reaching out to providers with impacted outcomes to confirm their decision to waive the requirement. HHSC has included in today's notes a summary of MSLC's assessment of the clinical impact of waiving the prior year encounter requirement for providers to review before making a decision about waiving the encounter requirement.

Waiver Renewal Planning

  • The link to the survey for stakeholder feedback on protocol level proposals for the 1115 Transformation Waiver Extension Application remains open: https://www.surveymonkey.com/r/YJFKRMG. More information can be found on the waiver website’s Waiver Renewal page.
  • Attached is information on the transition year (DY 6) proposal that has been communicated to CMS, which is consistent with the September webinar.
  • The waiver team is focusing on additional details for the proposed transition year (DY 6) and targets December 2015/early January 2016 to provide additional information and will update the survey for feedback at that time
  • HHSC is continuing to review projects to determine if a project is eligible to continue or requires changes for the waiver extension period and plans to provide information in January as previously communicated. Almost all of the projects reviewed will be eligible to continue, but some will require strengthening or next steps. HHSC may add additional projects for review based on October reporting submissions.
  • "Rebalancing": HHSC is proposing that DY7-10 valuation across Categories 1-3 and the performance bonus pool (formerly Category 4) be redistributed to fixed percentages of a provider’s total DY valuation. During DY2-5, distribution of funding across Categories varied based on the Program Funding and Mechanics Protocol requirements, initial provider determinations, withdrawn projects, and valuation changes. Currently, Category 1 and 2 DY5 valuation ranges from 25 to 82 percent of total provider DY5 valuation. Similarly, Category 3 DY5 valuation varies from 18 to 69 percent of total provider DY5 valuation. With the changes to DSRIP in the waiver extension (streamlining Category 1 and 2 milestones, changing Category 3 to pay-for-reporting and Category 4 to pay-for-performance for the Performance Bonus Pool), HHSC proposes to standardize funding across Categories while maintaining total provider valuation. HHSC will work with stakeholders to determine the distribution across Categories and submit for CMS review.

 

  • For example, Provider A has the following projects and funding distribution in DY5:

 

Update on Waiver Extension Application

 

  • HHSC met with CMS in November regarding the extension application. HHSC hopes to receive formal written feedback from CMS either in December or January.
  • HHSC anticipates getting some initial feedback from CMS on the transition year proposal this month.
  • For UC, CMS indicated that Texas' ask is more than what CMS thinks is warranted. HHSC will do the required independent analysis, but asked for an extension beyond the CMS requested submission date of May 31, 2016.
  • For DSRIP, CMS asked Texas to explore further financial integration of DSRIP into Medicaid managed care (i.e., running DSRIP payments through the managed care plans, similar to NAIP). HHSC explained at a high level the operational complexities of this (300 varying providers) and also that one of the DSRIP target populations is low income uninsured. CMS understands these considerations, and asked HHSC to explore potential options to move in this direction. HHSC is analyzing internally and will share more with stakeholders as they have more information.
  • Based on the discussions thus far with CMS, HHSC believes an initial 1-2 year extension is probable to enable more time for more detailed negotiations for the later years in the extension.

 

Please let me know if you have any questions.




DECEMBER 7, 2015
DSRIP

Good Morning Region 10 Providers,

 

I have a few brief updates for you this morning.

 

Waiver Extension

  • In late November, HHSC received from the federal Centers for Medicare and Medicaid Services (CMS) the attached letter, which they had been expecting. To support Texas’ extension request for the Uncompensated Care (UC) pool in the 1115 Transformation Waiver, the letter requests that HHSC submit an independent analysis by May 31, 2016 of the impact of the UC pool on overall UC in the state, Medicaid provider rates, Medicaid beneficiary access to services, and a number of other areas.
  • HHSC plans to ask for more time to submit the analysis, but given the tight deadline they plan to pursue an interagency agreement with a public state university to help complete the analysis.
  • HHSC continues to be optimistic about a waiver extension. They anticipate getting CMS’ initial written feedback and questions on the extension application submitted in September in the coming weeks. They will keep you apprised as they have more information.

 

October DY4 Reporting

  • Providers can expect to receive results of the October reporting period next week (estimated for December 9th).

 

Please let me know if you have any questions.


NOVEMBER 23, 2015
DSRIP
 

Good Morning Region 10 Providers,

 

I have few updates for you this morning.

 

Category 3 Stretch Activity 3

  • Attached is a guidance document for Category 3 Stretch Activity 3. This will give you a framework for working on a program evaluation for reporting in October DY5 if you have a Category 3 outcome that requires the completion of Stretch Activity 3. HHSC will also post this on the waiver website under Category 3.
  • HHSC is developing a template for reporting your SA3 evaluation findings to HHSC, so look for that early next year.
  • Questions related to other stretch activities should be sent to the waiver mailbox.

 

Waiver Extension Feedback

  • The survey for stakeholder feedback on the DSRIP protocol level proposals is still open and posted on the Waiver Renewal page.  The survey link is https://www.surveymonkey.com/r/YJFKRMG.
  • HHSC will continue to keep it open in its current form until they have any updates to make based on conversations with CMS, at  which point they will update it for additional stakeholder feedback on new items or changes. 

 

Myers & Stauffer Webinar

  • Attached are the presentation and a Q&A document from the webinar MSLC held on November 4th about their process for Cat 3 baseline reviews and Cat 1 and 2 validation.   HHSC will also post these documents on the waiver website under Recorded Webinars/Conference Calls (although there is no recording of this webinar).

 

Potential Grant Opportunity

  • The Substance Abuse Mental Health Services Administration (SAMHSA) recently released a Funding Opportunity Announcement for grants to expand care coordination Targeted Capacity Expansion (TCE) through the use of Technology Assisted Care (TAC) in targeted areas of need.  This could be a good opportunity for DSRIP Anchors and/or providers to coordinate and provide recommendations to the state. More information can be found at the following link: http://www.samhsa.gov/grants/grant-announcements/ti-16-001.
 
OCTOBER 19, 2015
DSRIP
 

Good Morning Region 10 Providers,


I have a few updates for you this morning.


Waiver Extension Application

 


Waiver Evaluation

 

  • Beginning November 1, 2015, the Waiver Evaluation Team will begin the second and final round of data collection for the Interorganizational Network Study. Members of the evaluation team will contact representatives of organizations that participate in DSRIP to schedule a 30-45 minute telephone survey.

 

Category 3

 

  • Category 3 Reporting Template Bug: There is a known bug in the Category 3 Reporting Template impacting Category 3 outcomes with 2 parts (7 and 30 day follow up, for example), where the second Rate 2 of 2 is not showing as complete in the summary tab. Providers encountering this bug may submit their template as is, providing all other outcomes are showing as complete and all required data fields have been filled.
  • Category 3 Certification Clarification for outcomes that are not reporting in October DY4: When certifying the Category 3 Oct DY4 reporting template, HHSC is asking for certification that information reported/corrected in October DY4 is accurate. When printing and signing the certification page, certifiers can strike through any previously reported baselines on the printed certification page that are not accurate and will be corrected at a later date.
  • For Category 3 outcomes with baselines currently under review by MSLC: If a provider with a current corrective action plan from MSLC reports DY4 achievement in October DY4, the corrected baseline and DY4 performance will be reviewed by MSLC and further audits of DY4 performance may occur. For Pay for Performance (PFP) outcomes, if an MSLC review determines that the actual AM-1.x milestone percent of goal achieved is less than the percent of goal achieved reported by the provider in DY4, recoupment of unearned portions of the DY4 achievement  milestones will occur. If portions of achievement milestones are recouped in DY4, providers could be eligible to earn unearned portions of DY4 achievement in DY5 through the Category 3 partial payment and carryforward process. The eligibility to earn carried forward portions of DY4 achievement will be contingent on completion of MSLCs corrective action plan and is subject to approval by MSLC, HHSC, and CMS pending a review of the outcomes reporting and compliance monitoring history. DY5 performance reporting may also be subject to compliance monitoring.
  • Please remember that Friday, October 23rd is the last day to submit a question about October reporting to the HHSC mailbox(TXHealthcareTransformation@hhsc.state.tx.us).

Please let me know if you have any questions.

 
 
OCTOBER 12, 2015
DSRIP
 

Good Morning Region 10 Providers,


I have a few brief October Reporting updates for you this morning.


October DY 4 Reporting

 

  • Category 3 Certification Clarification for outcomes that are not reporting in October DY4: When certifying the Category 3 Oct DY4 reporting template, HHSC is asking for certification that information reported/corrected in October DY4 is accurate. When printing and signing the certification page, certifiers can strike through any previously reported baselines on the printed certification page that are not accurate and will be corrected at a later date.

  • For Category 3 outcomes with baselines currently under review by MSLC: If a provider with a current corrective action plan from MSLC reports DY4 achievement in October DY4, the corrected baseline and DY4 performance will be reviewed by MSLC and further audits of DY4 performance may occur.

  • For Pay for Performance (PFP) outcomes, if an MSLC review determines that the actual AM-1.x milestone percent of goal achieved is less than the percent of goal achieved reported by the provider in DY4, recoupment of unearned portions of the DY4 achievement  milestones will occur. If portions of achievement milestones are recouped in DY4, providers could be eligible to earn unearned portions of DY4 achievement in DY5 through the Category 3 partial payment and carryforward process. The eligibility to earn carried forward portions of DY4 achievement will be contingent on completion of MSLCs corrective action plan and is subject to approval by MSLC, HHSC, and CMS pending a review of the outcomes reporting and compliance monitoring history. DY5 performance reporting may also be subject to compliance monitoring.

  • If you would like the Anchor Office to review any of you October reporting information please let us know by sending an email to (RHP_Region_10@jpshealth.org).

Please let me know if you have any questions.

 
 
OCTOBER 9, 2015
DSRIP
 

Good Morning Region 10 Providers,


Happy October Reporting! I know that each of you are working diligently on October Reporting and I wanted to share with you all of the updated reporting documents posted on the HHSC website.


Included in the attached zip folder are:


  • Category 3 DY 3 Status Template
  • Category 3 FAQs
  • Category 3 DY 4 Baseline & Performance Template
  • DY 4 Category 4 Template
  • Learning Collaborative Reporting Template (updated)
  • October DY 4 QPI Companion Document
  • October DY 4 QPI Template
  • October DY 4 Online Reporting User Guide
  • October  DY 4 Reporting Companion Document
  • DY 4 Reporting Coversheet

In the Reporting Webinar Presentations folder there are individualized presentations  from the reporting webinar yesterday.


Please let me know if you have any questions.

 
 
OCTOBER 5, 2015
DSRIP
 

Good Morning Region 10 Providers,


I have a lot of information to share with you this morning. Please take the time to read through the attached Anchor call notes. In the attached zip folder you will find the following reporting documents:


  • Category 3 DY 3 Status Template
  • DY 4 Category 4 Template
  • Learning Collaborative Reporting Template
  • October DY 4 QPI Companion Document
  • October DY 4 QPI Template
  • October DY 4 Online Reporting User Guide
  • October  DY 4 Reporting Companion Document
  • DY 4 Reporting Coversheet

Statewide Learning Collaborative


  • As a reminder, we have requested feedback from participants of the 2015 Statewide Learning Collaborative (SLC) Summit.  HHSC has extended the response deadline from October 2nd, until Monday, October 4th at 5pm CST. The survey can be accessed at the following link and should take only a few minutes to complete: https://www.surveymonkey.com/r/Z6S2C65.
  • Also regarding the SLC, HHSC is uploading the SLC recordings to a YouTube channel:  SLC 2015. All 10 of the videos should be uploaded Today. HHSC will post these links to the waiver website when all of the videos have uploaded.  

October DY 4 Reporting

 

  • All providers should complete their Semi-Annual Reporting (SAR) requirements and submit documentation for metrics they have been achieved by September 30, 2015. The deadline for October DY4 reporting submissions is 11:59pm on Saturday, October 31, 2015.
  • Reporting materials, including instructions, guidance, and templates, can be found on the Tools and Guidelines for Regional Healthcare Partnership Participants page on the waiver website under October DY4 Reporting. Items noted as “Pending” should be posted early this week.
  • HHSC will be holding an October DY4 Reporting Webinar on Thursday, October 8, 2015 from 10:00–11:30am which will cover General Reporting, Quantifiable Patient Impact (QPI), and Category 3 guidance. The webinar log-in information can be found on the waiver website’s Dates and Deadlines page. The webinar will be recorded and it will be posted on the waiver website about a week or so afterwards.
  • Reporting questions or issues with the reporting system should be sent to the waiver mailbox at TXHealthcareTransformation@hhsc.state.tx.us. Please include the RHP number, Project ID, and metric ID when submitting questions. If an error is being submitting with the reporting system, please mention the page the error occurred on and identify the button that was clicked when the error occurred. Please note the final date to submit questions regarding October reporting and inform HHSC of any issues with DY4 data in the reporting system is Friday, October 23, 2015.
  • For October DY4 reporting IGT changes, HHSC plans to post the estimated IGT due based on reported achievement by November 6, 2015. Providers may submit IGT changes (i.e., changes in IGT Entity or proportion of IGT funding) by November 20, 2015, instead of by the end of the reporting period on October 31, 2015.

Category 3

 

  • HHSC has reviewed all changes sent by providers in response to Category 3 summaries sent out last week. HHSC has sent anchors an updated regional file reflecting these changes, as well as individual zip files for distribution to providers. These files will be emailed to the lead providers for each organization early this week. As HHSC prepares for seeding the October DY4 reporting template, please only contact HHSC if the revised summary files identify a critical error (either incorrect IT selection or milestone structure).
  • The Category 3 October DY4 reporting template and Category 3 Reporting FAQ are currently scheduled for release to providers on Tuesday, October 6th.

QPI

 

  • As a reminder, all providers with a DY4 QPI metric are required to fill out a DY4 QPI template for SAR purposes - this is required for all providers - even those who have already reported DY4 QPI metrics for completion and those who are not ready to report yet for DY4. Providers should update data to demonstrate encounters provided/individuals served through September 30, 2015.
  • Just as a heads up, there is a slight formatting change to data entry cells in Step 6 (noted in the Companion and on the instructions tab). The functionality remains the same, but the formatting change saved a lot of room in the file size.
  • October DY4 is the last occasion to report a DY3 Carryforward.  If a provider is unable to achieve the DY3 Carryforward, they may forfeit their DY3 QPI payment and achievement and be able to start counting DY4 QPI from the beginning of DY4.  Instructions for doing this will be in the QPI Companion and covered during the Reporting Webinar on October 8th.

Compliance Monitoring/Mid-Point Assessment

 

  • Category 1 and 2 metrics review. MSLC is restarting its review of Category 1 and 2 reported information for DY2 and DY3. To minimize impact on the providers, during October MSLC will be reviewing available information for the selected metrics, which includes reported information submitted by the providers and QPI templates.
  • In November, MSLC will start sending out communication to the providers whose metrics are selected for the review. MSLC will provide instructions to providers on what information to submit and how to submit it.
  • As previously communicated, DY 2-3 metrics included for the review are selected process milestones and QPI metrics.
  • Estimated completion date of the review is April of 2016.

Waiver Renewal Planning

 

  • The slides for the DSRIP Extension Planning and Protocols webinar are posted on the Waiver Renewal page, and the recording should be posted in about a week or so. 
  • As stated in the webinar, CMS has given HHSC the go-ahead to push back the formal submission date for the DSRIP protocols until late spring/early summer 2016, so HHSC will have more time to work with stakeholders to flesh out what will be submitted.
  • HHSC is working on a communications process for feedback from stakeholders from the initial proposals in the webinar, and information we receive from CMS. This will include feedback already received (such as through the public meetings), so stakeholders do not need to duplicate input. HHSC will notify you once the process is posted on the waiver website.

 

Alignment with Managed Care

 

  • The Texas External Quality Review Organization and HHSC Managed Care Operations Quality team are hosting a 2015 Fall Texas Medicaid/CHIP Managed Care Quality Forum & Collaborative PIP Workshop on November 5 and 6. The PIP Collaborative Workshop will be November 6. HHSC plans to invite providers who will be partnering with MCOs on their 2016 required PIPs to the workshop.
  • Please be on the lookout for the email with registration information. It should be sent out after October 9.

 

Please let me know if you have any questions.
 
 
OCTOBER 2, 2015
DSRIP
 

Good Morning Region 10 Providers,


The October DY4 Reporting Period is now open in the DSRIP Online Reporting System.  HHSC is currently in the process of posting October DY4 reporting instructions and other materials  on the HHSC Waiver Website at http://www.hhsc.state.tx.us/1115-Waiver-Guideline.shtml. Items noted as “Pending” will be available on the waiver website the week of October 5, 2015.


HHSC will be holding an October DY4 Reporting Webinar on Thursday, October 8, 2015 from 10:00–11:30am which will cover General Reporting, Quantifiable Patient Impact (QPI), and Category 3 guidance. The webinar log-in information can be found on the waiver website’s Dates and Deadlines page at http://www.hhsc.state.tx.us/1115-Waiver-Deadlines.shtml. If you are unable to attend the webinar at this time, it will be available on the waiver website about a week or so later.


General Reporting Reminders:

 

  • The October DY4 reporting period is the final opportunity to report achievement on DY3 Carryforward metrics.
  • Milestones and Metrics must have been completed by September 30, 2015 in order to report achievement and earn payment.
  • The reporting system will close on October 31, 2015 at 11:59pm.
  • Semi-Annual Reporting (SAR) Requirements:   Providers are required to report twice a year, whether or not they are reporting achievement for their milestones and metrics. If a provider does not submit information for the following required fields, DSRIP payments may be withheld until the complete report is submitted which also includes future payments.
    • Provider Summary (Located on the Provider Homepage in the DSRIP Online Reporting System)
    • Project Summary (For all Cat 1 and Cat 2 projects - located on the Project Reporting page)
    • Progress Update fields (For all Cat 1 or Cat 2 metrics and Cat 3 milestones - located on the milestone tabs)
    • QPI Template for ALL DY4 QPI Metrics (A completed template with QPI data through September 30, 2015 must be uploaded for ALL DY4 metrics that are marked as “Y” for QPI.)
    • QPI:   Please remember to use the Pre-DSRIP Baseline when inputting data into the QPI template. The provider should NOT be using baselines established during DSRIP which may be listed in their QPI metric’s baseline/goal language.
    • Documentation:   Supporting documentation should only be uploaded to metrics that are reporting achievement for payment and DY4 QPI metrics (regardless if they are reporting achievement or not). HHSC will not be reviewing documentation uploaded to metrics that are NOT reporting achievement.
    • Reporting System Access: If additional team members require access to the reporting system, please submit an RHP Contact Change Form to the waiver mailbox at TXHealthcareTransformation@hhsc.state.tx.us. (PLEASE NOTE: If a user has recently transferred organizations and noted so in the User Update that was submitted at the end of September, the user may use his/her old username unless otherwise notified. Please use your new email address if you need to reset your password.)
Questions regarding reporting should be submitted to the waiver mailbox at TXHealthcareTransformation@hhsc.state.tx.us, so the question(s) can be triaged to the appropriate HHSC staff members. Please remember to include your RHP, Project ID, and Metric ID when submitting your questions. Response times may vary depending on the volume of questions HHSC receives and how much research a question requires.
 
 
SEPTEMBER 28, 2015
DSRIP
 

Good Morning Region 10 Providers,


I have a few updates for you this morning.


Webinars


  • HHSC scheduled the October DY4 Reporting webinar for Thursday, October 8, 2015, 10:00 – 11:30 am Central Daylight Time.
  • A reminder that the webinar on DSRIP Extension Planning and Protocols is scheduled for next Wednesday, September 30, 2015 from 1:30 – 3:00 pm.
  • If you did not receive webinar access information for the Reporting webinar or the Planning and Protocol webinar please send an email to the RHP 10 mailbox at (RHP_Region_10@jpshealth.org) and I will send the information to you. 

Category 3

 

HHSC sent out provider-level Category 3 outcome summary files last Monday. The information below is to clarify the process for updating Category 3 baseline information.


  • For all Category 3 outcomes requiring corrections, including those under review by Myers and Stauffer (MSLC):

  • If the baseline measurement period and/or the subset need to be corrected, the provider should send an email to the Waiver mailbox outlining the requested changes ASAP.

  • Providers should NOT send information to HHSC regarding outcomes that do not require changes to baseline measurement periods or subsets. In the interest of time prior to October reporting, HHSC will not be responding to emails requesting other types of Cat 3 changes next week.

  • The process for updating baseline information other than baseline measurement periods or subsets is as follows:

  • For providers reporting performance of a Category 3 outcome measure in October DY4 reporting: If a baseline needs to be corrected due to errors in abstraction or understanding of measure interpretation, updates can be made through the October DY4 reporting template at the time DY4 performance is reported. 

  • For providers not reporting performance of a Category 3 outcome measure in October DY4 reporting:
    • If the outcome is under review by MSLC, no action is needed by the provider. When MSLC completes their entire review, they will send HHSC their findings, and HHSC will update records at that time.
    • For outcomes not under review by MSLC on which the provider is not reporting performance during October DY4 reporting (i.e., they are carrying forward), if a baseline needs to be corrected due to errors in abstraction or understanding of measure interpretation, providers will have an opportunity to make these changes during or prior to April DY5 reporting.

  • As a reminder, while all Category 3 outcomes with a reported DY3 baseline (including those under review by MSLC) will be eligible to report DY4 performance in October. All reporting is subject to compliance monitoring. In cases where compliance monitoring determines that actual achievement is less than reported achievement, payments above actual achievement will be recouped. Providers uncertain of their baselines are strongly encouraged to carry forward reporting of their DY4 performance. This will reduce the possibility of recoupment and additional administrative work for the provider and HHSC.

Please let me know if you have any questions.
 
 
SEPTEMBER 21, 2015
DSRIP
 

Good Morning Region 10 Providers,


I just wanted to give you a brief update this morning.


DSRIP Extension Protocols

  • CMS has given HHSC the go-ahead to push back the formal submission date for the DSRIP protocols until late spring/early summer 2016, so HHSC will  have more time to work with stakeholders to flesh out what will be submitted.  Since the time pressure has lessened a bit regarding the extension protocols HHSC will be able to focus efforts on what the transition year will look like.  HHSC will have more information on that in the upcoming 9/30 webinar.   

Category 3

  • HHSC will be sending provider-level Category 3 outcome summary files early this week (target is today), copying the Anchors. The files will contain each current Category 3 IT selection including milestone structure, reporting history, baseline numerator and denominator if reported and DY4 and DY5 goals if applicable. The information in the files will be used to update milestones in the online reporting system and populate the October DY4 Category 3 reporting template.  Providers will have an opportunity to let HHSC know about needed corrections by September 25th; more information will be in the email sent this week.
  • HHSC is no longer accepting baseline correction forms for baselines reported in October DY3 or April DY4.  Updates to baseline numerator and/or denominator (due to errors in abstraction or understanding of measure interpretation) can be made through the October DY4 reporting template at the time DY4 performance is reported.

Please let me know if you have any questions.

 
 
SEPTEMBER 11,2015
DSRIP
 

Good Afternoon Region 10 Providers,


I have a few updates for you this afternoon.


  • The DSRIP Extension Webinar has been scheduled for Wednesday, September 30, 2015 from 1:30 – 3:00 pm, Central Daylight Time.  HHSC will be discussing planning for transition and working with CMS on the protocols. The call-in information was sent out to providers and Anchors.  Each of you should have received a meeting invite from me containing all of the webinar access information.

  • The SLC evaluation survey link was sent out to SLC participants and all providers – https://www.surveymonkey.com/r/Z6S2C65. HHSC is hoping to get feedback from both in-person participants and those who viewed via live stream.  The survey will be open until COB Friday, October 2nd.

  • Attached is the letter HHSC received in July from CMS concerning approval of DY4 & DY5 DSRIP valuations. A provider recently inquired about it, so they thought it might be of interest to others.   

  • HHSC will be sending out requests for additional information for projects under HHSC review for continuation in the extension period starting next week through October 9th and may send additional requests starting again in November through December. Providers will have one week to respond and may request additional time if needed. HHSC will only be contacting providers if they need additional information so some providers may not hear from HHSC. Additional projects may be added to the review after October reporting. HHSC plans to notify all providers of the review results in late January.

  • MCO plans were provided their Performance Improvement Project (PIP) assignments in August. They were encouraged to collaborate with a DSRIP project. “For those plans that are required to conduct a collaborative PIP in 2016, we encourage you to reach out to the Regional Health Partnerships (RHPs) in your area to find DSRIP projects that align with your 2016 PIP topic or intervention ideas. . . PIP plans will be due by COB October 9th.” Attached, please find a list of the assignment topics by MCO plan and contact information (though not yet complete) for the plans. The RHPs each MCO serves (listed by STAR/CHIP and STAR+PLUS) are listed in the columns on the right.


Please let me know if you have any questions.

 
 
SEPTEMBER 8, 2015
DSRIP
 

Good Afternoon Region 10 Providers,


I have a lot of information to share with you this afternoon. I have complied a brief summary of the Anchor Call notes below, but I ask that you please read through them in their entirety.


DY 4 October Reporting


  • HHSC wants to encourage providers to check the Online Reporting System to review their Category 1 and 2 DY3 carryforward and DY4 metrics they have not yet reported for achievement, and begin sending any questions about metrics or documentation so HHSC will have time to respond.  Please note that recent Category 3 changes are not yet integrated into the Online Reporting System.
  • The estimated payments for approved April NMI milestones and metrics are attached. Please refer to column G "DY4 Round 1 NMI Approved DSRIP" and column K "DY3 Round 1 NMI Approved DSRIP" for the NMI approved amounts that will be included for January 2016 payments.

Category 3

 

Baseline TA:

  • HHSC continues to work with providers on outstanding issues related to Category 3 baselines reported in October DY3 and April DY4.
  • HHSC will aggregate all changes made through the Category 3 baseline TA process and baseline corrections and send an updated summary of Category 3 baselines and reporting status to Anchors and providers for review with a current target date of September 18th.

Reporting Template:

  • In the October DY4 reporting period, all Category 3 reporting will be done in one provider template including both baseline reporting and DY4 performance reporting.
  • As providers are needing to make baseline corrections as a result of improvements in data integrity and understanding of measure specifications, the October DY4 reporting template will include the option to correct a currently reported baseline due to errors in outcome interpretation or data collection. If a baseline is corrected through the reporting template, the template will be able to recalculate DY4 and DY5 goals in most scenarios and determine percent of DY4 goal achieved. Providers will not be able to add or remove approved subsets or change measurement periods during the reporting process.

Milestone Structure for Non-standard Baselines:

  • As a reminder, in cases where  a provider has no or inadequate data to establish a baseline that ends by 09/30/2014 (the end of DY3), DY4 data may be used to establish a baseline and this results in a change to the Category 3 milestone structure. Outcomes approved to report with a DY4 baseline must report a baseline with 12 months of data, and the 12-month period should be as early as possible and end no later than the end of DY4.
  • Providers intending to report a baseline with DY4 data should notify HHSC prior to October reporting as this results in a change to the DY4 payment structure, removing the DY4 achievement milestone. Providers who report a baseline with DY4 data and do not contact HHSC prior to the October reporting period will not be eligible to receive the DY4 funds associated with their AM-1.x achievement milestone during the October reporting period.

Meyers & Stauffer:

  • By September 30th, providers with Category 3 baselines selected in Round 1 or Round 2 of review will receive preliminary notifications and corrective action plans if needed.
  • MSLC will begin working with providers to complete corrective action plans and finalize baseline corrections beginning in October, extending through December 2015.
  • HHSC will not be removing reporting eligibility for October DY4 reporting based on Myers and Stauffer findings.

October DY 4 Reporting Eligibility:

  • All outcomes with a reported DY3 baseline will be eligible to report DY4 performance in October. All reporting is subject to compliance monitoring and in cases where compliance monitoring determines that actual achievement is less than reported achievement, payments above actual achievement will be recouped.
  • Providers uncertain of their baseline are strongly encouraged to carry forward reporting of their DY4 performance. This will reduce the possibility of recoupment and additional administrative work for the provider and HHSC.

Population Focused Priority Measures & Stretch Activities

  • HHSC will be posting a revised Population Focused Priority (PFP) Measures menu to the HHSC website and it is also attached to this email. The menu has been updated to reflect the final selection PFP IDs and the corresponding Category 3 Measure for specifications.
  • HHSC has not yet reviewed PFP baselines that may have been reported in October DY3 or April DY4, and will begin that process in January 2016.
  • HHSC is working on enhanced guidelines for Stretch Activities and these will be available after the October reporting period, with providers eligible to report achievement of Stretch Activities in October DY5. Stretch Activity milestones (PM-11) do not need to be reported in the same reporting period as their associated Category 3 outcome reporting (PM-10 or PM-12).

3-Year Project Change Requests


  • HHSC has completed the review of the submitted change requests, and MSLC has completed their review of those change requests that required their secondary review.
  • The RHP 10 Anchor Office requests that any responses back to HHSC be submitted to the RHP mailbox (RHP_Region_10@jpshealth.org) by September 18th.

Compliance Monitoring/Mid-Point Assessment

 

  • Addendum to the Mid-Point Assessment Report with results of the review of 3 year projects is completed and attached. There are three attachments for this addendum: 3 Year Project Review Methodology, Appendix 1- 3 Year Projects Risk Ranking, and  Appendix 2-3 Year Projects Analysis Recommendations Responses.

Statewide Learning Collaborative Summit

 

  • HHSC will be sending out a Survey Monkey link requesting feedback on both the content and structure of the event.  This survey will be open and emailed to participants, planned by Tuesday, September 8th and will remain open until Friday October 2nd.

Waiver Renewal Planning

 

  • HHSC has submitted the waiver extension packet to the Governor's office for submission to CMS by September 30, 2015.
  • The DSRIP protocol webinar is tentatively planned for Wednesday, September 30, 2015 from 1:30 p.m. - 3:00 p.m.
  • HHSC will be posting the proposed extension menu for replacement projects and a survey for feedback soon. The extension menu is also attached.
  • HHSC also plans a survey for feedback on the Statewide Analysis plan after the webinar, to include Categories 3 and 4 and the performance bonus pool.
  • For overall planning HHSC will stagger the feedback loop to account for providers reporting in October, and HHSC's review of reporting in November, for the planned timeline of protocol submissions to CMS in early 2016.

 

General Updates

 

  • HHSC wants to reiterate for all waiver stakeholders an issue that may impact available UC funds in DY5. In November-December 2011 when waiver negotiations with CMS were being finalized, HHSC paid out $466 million in UPL funds and CMS added a provision to the waiver requiring that during the 5-year waiver term, these payments be offset against the UC pool (i.e., reducing UC pool payments by $466 million). HHSC has not yet done this offset, which could reduce the amount of UC funds available in DY5 from $3.1 billion to less than $2.8 billion. HHSC plans to count toward the UPL offset recoupments as each DY's UC payments (based on a 2-year data lag) are reconciled to actual UC costs that year. For example, for DY1 this recoupment amount is almost $100 million. HHSC should also be able to do the DY2 reconciliation before DY5 payments are finalized (DY2 recoupment amount still TBD). To the extent that HHSC can offset recoupments against the $466 million, this will reduce the payment reduction from the DY5 UC pool. HHSC will keep stakeholders updated as we have more information.
  • Attached you will find the RHP 10 DY 4 revenue summary. If you have any questions, updates or comments please let me know.

Please let me know if you have any questions.

 
SEPTEMBER 1, 2015
DSRIP
 

Good Afternoon Region 10 Providers,


I know that many of you attended the Statewide Learning Collaborative but I wanted to be sure to share with you all the presentations that were given. The presentations can be found at http://www.hhsc.state.tx.us/1115-Waiver-Deadlines.shtml. I will be sure to send out information once the video recording is available. Also, attached is the presentation specifically given on Waiver Extension and Protocols. I implore each of you to read through this information and if you have any questions please let me know.

 
SEPTEMBER 1,2015
DSRIP
 

Good Afternoon Region 10 Providers,


HHSC has provided the below additional guidance on QPI.


In reporting to date, HHSC has found that Quantifiable Patient Impact (QPI) reporting remains challenging. We wanted to provide some reminders on QPI in advance of October reporting, including what it is intended to measure and how the template works, with special focus on the pre-DSRIP baseline.


QPI is intended to capture the impact of a DSRIP project by measuring the increase in the number of individuals served or encounters provided as a result of that project. Another way to think about the QPI is to think about the change in the provider's workload as a result of DSRIP funding.


To that end, the QPI template is set up to isolate the number of individuals served or encounters provided (based on the metric’s QPI grouping) in any one demonstration year (DY) as a result of the DSRIP intervention. To do this, it compares the level of service in that DY against the level of service prior to the start of the project. That level of service prior to the start of the project is your pre-DSRIP baseline. In practice, the template will subtract the pre-DSRIP baseline from the total level of service (individuals served or encounters provided) in the DY for which you are reporting.


Pre-DSRIP Baseline:

Every QPI metric will have only one pre-DSRIP baseline. The pre-DSRIP baseline is the point of comparison for each DY and will not change over the life of the waiver. The pre-DSRIP baseline is established the first time the provider reports a QPI metric, and is a number that indicates the number of individuals served or encounters provided in the year before the start of any DSRIP interventions. If you have reported the QPI metric for achievement, your pre-DSRIP baseline for that QPI metric cannot be changed. If you have only reported on a QPI metric for the purposes of the Semi-Annual Reporting (SAR) or program updates (you have not reported your QPI metric for achievement), the field (Step 5 in the QPI Template) to establish the pre-DSRIP baseline may still be changed in your QPI template. In that case, if you find you have made a mistake in the pre-DSRIP baseline, you may change it.


As a reminder, if your DSRIP project is providing a new service, your pre-DSRIP baseline is "0".

If your DSRIP project is an expansion of existing services, your pre-DSRIP baseline should be the level of service (encounters or individuals, depending on your QPI grouping) you provided in the year prior to the start of your DSRIP intervention, a number greater than 0. This is not to be confused with the level of service you provided in the early years of the DSRIP project (DY2 or DY3). Those may be a level of service upon which you plan to build, but are not the same thing as the pre-DSRIP baseline.


For example, let's say your project is to increase the number of individuals to whom you provide navigation services. Your practice previously provided navigation services, so this is not a new service. In the year before you implemented the expanded services, you provided navigation services to 378 individuals. In the first year of the expanded level of services with DSRIP funding, let's say DY3, you provide 621 individuals with navigation services. In your QPI template, in Step 5, Pre-DSRIP Baseline, you would report 378 individuals with the dates of 10/01/2011 to 9/30/2012. Remember to describe the data used to calculate the pre-DSRIP baseline. In Step 6, you would copy and paste the patient ID and date of service for all 621 individuals you served in DY3 (10/01/2013 to 9/30/2014). The template will then calculate your QPI for DY3, which will be 621 individuals minus 378 individuals of the pre-DSRIP baseline for a total DY3 QPI of 243 (621 - 378 = 243). Let's assume your goal was 230; you have met (and exceeded!) your QPI goal for DY3.


Building on that example, let's say your DY4 QPI goal is to provide services to 300 individuals. Your pre-DSRIP baseline will still be 378 individuals. You must then provide services to 678 individuals in total in DY4 to meet your DY4 QPI goal of 300 individuals (678 - 378 = 300).


Common Points of Confusion:

Baseline reference in your Baseline/Goal Statement:

  • Sometimes, the baseline/goal statement talks about      improving over the previous demonstration year or an estimated baseline. Unless      the reference in this statement is the pre-DSRIP baseline that has been      reported for achievement and reviewed by HHSC, you may ignore the      reference in the baseline/goal statement. There is only one pre-DSRIP      baseline and it is from the period before the start of the DSRIP project.      It is established in the QPI template the first time you report for      achievement.

 

Numeric goal versus percentage goal:

  • In most cases, your numeric goal is the numeric      equivalent of the percentage goal. For example,  your QPI metric goal      could be,  “Provide navigation services to 230 individuals, or 90% of      eligible patients.”  In this example, 230 individuals and 90% of      eligible patients are equivalent.  The 230 individuals would be      reported through the QPI template, but you would provide separate      documentation to show that 230 equals at least 90% of eligible      patients.  For these types of QPI goals, the numeric goal (230) is      the primary goal, while the percentage (90%) may vary with      explanation.  In other words, if 230 equals only 85% of eligible      patients, you would show that calculation through separate documentation      and include an explanation for why the percentage was lower than      expected.  The metric could still be approved for payment if the      numeric goal of 230 were achieved. 

QPI goals based on previous year estimates:

  • In some instances, the QPI goal may be based on a      previous year of the DSRIP project, and the previous year volume was only      an estimate when the QPI goal was set.  For example, let's say in DY2      for this same project you expected to provide 400 individuals with the      intervention and your DY3 goal was 10% increase over the previous year.      The DY3 numeric goal was set at 40. But then, once you started the      project, you actually provided 500 individuals with the intervention in      DY2.  Even though the DY2 baseline level of service against which you      were comparing was only an estimate when the DY3 metric was drafted, you      should stick with the numeric goal that is included in the online      reporting system and in your template -- which would still be 40. If you      serve 50 additional individuals, all the better, but your achievement      will be measured by the numeric goal HHSC has on record.

 

In some instances, your QPI metric goal statement includes more than one QPI goal. A performing provider must achieve all of the goals in the “Baseline/Goal” in order to be eligible for payment for the metric.

  • For example, your QPI goal is “Hire 1 new navigator to      provide navigation services to 230 individuals in DY3.” In this instance,      you should utilize the QPI template to demonstrate achievement of the 230      individuals metric, and then submit other supporting documentation through      the online reporting system as evidence of your hiring the new navigator.
  • Another example is that you may have to achieve both      your percentage goal and your numeric goal, if they were intentionally      meant to measure different things. For example, you are providing new      trainings to providers throughout your diabetes clinic. Your QPI      baseline/goal statement is,  “250 patients will be impacted by the      new interventions, and 75% will provide a positive rating on the patient      survey.”  In this instance, your QPI template should reflect all      patients receiving the intervention -- so all patients who are treated by      the providers who have received the new training. And, the percentage that      provide a positive rating on the patient survey should be reported through      additional supporting documentation. The QPI templates are not set up      to calculate percentages.

 

We hope this information has helped clarify some common points of confusion. As always, if you have questions, please email the waiver mailbox at TXHealthcareTransformation@hhsc.state.tx.us. If you have questions specific to QPI, we encourage you to submit these questions as soon as possible.

 
AUGUST 19, 2015
DSRIP
 

Good Morning Region 10 Providers,


HHSC has arranged for the Statewide Learning Collaborative Summit to be available for viewing on-line, in real time, in order to allow all interested individuals to watch the proceedings.  To access the Summit via webcast on August 27th and/or 28th, please click on the HHSC Webcast link: www.zodiacstudios.net/texas-health-and-human-services-commission.html. The webcast will only stream the sessions that are occurring in the Grand Ballroom.  Please see the attached agenda for Summit sessions. 


A test stream will be available on August 19th -  21st each day between the hours of 8:00AM and 10:00PM at the same link (www.zodiacstudios.net/texas-health-and-human-services-commission.html) in order for viewers to troubleshoot any firewall issues prior to the Summit.  If issues are encountered during the test stream, HHSC recommends facilities wanting to watch the Summit open up the ability to offer streaming through their firewall and test again to make sure it is working.

When you access this site during the test period or the Summit hours, please press play to begin watching on-going sessions. If at any time a participant leaves the webcast and returns later, you will need to click on the same link and press play to re-join. During the webcast, participants may submit questions through an online chat function. Questions will be answered after the Summit concludes.

For technical difficulties accessing the webcast, please send an e-mail to: TXHealthcareTransformation@HHSC.state.tx.us. Please feel free to share the webcast information with other interested individuals.

Please let me know if you have any question.

 
 
AUGUST 17, 2015
DSRIP
 

Good Morning Region 10 Providers,


HHSC has released the final agenda (attached) for the Statewide Learning Collaborative. I will send out more information, as it becomes available, for those who would like to watch the live streaming of the event.

 
 
AUGUST 11, 2015
DSRIP
 

Good Morning Region 10 Providers,


I have quite a bit of important information to share with you this morning.


HHSC DSRIP Dashboard


  • HHSC posted a DSRIP Tableau Dashboard searchable statewide DSRIP database (along with the user reference guide) on the Regional Healthcare Partnership (RHP) Plans page. The DSRIP Tableau Dashboard presents Category 1-3 data in summaries and graphs. It allows project filters based on RHP, Provider Name, Provider Type, Project Option, Primary Project Type, and Category 3 Outcome.

DY 4 April Reporting


  • Project payment summaries have been posted on the waiver website through April DY4 reporting.
  • Provider and project reporting summaries have been posted on the waiver website containing provider-level and project-level status information submitted during the October DY2 through April DY4 reporting periods.

Category 3

 

  • HHSC Staff are still conducting Category 3 technical assistance for baselines that were reported in October DY3 and flagged as needing baseline clarification or assistance in determining DY4 and DY5 goals. HHSC is contacting providers via email with a description of any outstanding baseline clarification or technical assistance issues, and either setting up a call or proposing a resolution.  All providers have been assigned to an HHSC staff member at this point, and we believe a dozen are still to be contacted.
  • On Thursday HHSC sent out a provider level summary for baselines that were submitted in April. Providers reporting PM-9 for achievement in April DY4 should have received a spreadsheet outlining DY4 and DY5 goals, and any baseline clarification or technical assistance issues that need to be resolved before providers can report DY4 performance.
  • As a reminder, to submit a correction to an already reported Category 3 baseline that has not been selected for compliance monitoring by Myers and Stauffer, please send an email to the waiver mailbox (TXHealthcareTransformation@hhsc.state.tx.us) indicating the Category 3 project ID of any baselines that need correction, and a brief description of the baseline issue. HHSC will then send the provider a Category 3 Baseline Correction Form specific to their outcome that should be completed by the provider and returned to the waiver mailbox. Please submit baseline correction forms to HHSC by August 15th.
  • HHSC has received a number of inquiries about the transition to ICD-10 and Category 3 reporting. HHSC will not be updating the compendium with new ICD-10 codes and they do not plan to issue a code crosswalk specific to DSRIP Category 3. HHSC asks providers (and Myers and Stauffer when relevant) to treat this as an instance where providers are using their best clinical judgment and then maintaining documentation of those clinical judgments and consistency throughout reporting periods. In this case, HHSC would allow providers to use whatever guidance/crosswalks they are applying system-wide for the transition (for example, CMS GEMs 2016). Please notify HHSC if you identify a specific instance where the transition may make comparison between measurement periods invalid.

Compliance Monitoring


  • HHSC anticipates the Mid-Point Assessment Report for 3 year projects will be completed and released this week.
  • HHSC is working with MSLC to expand the sample for the review of baselines to make sure that at least one Category 3 measure for each provider is reviewed during compliance monitoring.  Last week, a second group of providers was informed about Cat 3 review selection.
  • Category 1 and 2 metrics review. MSLC started the first phase of the Category 1 and 2 reviews. Close to 100 projects are included in this phase. Providers were already notified and are in the process of submitting information for the FTP set up. MSLC will start with reviewing available reported information for the selected metrics. In case additional information is required, MSLC will ask providers to submit it.
  • Due to the expansion of the work on Category 3 baseline review, MSLC will delay majority of additional requests for Category 1 and 2 review until later time.
  • Below is a high-level timeline for work conducted by MSLC. Although October is listed, HHSC has informed MSLC that there will need to be additional flexibility afforded to providers during October due to reporting submissions that month.
    • May 2015 through September 2015 - Category 3 baseline review - baseline correctness
    • October 2015 through December 2015 - Category 3 baseline review - corrective action plan, technical assistance and follow-up
    • October 2015 through February 2016 - Category 1 and 2 validation - Round 1
    • March 2016 through May 2016 - Category 4 review
    • March 2016 through June 2016 - Category 1 and 2 validation - Round 2
    • May 2016 through August 2016 - Category 2 performance review and Population Focused Priority Measure Baseline Review

Waiver Renewal Planning


  • A summary of all comments from the public hearings (including the webinar) have been posted on the waiver website on the Waiver Renewal page.
  • HHSC will continue to work with stakeholders on detailed programmatic changes to the protocols not addressed in the waiver extension draft.
    • More information on protocol-level proposals will be provided at the Statewide Learning Collaborative Summit August 27 - 28.
    • HHSC tentatively plans to hold a DSRIP protocol webinar in September (rather than August as previously indicated).
    • HHSC has notified providers of projects that will be reviewed for possible changes for waiver renewal, including the reason for review.  Providers should notify HHSC by August 28, 2015 if they do not plan to continue any of the projects under review after DY5 or do not plan to use the funds for a replacement. That is the only action needed at this time. Note that HHSC will provide information regarding replacing and combining any current projects at the Statewide Learning Collaborative.

Statewide Learning Collaborative Summit

 

  • HHSC will provide an update to the anchors of any unused and reallocated slots soon.
  • Providers who have already been notified by HHSC that their posters were accepted may go ahead and register their poster presenter at this time if they have not already done so (even if they have already registered for their 1-2 provider slots).
  • A more detailed agenda will be sent this week as details are finalized. 
  • For projects that were selected to present a poster at the event, yesterday, August 10th was the deadline to submit a PDF of posters to the Waiver mailbox(TXHealthcareTransformation@hhsc.state.tx.us).  HHSC has received a few questions inquiring as to whether they will be printing out the posters for this session.  HHSC is not able to provide printing services so providers will need to make arrangements to print posters prior to the event. If you are a poster presenter, please remember to bring business cards or one-pagers with contact information to provide to summit attendees.

Please let me know if you have any questions.

 
 
JULY 24, 2015
DSRIP
 

Good Morning Region 10 Providers,


I have quite a bit of information to share with you this morning.


DY 4 April Reporting


  • July 31, 2015 ‐ April reporting DY2 and DY3 DSRIP payments processed for all providers and DY4 DSRIP payments processed for remaining providers that were not paid on July 21, 2015.  Note that there are separate transactions for each payment for each DY.
  • August 7, 2015 – HHSC and CMS will approve or deny the additional information submitted in response to HHSC comments on April reported milestone/metric achievement. Providers who previously received “Needs More Information” (NMI) requests will receive coversheets summarizing metric achievement determinations no later than August 7. Approved metrics will be included for payment in the next DSRIP payment period, estimated for January 2016.

Category 3


  • Next week, HHSC will be begin reviewing Category 3 baselines submitted during the April DY4 reporting period, and will notify providers of any needed baseline clarifications or technical assistance.
  • HHSC has received additional Category 3 guidance prepared by Myers and Stauffer (referenced in the Compliance Monitoring notes section below) and is attached. Myers and Stauffer have prepared a summary of common baseline issues identified during their review for Category 3 Outcomes IT-1.10 Diabetes Poor Control, IT-1.11 Diabetes Care: BP Control,  and IT-1.13  Diabetes Care: Foot Exam. Providers are encouraged to review their own baselines to identify any of these common mistakes and take the necessary actions to correct any identified errors that result in a change to reported baseline.
  • As a reminder, to submit a correction to an already reported Category 3 baseline that has not been selected for compliance monitoring by Myers and Stauffer, please send an email to the waiver mailbox indicating the Category 3 project ID of any baselines that need correction, and a brief description of the baseline issue. HHSC will then send the provider a Category 3 Baseline Correction Form specific to their outcome that should be completed by the provider and returned to the waiver mailbox. Please submit baseline correction forms to HHSC by August 15th.

 

Compliance Monitoring

 

  • HHSC is working with MSLC to expand the sample for the review of baselines to make sure that at least one Category 3 measure for each provider is reviewed during compliance monitoring.  Most likely next week a second group of providers will be informed about Cat 3 review selection.
  • MSLC provided HHSC with the summary of common issues identified for three outcomes, IT-1.10, IT - 1.11 and IT-13.
  • Attached you will also find a description of Myers & Stauffer process for Category 3 baseline review.
  • Category 1 and 2 metrics review. MSLC started the first phase of the Category 1 and 2 reviews. Close to 100 projects are included in this phase. Providers were already notified and are in the process of submitting information for the FTP set up. MSLC will start with reviewing available reported information for the selected metrics.
  • Due to the expansion of the work on Category 3 baseline review, MSLC will delay majority of additional requests for Category 1 and 2 review until a later time.

Waiver Renewal Planning

 

  • The survey link (https://www.surveymonkey.com/r/5F56T2C)  for stakeholders to give comments on the draft will remain open until August 5th, when the public comment period ends.
  • Comments at the public meetings are recorded and HHSC will read and consider all of the submitted comments. It is not necessary for stakeholders to comment on the draft waiver extension using more than one feedback mechanism.
  • HHSC will continue to work with stakeholders on detailed programmatic changes to the protocols not addressed in the waiver extension draft.
    • More information on protocol-level proposals will be provided at the Statewide Learning Collaborative Summit August 27 - 28.
    • HHSC will tentatively plan to hold a DSRIP protocol webinar in September (rather than August as previously indicated)
    • HHSC will notify providers next week of projects that will be reviewed for possible changes for waiver renewal, including the reason for review.

Clinical Champions


  • HHSC staff is working with members of the Clinical Champions group, based on members' area of expertise, to inform the preliminary development of the RHP Planning Protocol which will be used for replacement projects in the Renewal period.  This work is just starting and will continue over the coming months and opportunities for feedback will be provided. 
  • Preliminary information from this process will be shared with providers at the Statewide Learning Collaborative Summit and will be used to inform and support the peer to peer learning sessions.

Statewide Learning Collaborative Summit

 

  • HHSC has sent out the invitation/registration information for the August 27-28, 2015 statewide summit.
  • HHSC is very close to finalizing panelists and breakout mentors for the Summit.  Both panelists and mentors will receive a registration slot for their participation.
  • Please see the attached draft agenda that should assist with registration. Please be sure to register no later than July 31 (next Friday) if at all possible, to inform planning and redistribution of slots.

Please let me know if you have any questions.

 
JULY 17, 2015
DSRIP
 

Good Afternoon Region 10 Providers,


I wanted to send out a quick reminder that the Texas HHSC 1115 Waiver Renewal Public Meeting at Old Red Museum of Dallas County Culture and History - 4th floor Restoration Room will be taking place Tuesday, July 21st from 10AM to 12 (noon). If you are interested in providing a public comment when you arrive please be sure to fill out the request to appear during the Public Hearing  form.  I recommend that you bring two copies of your comments, one to attached with the form and one for your personal reference. Comments during the public meeting will be limited to 3 minutes per person. Also, attached are the directions and parking instruction for the Public Meeting.


We are looking forward to your support of the Waiver renewal process.


Please let us know if you have any questions.

 
JULY 13, 2015
DSRIP
 

Good Morning Region 10 Providers,


I have quite a bit of important information to share with you this morning.


DY 4 April Reporting Timeline


  • July 21, 2015 – April reporting DY4 DSRIP payments processed for transferring hospitals and top 14 IGT Entities.
  • July 31, 2015 ‐ April reporting DY2 and DY3 DSRIP payments processed for all providers and DY4 DSRIP payments processed for remaining providers that were not paid on July 21, 2015.  Note that there are separate transactions for each payment for each DY.
  • August 7, 2015 – HHSC and CMS will approve or deny the additional information submitted in response to HHSC comments on April reported milestone/metric achievement. Approved reports will be included for payment in the next DSRIP payment period, estimated for January 2016.

Category 3


  • HHSC Staff are still conducting Category 3 technical assistance for baselines that were reported in October DY3 and flagged as needing baseline clarification or assistance in determining DY4 and DY5 goals.
  • HHSC will be begin reviewing baselines submitted in April DY4 in July, and will notify providers of any needed baseline clarifications or technical assistance.
  • HHSC has received several requests to the waiver mailbox to correct a Category 3 baseline that was randomly selected for compliance monitoring by Myers and Stauffer.  Myers and Stauffer will have a process in place to make any needed baseline corrections through their review process and providers do not need to contact HHSC to make changes to Category 3 baselines selected for compliance monitoring.
  • To submit a correction to a reported baseline that was not selected for compliance monitoring, please send an email to the waiver mailbox indicating the Category 3 project ID of any baselines that need correction, and a brief description of the baseline issue, and HHSC will send the provider a Category 3 Baseline Correction Form to be completed by the provider and returned to the waiver mailbox.

QPI


  • HHSC has resolved all outstanding DY5 QPI changes and notified providers of results if a lower DY5 QPI goal was proposed or the current DY5 goal was requested to be maintained.

3-Year Project Change Request Process (Plan Modification Requests and Technical Change Requests)



Compliance Monitoring


  • Please be sure to read through the Anchor call notes section on compliance monitoring.
  • HHSC will be work with MSLC to expand the sample for the review of baselines to make sure that at least one Category 3 measure for each provider is reviewed during compliance monitoring.
  • Category 1 and 2 metrics review. MSLC is getting ready to start the first phase of the Category 1 and 2 reviews. Close to 100 projects will be included in this phase. For the projects included in the first phase, MSLC will review selected process milestones, reported QPI metrics and MLIU information. HHSC should have a list of these projects this week.

Waiver Renewal Planning


  • HHSC has posted the 1115 Waiver Extension draft on the HHSC website’s Waiver Renewal page. Public meeting dates and locations have also been posted, as well as a new survey link for stakeholders to give comments on the draft.  
  • Comments at the public meetings will be recorded and HHSC will read and consider all of the submitted comments. It is not necessary for stakeholders to comment on the draft waiver extension using more than one feedback mechanism.
  • HHSC will also hold a web-based public meeting on July 23, 2015 from 9:30 AM - 11:30 AM CDT To join the online meeting:
    • Go to Join WebEx meeting  
    • Click on Attend Meeting
    • Enter Meeting Number: 737 370 214
    • Call 866-430-8535
    • HHSC will continue to work with stakeholders on detailed programmatic changes to the protocols not addressed in the waiver extension draft.
    • HHSC tentatively plans to hold a DSRIP protocol webinar in August and also will discuss protocol changes at the August 27-28 Statewide Learning Collaborative Summit tailored to the summit audience.

Update on Private Hospital Deferral Financing Issue


  • CMS confirmed via email that Texas will have until September 2017 to come into compliance with whatever CMS and HHSC agree upon as acceptable to address CMS concerns after the series of calls this summer.

Medicaid Benefits Coordination


  • The HHSC Office of Policy has instituted a new benefits review process. The Transformation Waiver team is in coordination with the Office of Policy to use lessons learned and data from DSRIP to inform benefits that are reviewed.
  • Please see the link below. At the bottom you will see a section called “Submitting Medicaid Medical or Dental Benefit Requests”  If DSRIP providers and other stakeholders have specific requests for a new Medicaid medical or dental benefit or a change to an existing benefit, please refer them to this web page and direct them to that last section.  They will complete the form and mail it along with supporting documentation to the Medicaid Benefit Request mailbox (per the instructions). http://www.hhsc.state.tx.us/medicaid/MPR/index.shtml

Statewide Learning Collaborative Summit

 

  • HHSC has sent out the invitation/registration information for the August 27-28, 2015 statewide summit. As a reminder, the deadline to register is Wednesday, August 5th. HHSC asks that providers register as soon as possible so that "leftover" slots may be reallocated to those providers who have requested to send additional participants. Please remember that performing providers with 10 - 19 active projects may send two representatives, and those with 20 or more projects are invited to send three.

Please let me know if you have any questions.

 
 
JULY 3, 2015
DSRIP
 

Good Morning RHP 10 Stakeholders,


HHSC has updated their Waiver Renewal webpage (http://www.hhsc.state.tx.us/waiver-renewal.shtml) to include the 1115 Waiver Extension Application Draft with supporting documents. HHSC will be taking comments on this draft document during July at the statewide public meetings. HHSC will post a survey link on the Waiver Renewal website for stakeholders to provide feedback and comments on the waiver extension draft.


Documents available on the HHSC website include:


As a friendly reminder, the DFW public meeting will be hosted Tuesday, July 21, 10AM-12PM, at the Old Red Museum of Dallas County Culture and History - 4th floor Restoration Room (100 South Houston St. Dallas, TX  75202).


Please let me know if you have any questions.

 
JULY 2, 2015
DSRIP
 

Good Afternoon Region 10 Providers,


I hope that you all had time to attend the 3-Year Project Change Request webinar hosted by HHSC. I wanted to make sure that you received all of the documents related to the change requests.


In the attached folder you will find:


  • 3-Year Project Change Request Companion Document
  • The Change Request Form
  • Slides from the change request webinar

The deadline to submit change requests to the RHP Mailbox (RHP_Region_10@jpshealth.org) is Wednesday, July 22nd. If you are not planning on submitting a change request please be sure to send an email to the RHP mailbox indicating this.


Please let me know if you have any questions.

JUNE 22, 2015

DSRIP
 

Good Afternoon Region 10 Providers,

 

Registration Information - Texas 1115 Healthcare Transformation Waiver Statewide Learning Collaborative (SLC) Summit/ August 27-28, 2015

 

The purpose of this e-mail is to invite you to participate in the 1115 Healthcare Transformation Waiver Statewide Learning Collaborative (SLC) Summit scheduled in Austin on Thursday, August 27th and Friday, August 28th at the AT&T Executive Education and Conference Center.   The deadline to register is Wednesday, August 5th.   Seats are limited, and therefore registration is required.   Background information, as well as registration instructions, is included below.

 

What is the Purpose of the SLC Summit?   The primary goal of the Summit for 2015 is to share outcome data and best practices from projects, highlight effective systems of care and discuss next steps as we look to the future of the 1115 Healthcare Transformation Waiver.   Guest speakers and your peers who participate in the waiver from across the state will present on shared learning and best practices.   Technical assistance also will be included for DSRIP providers, RHP anchors and other stakeholders on topics such as data analytics and quality alignment with Medicaid managed care. We will forward a full conference agenda to your attention prior to the Summit. 

 

How Have Summit Participants Been IdentifiedDue to limited space, in-person attendance is capped at 500 attendees.   Every DSRIP performing provider will have an opportunity for at least one representative to attend in person. Performing providers with 10 - 19 active projects may send two representatives, and those with 20 or more projects are invited to send three. The SLC Summit will be webcast and have interactive capabilities so that individuals who are not able to attend may also participate (see more below).  In order to gain the most benefit from the Summit, we encourage individuals who attend in person in Austin to be actively engaged in project implementation.  Providers that have included statewide learning collaborative metrics in their projects will be able to submit supporting documentation whether attending in person or via webcast to meet metrics. HHSC will provide additional details for the documentation and participation required to meet metrics prior to the event.

 

If you have any questions about attendance or the invitation process, please email the waiver mailbox at txhealthcaretransformation@hhsc.state.tx.us.  

 

What If I Can’t Attend the Summit?  HHSC will broadcast the conference online so that individuals not able to attend in-person can watch presentations, hear discussions, and submit questions through an online chat function.  Once the details of the webinar are available, login instructions will be posted: http://www.hhsc.state.tx.us/1115-waiver.shtml   

 

How Do I Register for the Summit? To be guaranteed a spot at the conference, designated individuals must register at https://2015slcsummit.eventbrite.com by Wednesday, August 5th. The registration passcode is HHSC2015.  Upon completing registration, registrants will receive an e-mail confirming their registration. 

 

What Arrangements Should I Make?

  • A limited number of group room rates at the AT&T Executive Education and Conference Center of $174.00 per night are available until Saturday, August 1, 2015. A limited number of Government room rates are also available at $126.00 per      night. 
  • Hotel parking is available in the underground, attached garage. Guests may self-park or use valet services at the University Avenue entrance.
  • The dress code is business casual.  Please keep in mind that hotel temperatures often fluctuate so consider bringing a sweater or jacket.
  • Breakfast and lunch will be provided for all registered attendees both days  of the conference, but dinner will be on your own.
  • Please come prepared to discuss your projects, share your successes and challenges, and learn from other providers across the state. You may bring any materials you think would be helpful for this purpose.

 

We are excited about the Summit, and look forward to your participation.  If you have any questions, please send your questions to:  TXHealthcareTransformation@hhsc.state.tx.us   

 

For providers with projects in multiple regions, HHSC proposes to use the same RHP assignments as last year for the purposes of coordinating SLC registration:

 

RHP

Provider Name

RHP 9

Children's Medical Center   of Dallas

RHP 9

Lakes Regional MHMR Center

RHP 9

The University of Texas   Southwestern Medical Center (Moncrief Cancer Institute or UTSW/MCI)

RHP 10

PECAN VALLEY CENTERS FOR   BEHAVIORAL AND DEVELOPMENTAL HEALTHCARE

RHP 19

Helen Farabee Center

 

 

Please let me know if you have any questions.

 

 

 
JUNE 15, 2015
DSRIP

 

Good Morning Region 10 Providers,

 

I have lots of important information to share with you this morning. Attached you will find the Anchor Call Notes.

 

DY 4 April Reporting

 

  • The Additional Information Reporting Period is now open. The deadline for providers to submit their Needs More Information (NMI) responses through the DSRIP Online Reporting System is 11:59 p.m. on Thursday, July 2, 2015. Providers with metrics or Semi-Annual Reporting (SAR) requirements marked as "Need More Information" or "Incomplete" must respond to HHSC requests for more information to be eligible for payment in January 2016.  Not responding to an NMI request will result in the providers either forfeiting all monies for that metric or delaying payments if they did not complete their SAR requirements.
  • Payment Timeline:
    • Late June – HHSC Rate Analysis will send out the IGT due amounts using FMAP of 58.05. (Please do not refer to the IGT due amounts that are currently listed in the online reporting system, as they are not accurate.)
    • July 8, 2015 – IGT due for April reporting DSRIP payments.
    • July 21, 2015 – April reporting DY4 DSRIP payments processed for transferring hospitals and top 14 IGT Entities.
    • July 31, 2015 – April reporting DY2 and DY3 DSRIP payments processed for all providers and DY4 DSRIP payments processed for remaining providers that were not paid on July 21, 2015. Note that there are separate transactions for each payment for each DY.
    • NMI Reporting Reminders:
      • Providers should continue to use coversheets to help explain their documentation.
      • Only information needed to make a determination of metric achievement should be uploaded during this time.
      • Documentation should include "NMI" at the beginning of the file name to help distinguish the newly uploaded files from the documentation that was submitted during the April reporting period.
      • If NMI responses require changes to the metric's Progress Update entered in the online reporting system, providers should not overwrite the original Progress Update that was submitted during the April DY4 reporting period, but should instead add to the Progress Update and label the new information as "NMI Response."
      • In the Online Reporting System, please note that the statuses shown on the Provider Details page, "Reporting Status" tab, for Category 1 and 2 projects are linked to their associated Category 3 projects since they are reported on the same project reporting page. Although a status may say that Category 3 has an NMI, it may be because the related Category 1 or 2 project received an NMI and vice versa.  It is important to check the individual milestone and metric tabs on the Project Reporting page to view the actual HHSC Signoff.
      • HHSC has posted a revised version of the QPI Reporting Template on the Tools and Guidelines for Regional Healthcare Partnership Participants page. Providers responding to Needs More Information requests should use this revised template when reporting.

 

Change Request Process

 

  • In late June, HHSC will provide an opportunity for 3-year projects to submit change requests for DY5 only.  This 3-year project change request process will be similar to the Summer 2014 change request process.  Anchors/ providers will have about one month to submit change requests. HHSC will send the timeline for this process to the anchors early this week.

 

Compliance Monitoring

 

  • Myers and Stauffer continues to send out emails with the information request for Category 3 baseline review. Baseline information review is expected to continue through the end of summer.
  • Providers need to work with Myers and Stauffer within the specified timelines, including responding to follow up questions related to the requested information. Please remind your participating providers that DSRIP payments are Medicaid payments, and as such, may be subject to state and federal audits. HHSC's contract with Myers and Stauffer (including the data use agreement) requires that they maintain confidentiality for protected health information and other confidential information. Some providers have expressed concerns about providing patient-level information for the compliance monitoring review. If providers do not provide the information requested for compliance monitoring, they risk recoupment of funds related to that project.
  • Myers & Stauffer is not planning to schedule on-site visits at this time. Whether on-site visits are necessary will be determined after Myers and Stauffer review supporting documentation submitted by providers.
  • Please remember that TODAY is the due date to submit the FTP site information spreadsheet to Meyers & Stauffer.

 

Waiver Renewal Planning

 

  • HHSC plans to have a draft of the Waiver Extension/Renewal for public review in June 2015 and plans for public meetings in July 2015. HHSC also plans to schedule a webinar for those not able to attend the public meetings in person.
  • The waiver renewal packet will be relatively high level, with programmatic details worked out through revisions to the protocols. HHSC plans to make changes to the two key DSRIP protocols. The protocols are not required to be submitted to CMS by September 2015, so HHSC will have more time to work with stakeholders on detailed programmatic changes.
  • HHSC tentatively plans to hold a DSRIP protocol webinar in August and also will discuss protocol changes at the August 27-28 Statewide Learning Collaborative Summit tailored to the summit audience.

 

Statewide Learning Collaborative Summit

 

  • HHSC will soon send out the invitation/registration information for the August 27-28, 2015, statewide summit in Austin. We plan to use a process similar to the one used last year, in which each anchoring entity will get 2 slots and each performing provider will get 1-3 slots depending on its number of active projects.

 

Please let me know if you have any questions.

June 11, 2015
DSRIP

Good Morning Region 10 Providers,

 

HHSC has  distributed the Initial Review Results for April DY4 Reporting to the RHP 10 providers. Individuals using the reporting system may also received an automated email informing them that the “Needs More Information” reporting period is now open on the DSRIP Online Reporting System. This additional reporting period will be open from 12:00 a.m. on Wednesday, June 10, 2015 to 11:59 p.m. on Thursday, July 2, 2015.  

 

It is during this time that providers with metrics or Semi-Annual Reporting (SAR) requirements marked as "Need More Information" or "Incomplete" must respond to HHSC requests for more information to be eligible for payment in January 2016.  Providers should respond and submit any supporting documentation to HHSC for additional review through the online reporting system.  Not responding to an NMI request will result in the providers either forfeiting all monies for that metric or delaying payments if they did not complete their SAR requirements.

 

NMI Reporting Reminders:

  • Providers should continue to use coversheets to help explain their documentation.
  • Only information needed to make a determination of metric achievement should be uploaded during this time.
  • Documentation should include "NMI" at the beginning of the file name to help distinguish the newly uploaded files from the documentation that was submitted during the April reporting period.
  • NMI responses can either be uploaded in a separate document or included as an additional update to the metric's Progress Update. Providers should not overwrite the original Progress Update that was submitted during the April DY4 reporting period.
  • In the Online Reporting System, please note that the statuses shown on the Provider Details page, "Reporting Status" tab, for Category 1 and 2 projects are linked to their associated Category 3 projects since they are reported on the same project reporting page. Although a status may say that Category 3 has an NMI, it may be because the related Category 1 or 2 project received an NMI and vice versa.  It is important to check the individual milestone and metric tabs on the Project Reporting page to view the actual HHSC Signoff.
  • HHSC will not re-review metrics that received a “Needs More Information” determination between the Initial and Needs More Information (NMI) review periods.  All “Needs More Information” metrics will be reviewed once the June/July provider response period closes based on information submitted to the online reporting system.  If a provider has submitted documentation to the Waiver mailbox for re-review, the provider should instead upload this information to the online reporting system and expect a response after the Needs More Information HHSC review period closes in August.

 

Payment Timeline:

 

  • Late June – HHSC Rate Analysis will send out the IGT due amounts using the FMAP of 58.05. (Please do not refer to the IGT due amounts that are currently listed in the online reporting system, as they are not accurate.)
  • July 8, 2015 – IGT due for April reporting DSRIP payments.
  • July 21, 2015 – April reporting DY4 DSRIP payments processed for transferring hospitals and top 14 IGT Entities.
  • July 31, 2015 – April reporting DY2 and DY3 DSRIP payments processed for all providers and DY4 DSRIP payments processed for remaining providers that were not paid on July 21, 2015. Note that there are separate transactions for each payment for each DY.

 

If a provider has questions regarding the April DY4 reporting results, they should contact the Waiver mailbox at TXHealthcareTransformation@hhsc.state.tx.us.

 

Please let me know if you have any questions.


June 9, 2015

DSRIP

Good Afternoon Region 10 Providers,

 

I have an update and a two reminders for you this afternoon.

 

Category 3 Compliance Monitoring

 

Attached is the final list of Category 3 baselines that were randomly selected by Myers and Stauffer for compliance monitoring.

 

Myers and Stauffer notified 10 selected Category 3 projects at the end of May (noted in column G of the attached file), and will notify the rest of selected providers by next week. Myers and Stauffer will then begin working with providers over the next several weeks on specific document requests.

 

Just like with mid-point assessment communications, HHSC emails about compliance monitoring will come from the DSRIP Compliance mailbox: TXHealthcareTransformationDSRIP_Compliance@hhsc.state.tx.us. Anchors and providers can send any questions about compliance monitoring to this mailbox as well.

 

Transformational Impact Summaries

Please remember that these are due to the RHP Mailbox(RHP_Region_10@jpshealth.org) by COB Friday, June 12th. In a previous email the date was mistakenly June 14th, sorry for any confusion.

 

April reporting NMI’s

 

RHP 10 providers should receive information from HHSC on any NMI’s by tomorrow, June 10th.

 

 

Please let me know if you have any questions.

 

June 1, 2015
DSRIP

Good Morning Region 10 Providers,

 

I have a few brief updates for you this morning. Attached you will find the Anchor Call notes.


 

DY 4 April Reporting

 
  • HHSC and CMS will complete review and approval of April reports or request additional information (NMI) no later than June 10, 2015

Change Request Process

 
  • In late June, HHSC will provide an opportunity for 3-year projects to submit change requests for DY5 only.  This 3-year project change request process will be similar to the Summer 2014 change request process.  Anchors/ providers will have about one month to submit change requests.  Additional information will be forthcoming.

 

DSRIP Mid-Point Assessment


 
  • HHSC has submitted the Mid-point Assessment report to CMS and it is attached. It consists of three PDF documents - the main report and two appendices.
  • Based on Myers and Stauffer's assessment, 79 percent of the projects are at low or moderate risk, meaning that they are on track for meeting their project outcome objectives at the time the review was done (based on data through April 2014).
  • Myers and Stauffer describes the risk assessment methodology and ranking on pages 3 -5 of the report. Information for each RHP is also included in the report starting on page 12.
  • A description of HHSC's approach to Myers and Stauffer recommendations is included at the end of the report on page 52.
  • Appendix 1 includes a risk scoring for each project reviewed during the mid-point assessment.
  • Appendix 2 provides Myers and Stauffer's recommendation for each project and HHSC's response.

Compliance Monitoring

  • Myers and Stauffer continues to send out emails with the information request for Category 3 baseline review. Baseline information review is expected to continue through the end of summer.
  • Just like with mid-point assessment communications, emails about compliance monitoring will come from the DSRIP Compliance mailbox: TXHealthcareTransformationDSRIP_Compliance@hhsc.state.tx.us. Anchors and providers can send any questions about compliance monitoring to this mailbox as well.
 

Waiver Renewal Planning

 

  • HHSC plans to have a draft of the Waiver Extension/Renewal for public review in June 2015 and plans for public meetings in July 2015. They also plan to schedule a webinar for those not able to attend the public meetings in person.
  • Tentative dates/times/locations for the public meetings:
    • 7/13 10:00 AM- 12:00 PM - Houston (Texas Department of Transportation)
    • 7/15 1:00 PM - 3:00 PM - Edinburg (Doctors Hospital at Renaissance)
    • 7/16 10:00 AM - 12:00 PM - Tyler (Tyler Junior College West Campus)
    • 7/16 2:00 PM - 4:00 PM - Austin (HHSC Brown Heatly Building)
    • 7/20 9:00 AM - 11:00 AM - San Antonio (Omni Colonnade)
    • 7/21 10:00 AM - 12:00 PM - Dallas/Ft. Worth (Old Red Museum, Dallas)
    • 7/22 1:30 PM - 3:30 PM - El Paso (El Paso First Health Plans, Inc.)
    • Amarillo TBD
    • HHSC will communicate when the dates and locations have been confirmed as soon as available.
 
  • The waiver renewal packet will be relatively high level, with programmatic details worked out through revisions to the protocols. HHSC plans to make changes to the two key DSRIP protocols. The protocols are not required to be submitted to CMS by September 2015, so HHSC will have more time to work with stakeholders on detailed programmatic changes.
  • HHSC tentatively plan to hold a DSRIP protocol webinar in August and also will discuss protocol changes at the August 27-28 Statewide Learning Collaborative Summit tailored to the summit audience.

 

Update on Private Hospital Deferral Financing Issue

  • HHSC continues to work with CMS on technical issues related to the private hospital financing deferral issue. CMS continues to indicate Texas will have until September 2017 to come into compliance with whatever CMS and HHSC agree upon as acceptable to address CMS concerns after the series of calls this summer.

Transformational Impact Summaries

 

Statewide Learning Collaborative Summit

  • HHSC will soon send out the invitation/registration information for the August 27-28, 2015, statewide summit in Austin. They plan to use a process similar to the one used last year, in which each anchoring entity will get 2 slots and each performing provider will get 1-3 slots depending on its number of active projects.

 

Please let me know if you have any questions.

May 26, 2015
DSRIP

Good Morning Region 10 Providers,

 

I have an update and reminder for you this morning.

 

Waiver Renewal

 

  • HHSC has posted a survey link on the HHSC website’s Waiver Renewal page for stakeholders to give preliminary feedback on the draft waiver renewal document discussed at the May 14th Executive Waiver Committee meeting.  That document is also posted on the Waiver Renewal page. HHSC will be replacing that survey with another one when the official draft waiver renewal document is available in late June/early July in order to get feedback specific to the actual waiver renewal request.
  • Here is the current survey link: https://www.surveymonkey.com/s/NMMSSLG

 

Reminders

Do not forget that the RHP 9 & 10 Learning Collaborative is tomorrow! If you plan to attend please be sure to register.

RHP 9 & RHP 10 present

Collaborative Connections – Impacting Care

Learning Collaborative Event

 

The Hurst Conference Center

1601 Campus Drive

Hurst, TX 76054

 

 

Collaborative Connections - Impacting Care is a two day event highlighting the triple aim, 1115 waiver impacts on healthcare, waiver renewal activities, how to sustain the gain in your project, depression screening in primary care, integrated behavioral health and primary care, breakout sessions by project types and category 3 outcome measures, and more. 

 

Wednesday, May 27, 2015:  8:00 a.m. - 4:00 p.m.

Thursday, May 28, 2015:  8:00 a.m. - 4:00 p.m.

 

Sign-in & Breakfast: 8:00 a.m.

Program begins at 8:50 a.m.

 

Click RHP9 & RHP10 Collaborative Connections to Register for the Event.

 

 

Objectives: 

 

  • Identify est practice care models through presentations and collaborative interactions with other providers
  • Incorporate various process improvement tools in your projects to enhance outcomes and share your successes
  • Create opportunities for networking amongst providers and community providers.

 

 

Please let me know if you have any questions.



May 18, 2015
DSRIP


Good Morning Region 10 Providers,

 

I have quite a bit of information to share with you this morning. Please be sure to read all the way through the Anchor call notes for complete details. Attached are the historical project payment summaries (DY2 – April DY3 and October DY3). They should also be posted on the HHSC waiver website today.

 

DY 4 April reporting

  • May 20, 2015, 5:00pm – Due date for IGT Entities to approve and comment on their affiliated providers’ April reported progress on metrics using the "IGT Info" tab for each project. The tab is not an opportunity to identify technical errors entered in the reporting system. Examples of issues to include are reported progress that was not actually achieved, changes in project scope that were not reported by the provider, and risks to the project that were not reported by the provider. If there are no issues, comments do not need to be submitted and HHSC will assume the IGT Entity has approved the reported information.
  • June 10, 2015 – HHSC and CMS will complete their review and approval of April reports or request additional information (referred to as NMI) regarding the data reported. Note that HHSC completes multiple levels of review prior to determining that a milestone/metric requires additional information. If additional information is requested, the DSRIP payment related to the milestone/metric will not be included with July DSRIP payments.
  • July 2, 2015, 11:59pm – Due date for providers to submit responses to HHSC requests for additional information (NMI requests) on April reported Category 1‐4 milestone/metric achievement and Semi‐Annual Reporting requirements. Please include "NMI" in the file name when uploading documentation in response to NMI requests.
  • July 8, 2015 – IGT due for April reporting DSRIP payments, including DY4 Monitoring IGT.
  • July 21, 2015 – April reporting DY4 DSRIP payments processed for transferring hospitals and top 14 IGT Entities.
  • July 31, 2015 ‐ April reporting DY2 and DY3 DSRIP payments processed for all providers and DY4 DSRIP payments processed for remaining providers that were not paid on July 21, 2015. Note that there are separate transactions for each payment for each DY.
  • August 7, 2015 – HHSC and CMS will approve or deny the additional information submitted in response to HHSC comments on April reported milestone/metric achievement. Approved reports will be included for payment in the next DSRIP payment period, estimated for January 2016.

 

Change Request Process

  • In June, HHSC will provide an opportunity for 3-year projects to submit change requests for DY5 only.  This 3-year project change request process will be similar to the Summer 2014 change request process.  Anchors/ providers will have about one month to submit change requests (sometime in July).

 

DSRIP Mid-Point Assessment

  • RHPs are still in the process of hearing from HHSC on the results of 3 year projects reviews, as well as closing out the last questions on all other projects that were reviewed during the mid-point assessment.
  • The mid-point assessment report is being finalized and will be shared with RHPs soon.
  • For providers who received DY 5 QPI goal increases, please be sure to respond to by Wednesday, May 20th, 2015 by 5:00PM. If HHSC does not receive a response by 5:00PM they will assume that providers are accepting the proposed DY 5 QPI goal.

 

Compliance Monitoring

  • HHSC and MSLC are starting a new component of the waiver review - validation of the reported information (Component 2).The primary purpose of DY4 and DY5 monitoring performed by the Independent Assessor is to validate the data submitted by performing providers that serves as the basis for their DSRIP payments.
  • This validation also includes a review of Category 3 outcome measures to ensure that they are being implemented as required by the approved project plan. All projects which have reported metrics are eligible for review.
  • The following is included in this component:  Validation of reporting for Category 1 and 2; Validation of the reported Cat 3 information - baselines and achievement; and Category  4  measures required to be reviewed by CMS.
  • For Category 4, Providers reporting an alternate medication reconciliation rate for RD4 component 2 (not reporting NQF 0646 to specifications) will be subject to compliance monitoring as stated in the October DY3 and April DY4 reporting companions. Providers who reported few rates in RD6 will be included in compliance monitoring
  • MSLC is beginning the first round of Category 3 baseline validation. During the month of May, Myers and Stauffer will be looking at approved baselines from IT-1.10 HbA1c poor control and IT-3.22 Risk Adjusted All Cause Readmission. Validation of other outcomes with approved baselines will begin in June and continue through August. 
  • Inclusion in Category 3 baseline validation review will be at random. Outcomes where providers are still working with HHSC on a baseline correction or clarification will not be included in this round of baseline validation.

 

Waiver Renewal Planning

  • HHSC plans to have a draft of the Waiver Extension/Renewal for public review in June 2015 and plans for public meetings in July 2015. We also plan to schedule a webinar for those not able to attend the public meetings in person. We will communicate dates and locations as soon as available.
  • The waiver renewal packet will be relatively high level, with programmatic details worked out through revisions to the protocols. HHSC plans to make changes to the two key DSRIP protocols. The protocols are not required to be submitted to CMS by September 2015, so HHSC will have more time to work with stakeholders on detailed programmatic changes.
  • HHSC also is working on a process for comments to be able to be posted through an on-line form.

 

Update on Private Hospital Deferral Issue

  • HHSC plans to hold a number of calls with CMS financial staff this summer to discuss the issues raised in the March binder from CMS in more detail.
  • CMS staff indicated that CMS may be willing to allow HHSC until September 2017 to come into compliance with whatever CMS and HHSC agree upon as acceptable to address CMS concerns after the series of calls this summer. While this date is not yet a formal commitment from CMS, HHSC is encouraged to have the opportunity to clarify how things work in Texas for CMS and that CMS appears to be willing to work with us around legislative timeframes if State leadership decisions are needed.

 

Clinical Champions

  • Anchors received a Transformational Impact Summary template for each active project in your region this week. RHP 10 has not received theirs yet.
  • HHSC is asking that providers submit completed templates directly to Anchors no later than June 15th, 2015.  Anchors will send these templates to HHSC in two batches, the first scheduled for May 31st, 2015.
  • Some Anchors are planning to host TA sessions to guide providers through this process and have indicated that other regions are welcome to join. RHP 2 has offered to host the following two sessions (same call-in information for both):
    • Tuesday May 19th 3:00-4:00 CT
    • Thursday May 21st 9:00-10:00 CT
    • Dial-in number: 877.226.9790
    • Access: 3020674
    • Login: https://www.webmeeting.att.com
    • Meeting number: 8772269790
    • Code: 3020674
    • The peer assessment process is intended to:
      a.) identify and share promising practices with like projects around the state,
      b.) inform the transformative impact of DSRIP projects and the development of content for the Statewide Learning Collaborative,
      c.) support Waiver extension/renewal efforts with CMS, and
      d.) help inform ways to better evaluate projects  in the next phase of the Waiver. 
    • Providers should review all projects and please submit a template for the projects that providers have the best evidence that care is transforming  and have supporting data. HHSC has heard from many providers that Category 3 outcomes are not the best indicator of project success. This is an opportunity to provide the information that you think demonstrates the early success of projects. This process is not intended to be a formal peer-review or determine which projects are eligible for continuation beyond DY5.  

 

Submission of updated RHP Plan

This week will be asking each providers to sign and submit to the Anchor office the RHP 10 plan certification. The form will be sent to the lead provider in each organization today and will be due COB Friday, May 22nd, 2015.

Reminders

It is not too late to register!


RHP 9 & RHP 10 present

Collaborative Connections – Impacting Care

Learning Collaborative Event

 

The Hurst Conference Center

1601 Campus Drive

Hurst, TX 76054

 

 

Collaborative Connections - Impacting Care is a two day event highlighting the triple aim, 1115 waiver impacts on healthcare, waiver renewal activities, how to sustain the gain in your project, depression screening in primary care, integrated behavioral health and primary care, breakout sessions by project types and category 3 outcome measures, and more.  See the attached agenda for more information. 

 

Wednesday, May 27, 2015:  8:00 a.m. - 4:00 p.m.

Thursday, May 28, 2015:  8:00 a.m. - 4:00 p.m.

 

Sign-in & Breakfast: 8:00 a.m.

Program begins at 8:50 a.m.

 

Click RHP9 & RHP10 Collaborative Connections to Register for the Event.

 

 

Objectives: 

 

  • Identify best practice care models through presentations and collaborative interactions with other providers
  • Incorporate various process improvement tools in your projects to enhance outcomes and share your successes
  • Create opportunities for networking amongst providers and community providers.

 

Please let me know if you have any questions.

May 11, 2015
DSRIP

Good Morning Region 10 Providers,

 

I have a few updates and reminders for you this morning.

 

Mid-Point Assessment

Myers & Stauffer (M&S) has completed their review of 3-year projects and has provided HHSC with the findings of their review, as well as their recommendations for possible changes.

 

HHSC has reviewed these findings and recommendations, and has determined which projects will require follow up communication with the provider. The providers whose projects have recommendations were contacted by HHSC late last week.  Please be sure to respond to any additional information requested by M&S to HHSC via email by closed of business on Wednesday, May 13th.

 

Compliance Monitor: Category 3 Baseline Validation

 

Myers and Stauffer will begin the first round of Category 3 baseline validation next week. During the month of May, Myers and Stauffer will be looking at approved baselines from IT-1.10 HbA1c poor control and IT-3.22 Risk Adjusted All Cause Readmission. Validation of other outcomes with approved baselines will begin in June and continue through August.  Outcomes where providers are still working with HHSC on a baseline correction or clarification will not be included in this round of baseline validation, but will be eligible for inclusion in future rounds (likely to occur during the summer of 2016). Providers should be prepared to submit documentation supporting the determination of their baseline numerator and denominator and measurement periods.

DY 4 April Reporting Timeline

  • June 10, 2015 – HHSC and CMS will complete their review and approval of April reports or request additional information (referred to as NMI) regarding the data reported.
  • July 2, 2015, 11:59pm – Due date for providers to submit responses to HHSC requests for additional information (NMI requests) on April reported Category 1‐4 milestone/metric achievement and Semi‐Annual Reporting requirements. Please include "NMI" in the file name when uploading documentation in response to NMI requests.
  • July 8, 2015 – IGT due for April reporting DSRIP payments.
  • July 21, 2015 – April reporting DY4 DSRIP payments processed for transferring hospitals and top 14 IGT Entities.
  • July 31, 2015 ‐ April reporting DY2 and DY3 DSRIP payments processed for all providers and DY4 DSRIP payments processed for remaining providers that were not paid on July 21, 2015.
  • August, 7 2015 – HHSC and CMS will approve or deny the additional information submitted in response to HHSC comments on April reported milestone/metric achievement.

 

Project Withdrawal and IGT Monitoring Amounts

 

  • Attached is a summary file of projects that withdrew prior to May 1st during the post mid-point assessment period.
  • Also attached is an updated Monitoring IGT file based on project withdrawals prior to May 1st.

RHP 10 DY3 Revenue Summary Spreadsheet

Attached you will find a spreadsheet summarizing the Region 10 DY 3 achievements. Please let me know if there are any updates that need to be made.

 

Reminders

  • The project categorization form is due to the RHP mailbox (RHP_Region_10@jpshealth.org) by COB Wednesday, May 13th. It’s not too late to register for the RHP 9 & 10 joint learning collaborative!  Please see information below.  We look forward to seeing you there.

 

RHP 9 & RHP 10 present

Collaborative Connections – Impacting Care

Learning Collaborative Event

 

The Hurst Conference Center

1601 Campus Drive

Hurst, TX 76054

 

Collaborative Connections - Impacting Care is a two day event highlighting the triple aim, 1115 waiver impacts on healthcare, waiver renewal activities, how to sustain the gain in your project, depression screening in primary care, integrated behavioral health and primary care, breakout sessions by project types and category 3 outcome measures, and more.  See the attached agenda for more information. 

 

Wednesday, May 27, 2015:  8:00 a.m. - 4:00 p.m.

Thursday, May 28, 2015:  8:00 a.m. - 4:00 p.m.

 

Sign-in & Breakfast: 8:00 a.m.

Program begins at 8:50 a.m.

 

Click RHP9 & RHP10 Collaborative Connections to Register for the Event.

 

Objectives: 

 

  • Identify best practice care models through presentations and collaborative interactions with other providers
  • Incorporate various process improvement tools in your projects to enhance outcomes and share your successes
  • Create opportunities for networking amongst providers and community providers.

 

Hotel Information: 

  • Hampton Inn, 1600 Hurst Town Center Drive, Hurst, TX      76054

Phone: 817-503-7777

  • Holiday Inn Express, 820 Thousand Oaks Drive, Hurst,      TX 76054

Phone: 817-427-1818

Both of these hotels will offer at $119 per night (King or Double Room), as available, if you mention you will be attending the event at the Hurst Conference Center. Contact: Susan Watts, Director of Sales. All room reservations must be made by May 13th, 2015 in order to obtain the $119 rate.

 

If you have questions about the event please contact the event organizers:

 

Margaret Roche, RHP 9 Waiver Operations Director

Office: 214-590-0416

Email: margaret.roche@phhs.org

http://www.texasrhp9.com

 

 

Meredith Oney, RHP 10 Learning Collaborative Coordinator

Office: 817-702-6759

Email: money@jpshealth.org

http://rhp10txwaiver.com

 

 

Please let me know if you have any questions.



May 04, 2015
DSRIP

Good Morning Region 10 Providers,

 

I have several key pieces of information to share with you this morning. Below you will find a summary of the Anchor call notes, please be sure to read the Anchor call notes (attached) in their entirety.

 

Statewide Events Calendar

 

  • HHSC has added the DSRIP Statewide Events Calendar to the end of the Anchor Notes.  HHSC plans to update this calendar monthly and post it on the waiver website.

DY 4 April Reporting

  • June 10, 2015 – HHSC and CMS will complete their review and approval of April reports or request additional information (referred to as NMI) regarding the data reported.
  • July 2, 2015, 11:59pm – Due date for providers to submit responses to HHSC requests for additional information (NMI requests) on April reported Category 1‐4 milestone/metric achievement and Semi‐Annual Reporting requirements. Please include "NMI" in the file name when uploading documentation in response to NMI requests.
  • July 8, 2015 – IGT due for April reporting DSRIP payments.
  • July 21, 2015 – April reporting DY4 DSRIP payments processed for transferring hospitals and top 14 IGT Entities.
  • July 31, 2015 ‐ April reporting DY2 and DY3 DSRIP payments processed for all providers and DY4 DSRIP payments processed for remaining providers that were not paid on July 21, 2015.
  • August, 7 2015 – HHSC and CMS will approve or deny the additional information submitted in response to HHSC comments on April reported milestone/metric achievement.

Category 3

 

  • HHSC staff is continuing to work with providers to resolve outstanding October DY3 baseline TA flags.
  • Baselines reported in April DY4 will be reviewed in the same manner that baselines reported in October DY3 were reviewed, with baselines being either approved as reported or flagged for technical assistance.

Change Request Process for 3-Year Projects

  • In June, HHSC will provide an opportunity for 3-year projects to submit change requests for DY5 only.  This 3-year project change request process will be similar to the Summer 2014 change request process.  Anchors/ providers will have about one month to submit change requests (sometime in July). 

DSRIP Mid-Point Assessment

  • Myers and Stauffer (MSLC) completed its review of the 3 year projects. There were significantly fewer technical corrections for 3 year projects, but there were some recommendations provided by Myers and Stauffer to strengthen metrics and projects. HHSC will complete its review of the recommendations and will follow up with providers and anchors regarding further actions.
  • HHSC continues to work on changes to the metrics impacting DY5 and/or narratives for 4-year projects, and may be still contacting providers about these changes. HHSC plans to complete this work this week (through May 8).
  • Based on mid-point assessment policies and DSRIP's goal to increase service capacity year over year, HHSC will be requesting that projects that met or exceeded their DY5 QPI goal with DY3 QPI achievement by September 30, 2014 increase their DY5 QPI goals.
  • HHSC received results of the mid-point assessment review from MSLC and are coordinating with providers to finalize any changes needed from MSLC recommendations. HHSC will share the final report that will be submitted to CMS that is expected in May.

Waiver Renewal Planning

  • HHSC plans to have a draft of the Waiver Extension/Renewal for public review in June 2015 and plans for public meetings in July 2015. They also plan to schedule a webinar for those not able to attend the public meetings in person. They will communicate dates and locations as soon as available. (Tentatively, HHSC is looking at July 13-July 24, 2015 in the following locations: Dallas/Fort Worth metroplex, Tyler, Amarillo, El Paso, Austin, Houston, McAllen, and San Antonio.)
  • The waiver renewal packet will be relatively high level, with programmatic details worked out through revisions to the protocols. HHSC plans to make changes to the two key DSRIP protocols. The protocols are not required to be submitted to CMS by September 2015, so HHSC will have more time to work with stakeholders on detailed programmatic changes. HHSC tentatively plans to hold a DSRIP protocol webinar in August and also will discuss protocol changes at the August 27-28 Statewide Learning Collaborative Summit.
  • HHSC also is working on a process for comments to be able to be posted through an on-line form. They know that many stakeholders already have given broad renewal input through the previous survey, so HHSC is not requiring (or encouraging) stakeholders to submit comments using the on-line form unless you have comments you didn't previously provide or new comments.
  • As mentioned during the call, attached the letter CMS sent to Florida in April regarding Florida’s Low Income Pool.

 

Clinical Champions

  • DSRIP performing providers will have an opportunity to submit a template for their project(s) to undergo a peer assessment process to a.) identify and share promising practices with like projects around the state, b.) inform the transformative impact of DSRIP projects and the development of content for the Statewide Learning Collaborative, c.) support Waiver extension/renewal efforts with CMS, and d.) help inform ways to better evaluate projects  in the next phase of the Waiver.
  • Providers should review all projects and please submit a template for the projects that providers have the best evidence that care is transforming  and have supporting data.
  • Early - mid May HHSC staff will send anchors a zipped file containing a form for each active DSRIP project within the RHP as well as instructions for completing the template.

Submission of updated RHP Plans

  • The project categorization form is due to the RHP mailbox (RHP_Region_10@jpshealth.org) by COB May 13th.
  • Once all of the RHP plan information is posted the Anchor office will be sending out an form for each provider to certify.

 

Reminders

                      

 

RHP 9 & RHP 10 present

Collaborative Connections – Impacting Care

Learning Collaborative Event

 

The Hurst Conference Center

1601 Campus Drive

Hurst, TX 76054

 

 

Collaborative Connections - Impacting Care is a two day event highlighting the triple aim, 1115 waiver impacts on healthcare, waiver renewal activities, how to sustain the gain in your project, depression screening in primary care, integrated behavioral health and primary care, breakout sessions by project types and category 3 outcome measures, and more.  See the attached agenda for more information. 

 

Wednesday, May 27, 2015:  8:00 a.m. - 4:00 p.m.

Thursday, May 28, 2015:  8:00 a.m. - 4:00 p.m.

 

Sign-in & Breakfast: 8:00 a.m.

Program begins at 8:50 a.m.

 

Click RHP9 & RHP10 Collaborative Connections to Register for the Event

Objectives: 

 

  • Identify best practice care models through presentations and collaborative interactions with other providers
  • Incorporate various process improvement tools in your projects to enhance outcomes and share your successes
  • Create opportunities for networking amongst providers and community providers.

 

Hotel Information: 

 

  • Hampton Inn, 1600 Hurst Town Center Drive, Hurst, TX      76054

Phone: 817-503-7777

  • Holiday Inn Express, 820 Thousand Oaks Drive, Hurst,      TX 76054
Phone: 817-427-1818

Both of these hotels will offer at $119 per night (King or Double Room), as available, if you mention you will be attending the event at the Hurst Conference Center. Contact: Susan Watts, Director of Sales. All room reservations must be made by May 13th, 2015 in order to obtain the $119 rate.

 

If you have questions about the event please contact the event organizers:

 

Margaret Roche, RHP 9 Waiver Operations Director

Office: 214-590-0416

Email: margaret.roche@phhs.org

http://www.texasrhp9.com

 

Meredith Oney, RHP 10 Learning Collaborative Coordinator

Office: 817-702-6759

Email: money@jpshealth.org

http://rhp10txwaiver.com

                       

 

Please let me know if you have any questions.



April 20, 2015
DSRIP

Good Morning Region 10 Providers,

 

I have lots of updates for you this morning! Please be sure to read that attached Anchor call notes. Also, attached is an updated draft of the DSRIP payment schedule for DY4-DY5.

 

DY 4 April Reporting

  • HHSC posted a current list of projects with QPI issues that affect April DY4 reporting (similar to what was previously shared via email) on the Tools and Guidelines for Regional Healthcare Partnership Participants page of the Waiver website. Providers reporting QPI metrics for achievement during April DY4 should check this list prior to doing so.

 

  • HHSC posted a revised DY4 QPI Reporting Template on the Tools and Guidelines for Regional Healthcare Partnership Participants page of the Waiver website. Projects with a template delay (listed in the list of projects with QPI issues document) may report using this version of the template. Providers with projects that did not have a template delay may continue to use the DY4 QPI Template posted prior to the update, if they already began using it.

 

  • HHSC is prioritizing Waiver mailbox questions to first address issues that impact the ability to report during April DY4 reporting. When submitting a QPI question to the mailbox, please let us know if you intend to report the metric for achievement during April DY4 reporting. Also, please remember to include both your RHP and project ID numbers with your question.

Category 4

 

  • Last Friday, HHSC updated the Category 4 April DY4 reporting template posted on the waiver website. The new template makes minor updates in the language for the qualitative questions for RDs 3 & 5. Providers may submit the original version of the Cat 4 DY4 template if needed, while responding to the revised qualitative questions.

 

  • On April 3rd, HHSC sent PPE reports for CY2013 to UC and DSRIP Category 4 participants for DY 4 reporting. Technical notes for CY2013 PPA, PPR, and PPC reports have been posted to the waiver website under resources for DY4 reporting. We understand updates made to the 2013 PPA and PPR reports make direct comparisons between the two reporting periods challenging, and are currently preparing additional guidance on qualitative responses for the Category 4 DY4 Reporting Template

 

Change Request Process

 

  • In June, HHSC will provide an opportunity for 3-year projects to submit change requests for DY5 only.  Additional information will be forthcoming.

 

Mid-Point Assessment

  • Myers and Stauffer (MSLC) continues the work for the mid-point assessment by reviewing 3-year projects. Many providers received questions from Myers and Stauffer, which unfortunately overlapped with the reporting period.

 

  • HHSC is still working on changes to the metrics impacting DY5 and/or narratives, and may be still contacting providers about these changes. HHSC plans to complete this work by the beginning of May.

 

  • As part of the mid-point assessment, HHSC will be requesting that projects that met or exceeded their DY5 QPI goal with DY3 QPI achievement increase their DY5 QPI goals. HHSC will contact impacted providers in May and cc Anchors with the proposed updated DY5 QPI goals.

 

  • HHSC received results of the mid-point assessment review from MSLC and are in the process of finalizing our feedback. HHSC will share additional information regarding results of the review and next steps in the very near future

 

Waiver Renewal Planning

 

  • HHSC plans to have a draft of the Waiver Extension/Renewal for public review in June 2015 and plans for public meetings in July 2015. They will communicate dates and locations as soon as available.

 

Value Based Payment Structure

  • HHSC is reaching out to DSRIP projects and MCOs for examples and/or input in order to develop a model for implementing Value-Based Payments in Medicaid managed care. They are looking for good data and concrete steps that projects have used/are using for VBP arrangements with MCOs.

 

DSRIP Statewide Events Calendar

  • In the future, HHSC will be sending a monthly statewide DSRIP events calendar along with the Anchor notes. They will also post the calendar on the waiver website.

 

 

 

Please let me know if you have any questions.

 
April 9, 2015
DSRIP
 

Good Morning Region 10 Providers,

 

I wanted to inform you of a few things this morning.

 

April DY 4 Reporting

  • RHP 12 recorded both of the webinars from Tuesday. They are available at  HHSC Hosted April DY4 Reporting Webinars and I have attached the PowerPoints from these presentations also.
  • If you would like the Anchor office to review any of you April reporting information please let us know by sending an email to RHP_Region_10@jpshealth.org

 

Learning Collaborative

 
  • Do not forget that we have our Care Transitions webinar today at 11AM and Behavior Health at 1PM.

 

  • And do not forget to register for:COLLABORATIVE CONNECTIONS- IMPACTING CARE
    RHP 9 and RHP 10 would like to present you with a collaborative learning event focused on expert knowledge from around the State, optimal care tools and collaborative provider resources.

    MAY 27th- MAY 28th, 8am-4pm
    Hurst Conference Center

Upcoming Events

 

The Fort Worth museum of Science and History will be hosting Fine Line a free exhibit that tells the stories of those with mental health/mental illness. Please see the attached brochure for educational opportunities and more information.

 

*Please note that the presentation on April 20th is actually from 3-4PM as opposed to 10-11AM

Please let me know if you have any questions.
March 31, 2015
DSRIP

Good Afternoon Region 10 Providers,

 

Below you will find updates from HHSC on April DY4 DSRIP reporting.

 

October DY3 Provisional NMI Results

  • HHSC has completed the review of provisionally approved metrics that received "Need More Information" (NMI) requests.  HHSC will notify providers today via email with coversheet if a provisionally approved metric was ultimately not approved.  If a provider does not receive notification that a provisionally approved metric was not approved, the provider can assume that all provisionally approved metrics will remain approved.  To be clear, if you do not receive a coversheet from us today, your provisionally reviewed metrics were approved.  For provisionally approved metrics that were not approved, the HHSC Rate Analysis Division will inform the provider of the recoupment amount by mid-April.

 

April DY4 Reporting Updates

  • The DSRIP Online Reporting system opens April 1st and closes April 30th at 11:59pm CDT.
  • DY4 reporting companions and templates are being uploaded this week.  HHSC is posting to the waiver website resources to support April DY4 reporting.  Our goal is for all documents to be uploaded by the end of this week, so please continue to check in.  HHSC strongly encourages providers to review the reporting companions prior to submitting any information into the online reporting system. HHSC has updated the general reporting companion, as well as three topic specific template guides for QPI, Category 3 DY4 performance reporting and Category 4 DY4 performance reporting.  These last three companions (QPI, Cat 3 and Cat 4) are step-by-step instructions for how to populate the respective templates.
  • Upcoming webinars:
    • General Reporting and QPI:  Tuesday, April 7, 2015, 10:00AM - 11:30AM CDT.
    • Category 3 and Category 4 reporting:  Tuesday, April 7, 2015, 2:00PM - 4:00PM CDT.
    • Webinars will be recorded and posted to the waiver website as soon as possible.
    • QPI Update:
      • HHSC will be posting the DY4 QPI Reporting Template on the Waiver website prior to  next week’s webinar.
      • Providers whose projects were very recently in discussion or are still in discussion with HHSC about final changes to the QPI template or QPI metrics will have a delay in having the DY4 QPI template available to them. These providers will need to wait until a revised template is available and issues are resolved before beginning to report on the project(s) in question. 
      • In a limited number of cases, if QPI issues require further technical assistance, the provider will need to wait until the October reporting period before reporting achievement for the QPI metric.
      • HHSC will share the list of affected projects prior to when the DY4 QPI template is posted.
      • For projects that are not on the list of delayed projects, if an issue is raised by the provider or  identified by HHSC or the compliance monitor before April DY4 reporting closes, reporting may need to be delayed until October DY4 reporting.
      • Category 3 TA Status Updates:  HHSC staff reviewed all baselines reported in DY3 and identified which of these baselines required technical assistance (TA).  HHSC prioritized those outcomes that would be eligible to report in April of DY4, which is determined by the baseline measurement period reported by providers.  We will continue to provide baseline TA to those providers that are eligible to report outcomes in October of DY4 over the next couple of months.  To that end, HHSC staff will be sending a regional TA status to anchors this week.   This status will identify which projects are eligible to report in April vs October DY4 and which of the outcomes have remaining TA concerns.  This eligibility to report at the Category 3 project level will also be contained within the DY4 Performance Reporting template.  Please attend the Category 3 webinar (detailed above) for additional information.
      • Category 4 Update:
        • HHSC is attaching a summary of Cat 4 project Reporting Domains that are eligible for reporting in April DY4 based on their measurement period. DY4 measurement periods are set as the 12-month measurement period immediately following the measurement period selected for DY3 reporting. RDs with a DY4 measurement period ending by 03/31/2015 may report in either April or October DY4. RDs with a DY4 measurement period that ends between 03/31/2015 and 09/30/2015 will be eligible for October DY4 reporting only. For RDs 1-3, the DY4 measurement period is 01/01/2013 – 12/31/2013 and all RDs 1- 3 are eligible to report in April.
        • HHSC will be sending out PPA, PPR, and PPC reports the first week in April. Most providers will be receiving all three reports. Providers with very low volume may receive fewer than 3 reports. All providers will be required to answer qualitative questions for RDs 1-3 in DY4, regardless of volume.
        • The Category 4 template has changed slightly from DY3. Please attend the Category 3 and Category 4 webinar for detailed instructions on reporting Category 4 in DY4.
        • Changes Related to Mid-Point Assessment:  If HHSC has notified a provider or anchor by COB on April 1 that certain DY4 metrics will change as a result of the mid-point assessment, the provider should wait to report on the related metric(s) until HHSC notifies the provider that the required changes have been made.  The changes are expected to be complete by the end of this week.

 

Please let me know if you have any questions.


March 26, 2015
DSRIP

Good Afternoon Region 10 Providers,

 

Thank you to everyone who attended the stakeholder engagement webinar on Tuesday. As was discussed during the webinar attached you will find:

  • The stakeholder engagement webinar slides including the attendee list
  • The project withdrawal form
  • The estimated IGT commitment for DSRIP monitoring
  • And the contact change form for anyone who needs to be added to the DSRIP online reporting tool

I have also attached the formally submitted Transition Plan for the UC and DSRIP pools to CMS by HHSC.

Please let me know if you have any questions.


 
March 11, 2015
DSRIP
 

Good Morning Region 10 Providers,

 

I have some very important information to share with you this morning. Please be sure to read the Anchor Call Notes in their entirety. I have also put a brief summary of the main points from the notes below.

 

October Reporting and Review

  • HHSC is currently reviewing additional information submitted for provisionally approved metrics that received “Need More Information” (NMI) requests.
  • HHSC will make final determinations and notify providers of results by March 31.
  • If a provisionally approved metric is ultimately not approved, HHSC will inform the provider of the recoupment amount by mid-April. The provider will not be eligible for future payments until the recoupment occurs

 

Category 3

  • HHSC is continuing to work with providers for those projects where reported baselines were flagged as needing TA, prioritizing those projects eligible to report for Category 3 DY4 achievement in April. HHSC is targeting to close out TA for these projects by early next week.
  • For those providers not eligible to report DY4 achievement until October of DY4, HHSC will continue to work with these providers during the remainder of March and April as needed.

 

DY 4 April Reporting Preparation

  • Webinars are tentatively scheduled for April 7: 10-11:30 a.m. for general reporting and QPI; 2-4 p.m. for Category 3 & 4 guidance. Please be sure to go ahead and mark your calendars for these times.

 

DSRIP Mid-Point Assessment

  • RHP 10 has received their additional questions from Meyers and Stauffer. Please be sure to respond to these questions by Thursday March 12, 2015.
  • HHSC is reviewing draft recommendations for the RHPs that have been completed by Myers and Stauffer.
  • HHSC is contacting providers and anchors regarding possible plan modifications recommended by Myers and Stauffer. HHSC’s target completion date for notifications is April 1st.

 

Monitoring IGT

  • Per Texas Administrative Code §355.8204, HHSC may collect up to $5 million per demonstration year from DSRIP IGT entities to serve as the non-federal share (50 percent IGT/50 percent federal funds) for DSRIP monitoring contracts. For DY4, HHSC plans to collect $3 million in Monitoring IGT.
  • HHSC will request 100 percent of the DY4 IGT monitoring amount with July 2015 payment processing of April reports. If the full DY4 IGT monitoring amount is not submitted by an IGT Entity in July 2015, it will be requested with January 2016 payment processing of October reports.
  • The monitoring amount for each IGT Entity (attached) is a portion of the $3 million based on the January 1, 2015 value of the IGT Entity’s funded DY4 Category 1-4 DSRIP projects out of all DY4 Category 1-4 DSRIP projects in the state. This will be the maximum amount an IGT Entity may expect to transfer pending project withdrawals.
  • For the DY3 Monitoring IGT that was submitted in July 2014 or January 2015, HHSC expects to refund approximately $2 million to IGT Entities in September 2015 after the monitoring invoices for DY3 have been settled. HHSC may combine refunds for the same IGT Entity participating in multiple regions. Refunds of less than $20 will not be processed.

 

Please let me know if you have any questions.


 
March 6, 2015
DSRIP
 
 

Good Morning Region 10 Providers,

 

I wanted to send out a few quick reminders this morning.

 

October DY3 Reporting

  • Providers with provisionally approved metrics marked “Need More Info” will need to submit additional supporting documentation to demonstrate achievement. These NMI submissions should be emailed to DSRIP@deloitte.com by 11:59 pm TODAY, March 6, 2015.  Please be sure to copy the RHP mailbox on your submissions.

 

 

Mid-point Assessment

  • RHP 10 providers have received their additional questions from MSLC. The replies to the questions are due the MSLC by COB Thursday, March 12, 2015.
  • Myers and Stauffer continues with the review of projects and sending questions to providers in cases when additional information is needed. If a provider does not receive a document with follow up questions from MSLC, the provider should not be concerned about this. It means that MSLC staff did not have additional questions for these projects. 
  • In addition, MSLC started to review information reported for 3 year projects that did not have any information reported in April of 2014. MSLC may contact providers with additional questions regarding any of the 3-year project that reported in October, including projects in addition to those providers were notified had been selected by MSLC for review in September 2014.

Project Withdrawals

  • HHSC wanted to make sure that providers understand that projects that withdraw during the Feb 1st  – May 1st window will no longer be eligible for payments after May 1st. This includes any carryforward payments from DY2 and DY3 that have not been achieved or paid.

Change Requests

  • HHSC sent HHSC's Round 2 preliminary determinations and Myers & Stauffer's Round 1 determinations to anchors/providers this week. Please be sure to review this spreadsheet  to make sure that final determinations for plan modifications are correct. If the RHP anchor or a provider has questions related to HHSC’s feedback, please send an email to the Transformation Waiver mailbox with the following subject line: “Change Request Question – RHP 10 – Project ID#.” 

 

 

Please let me know if you have any questions.




March 2, 2015
DSRIP
 

Good Afternoon Region 10 Providers,

 

I have a few reminders to share with you this afternoon.

 

Project Withdrawals

  • HHSC wanted to make sure that providers understand that projects that withdraw during the Feb 1st  – May 1st window will no longer be eligible for payments after May 1st. This includes any carryforward payments from DY2 and DY3 that have not been achieved or paid.

 

Mid-point Assessment

  • Myers and Stauffer continues with the review of projects and sending questions to providers in cases when additional information is needed. If a provider does not receive a document with follow up questions from MSLC, the provider should not be concerned about this. It means that MSLC staff did not have additional questions for these projects. 
  • In addition, MSLC started to review information reported for 3 year projects that did not have any information reported in April of 2014. MSLC may contact providers with additional questions regarding any of the 3-year project that reported in October, including projects in addition to those providers were notified had been selected by MSLC for review in September 2014
  • Questions for 3 year projects will be coming in the near future.

October DY3 Reporting

  • HHSC has completed review of additional information submitted by providers for metrics fully reviewed during the October DY3 reporting period and initial review of metrics that were provisionally approved during the October DY3 reporting and review period.
  • Last week, HHSC sent providers (copying Anchors) files summarizing review results, and, when needed, requested additional information for DY3 reporting.
    • Providers with provisionally approved metrics marked “Need More Info” will need to submit additional supporting documentation to demonstrate achievement. These NMI submissions should be emailed to DSRIP@deloitte.com by 11:59 pm on March 6, 2015.  Please be sure to copy the RHP mailbox on your submissions.
    • Some providers still show Incomplete for their Progress Update Signoff and must complete Semi-Annual Reporting (SAR) requirements per the HHSC Comments to be eligible for future payments. Missing QPI Reporting Templates, required as part of SAR for all DY3 designated QPI metrics, should be sent to the Waiver mailbox ASAP. (If the zipped template is too large to send to the waiver mailbox, please send a request for assistance to the mailbox.) HHSC needs this information immediately, as we are working to prepare QPI Templates for April DY4 reporting. Providers who do not address Incomplete Progress Update Signoffs will forfeit all monies for that metric.
    • In order to avoid impacting payment to providers, HHSC did attempt to mark Progress Update Signoffs as Complete if a QPI template was submitted, but there were template issues. HHSC will, however, be contacting these providers in the coming weeks to correct outstanding QPI Templates, so that QPI Templates are correct for April DY4 reporting.

Category 3

 
  • Along with the October DY3 reporting review results, HHSC sent providers a summary of their Cat 3 baseline review and their TA status.  In the next couple of weeks HHSC will be contacting providers for Cat 3 TA, with the goal to resolve baseline issues first for those providers who are eligible to report Cat 3 in April for DY4 reporting.   After TA is provided, HHSC will copy Anchors on emails to providers describing any resolutions of Cat 3 baseline issues.
  • Anchors should work with providers to ensure prompt response where requested by HHSC for urgent baseline/goal corrections, survey administration form submission, and Carryforward status. Expectations for response and response deadlines were been outlined in the Cat 3 baseline summary email sent to Anchors this week.

 

Change Requests

  • HHSC is reviewing the Round 2 change request submissions and Myers & Stauffer is reviewing the Round 1 submissions that required their review. HHSC plans to send HHSC's Round 2 preliminary determinations and Myers & Stauffer's Round 1 determinations to anchors/providers this week.

 

Please let me know if you have any questions.

February 23, 2015
DSRIP
 

Good Afternoon Region 10 Providers,

 

 

I hope that everyone is staying warm this afternoon! I have a few updates for you from HHSC and a few reminders.

 

 

Important Due Dates for Category 3

  • Approved Baselines/Goal Corrections: to the waiver mailbox no later than Wednesday, February 25th
  • Technical Assistance/Baseline Clarification Flags: HHSC will contact providers
  • Missing Survey Administration Forms: to the waiver mailbox no later than Friday, February 27th
  • Carryforward Status/DY4 Carryforward Approval: to the waiver mailbox no later than Wednesday, February 25th

 

 

Mid-point Assessment

  • Myers and Stauffer continues with the review of projects and sending questions to providers in cases when additional information is needed. If a provider does not receive a document with follow up questions from MSLC, the provider should not be concerned about this. It means that MSLC staff did not have additional questions for these projects. 
  • In addition, MSLC started to review information reported for 3 year projects that did not have any information reported in April of 2014. MSLC may contact providers with additional questions regarding any of the 3-year project that reported in October, including projects in addition to those providers were notified had been selected by MSLC for review in September 2014
  • Please share with your providers that additional questions for 3 year projects will be coming in the near future.

 

Waiver Renewal

 

  • HHSC is working on the final draft of the Transition Plan for Funding Pools required by STC 48 of the waiver and due to CMS by March 31, 2015.  Thank you all for your comments and feedback on the last draft. They will share the next draft with you as soon as it is available.

 

October DY3 Reporting

  • HHSC has completed review of additional information submitted by providers for metrics fully reviewed during the October DY3 reporting period and initial review of metrics that were provisionally approved during the October DY3 reporting and review period.
  • This week, HHSC sent providers (copying Anchors) files summarizing review results, and, when needed, requesting additional information for DY3 reporting.

o   Providers with provisionally approved metrics marked “Need More Info” will need to submit additional supporting documentation to demonstrate achievement. These NMI submissions should be emailed toDSRIP@deloitte.com by 11:59 pm on March 6, 2015.

o   Some providers still show Incomplete for their Progress Update Signoff and must complete Semi-Annual Reporting (SAR) requirements per the HHSC Comments to be eligible for future payments. Missing QPI Reporting Templates, required as part of SAR for all DY3 designated QPI metrics, should be sent to the Waiver mailbox ASAP. (If the zipped template is too large to send to the waiver mailbox, please send a request for assistance to the mailbox.) HHSC needs this information immediately, as we are working to prepare QPI Templates for April DY4 reporting. Providers who do not address Incomplete Progress Update Signoffs will forfeit all monies for that metric.

o   In order to avoid impacting payment to providers, HHSC did attempt to mark Progress Update Signoffs as Complete if a QPI template was submitted, but there were template issues. HHSC will, however, be contacting these providers in the coming weeks to correct outstanding QPI Templates, so that QPI Templates are correct for April DY4 reporting.

 

Category 3

  • Along with the October DY3 reporting review results, HHSC sent providers a summary of their Cat 3 baseline review and their TA status.  In the next couple of weeks HHSC will be contacting providers for Cat 3 TA, with the goal to resolve baseline issues first for those providers who are eligible to report Cat 3 in April for DY4 reporting.   After TA is provided, HHSC will copy Anchors on emails to providers describing any resolutions of Cat 3 baseline issues.
  • Anchors should work with providers to ensure prompt response where requested by HHSC for urgent baseline/goal corrections, survey administration form submission, and Carryforward status. Expectations for response and response deadlines were been outlined in the Cat 3 baseline summary email sent to Anchors this week.

 

QPI Questions

  • HHSC is aware that there are questions related to DY4 QPI reporting that have come into the waiver mailbox and have not yet been answered.  They have been focused on getting DY3 reporting completed, finishing up change request reviews, and working with providers to clean up DY3 QPI templates to get them ready for DY4 reporting before we answer these questions, but please know that they haven’t forgotten them and will get to them as soon as possible. Thank you for your and your providers’ patience!

 

Change Requests

  • HHSC is reviewing the Round 2 change request submissions and Myers & Stauffer is reviewing the Round 1 submissions that required their review. HHSC plans to send HHSC's Round 2 preliminary determinations and Myers & Stauffer's Round 1 determinations to anchors/providers by the week of March 2nd.

 

 

Webinar on Adult Potentially Preventable Hospitalizations in Texas

Mar 04, 2015 at 10:00 AM CST.

Register: https://attendee.gotowebinar.com/register/3130475994798807810

Content: Participants will learn how Texans are impacted by the following potentially preventable hospitalizations: Bacterial Pneumonia; Dehydration; Urinary Tract Infection; Angina (without procedures); Congestive Heart Failure; Hypertension; Chronic Obstructive Pulmonary Disease and Older Adult Asthma; and Diabetes Complications. Adult hospitalizations for these conditions are called “potentially preventable” because if the individual had access to and cooperated with appropriate outpatient healthcare, the hospitalization would likely not have occurred. From 2008 to 2013 adult Texans received approximately $49 Billion in hospital charges for these conditions. 

Various communities in Texas are working successfully with the Texas Department of State Health Services (DSHS) to prevent these hospitalizations. The lessons learned on how to help keep Texans out of the hospital are applicable to health care payers, providers, state & local government, and patients. 

The event is sponsored by the Health Policy & Clinical Services division of Texas HHSC and the Texas Institute of Health Care Quality and Efficiency. Information on the Adult PPH program is here: http://www.dshs.state.tx.us/ph/ 

The webinar will be broadcast from the K-100 Lecture Hall at DSHS, located at 1100 W. 49th Street, Austin, 78756.

After registering, you will receive a confirmation email containing information about joining the webinar.

View System Requirements

Please let me know if you have any questions.

 

February 20, 2015
DSRIP
 

Good Afternoon Region 10 Providers,

 

 

I hope that everyone is staying warm this afternoon! I have a few updates for you from HHSC and a few reminders.

 

 

Important Due Dates for Category 3

  • Approved Baselines/Goal Corrections: to the waiver mailbox no later than Wednesday, February 25th
  • Technical Assistance/Baseline Clarification Flags: HHSC will contact providers
  • Missing Survey Administration Forms: to the waiver mailbox no later than Friday, February 27th
  • Carryforward Status/DY4 Carryforward Approval: to the waiver mailbox no later than Wednesday, February 25th

 

 

Mid-point Assessment

  • Myers and Stauffer continues with the review of projects and sending questions to providers in cases when additional information is needed. If a provider does not receive a document with follow up questions from MSLC, the provider should not be concerned about this. It means that MSLC staff did not have additional questions for these projects. 
  • In addition, MSLC started to review information reported for 3 year projects that did not have any information reported in April of 2014. MSLC may contact providers with additional questions regarding any of the 3-year project that reported in October, including projects in addition to those providers were notified had been selected by MSLC for review in September 2014
  • Please share with your providers that additional questions for 3 year projects will be coming in the near future.

 

Waiver Renewal

 

  • HHSC is working on the final draft of the Transition Plan for Funding Pools required by STC 48 of the waiver and due to CMS by March 31, 2015.  Thank you all for your comments and feedback on the last draft. They will share the next draft with you as soon as it is available.

 

October DY3 Reporting

  • HHSC has completed review of additional information submitted by providers for metrics fully reviewed during the October DY3 reporting period and initial review of metrics that were provisionally approved during the October DY3 reporting and review period.
  • This week, HHSC sent providers (copying Anchors) files summarizing review results, and, when needed, requesting additional information for DY3 reporting.

o   Providers with provisionally approved metrics marked “Need More Info” will need to submit additional supporting documentation to demonstrate achievement. These NMI submissions should be emailed toDSRIP@deloitte.com by 11:59 pm on March 6, 2015.

o   Some providers still show Incomplete for their Progress Update Signoff and must complete Semi-Annual Reporting (SAR) requirements per the HHSC Comments to be eligible for future payments. Missing QPI Reporting Templates, required as part of SAR for all DY3 designated QPI metrics, should be sent to the Waiver mailbox ASAP. (If the zipped template is too large to send to the waiver mailbox, please send a request for assistance to the mailbox.) HHSC needs this information immediately, as we are working to prepare QPI Templates for April DY4 reporting. Providers who do not address Incomplete Progress Update Signoffs will forfeit all monies for that metric.

o   In order to avoid impacting payment to providers, HHSC did attempt to mark Progress Update Signoffs as Complete if a QPI template was submitted, but there were template issues. HHSC will, however, be contacting these providers in the coming weeks to correct outstanding QPI Templates, so that QPI Templates are correct for April DY4 reporting.

 

Category 3

  • Along with the October DY3 reporting review results, HHSC sent providers a summary of their Cat 3 baseline review and their TA status.  In the next couple of weeks HHSC will be contacting providers for Cat 3 TA, with the goal to resolve baseline issues first for those providers who are eligible to report Cat 3 in April for DY4 reporting.   After TA is provided, HHSC will copy Anchors on emails to providers describing any resolutions of Cat 3 baseline issues.
  • Anchors should work with providers to ensure prompt response where requested by HHSC for urgent baseline/goal corrections, survey administration form submission, and Carryforward status. Expectations for response and response deadlines were been outlined in the Cat 3 baseline summary email sent to Anchors this week.
 

QPI Questions

  • HHSC is aware that there are questions related to DY4 QPI reporting that have come into the waiver mailbox and have not yet been answered.  They have been focused on getting DY3 reporting completed, finishing up change request reviews, and working with providers to clean up DY3 QPI templates to get them ready for DY4 reporting before we answer these questions, but please know that they haven’t forgotten them and will get to them as soon as possible. Thank you for your and your providers’ patience!

 

Change Requests

  • HHSC is reviewing the Round 2 change request submissions and Myers & Stauffer is reviewing the Round 1 submissions that required their review. HHSC plans to send HHSC's Round 2 preliminary determinations and Myers & Stauffer's Round 1 determinations to anchors/providers by the week of March 2nd.

 

 

Webinar on Adult Potentially Preventable Hospitalizations in Texas

Mar 04, 2015 at 10:00 AM CST.

Register: https://attendee.gotowebinar.com/register/3130475994798807810

Content: Participants will learn how Texans are impacted by the following potentially preventable hospitalizations: Bacterial Pneumonia; Dehydration; Urinary Tract Infection; Angina (without procedures); Congestive Heart Failure; Hypertension; Chronic Obstructive Pulmonary Disease and Older Adult Asthma; and Diabetes Complications. Adult hospitalizations for these conditions are called “potentially preventable” because if the individual had access to and cooperated with appropriate outpatient healthcare, the hospitalization would likely not have occurred. From 2008 to 2013 adult Texans received approximately $49 Billion in hospital charges for these conditions. 

Various communities in Texas are working successfully with the Texas Department of State Health Services (DSHS) to prevent these hospitalizations. The lessons learned on how to help keep Texans out of the hospital are applicable to health care payers, providers, state & local government, and patients. 

The event is sponsored by the Health Policy & Clinical Services division of Texas HHSC and the Texas Institute of Health Care Quality and Efficiency. Information on the Adult PPH program is here: http://www.dshs.state.tx.us/ph/ 

The webinar will be broadcast from the K-100 Lecture Hall at DSHS, located at 1100 W. 49th Street, Austin, 78756.

After registering, you will receive a confirmation email containing information about joining the webinar.

View System Requirements

 

Please let me know if you have any questions.

 

February 11, 2015
DSRIP
 

Good Morning Region 10 Providers,

 

I have a lot of very important information to share with you this morning. I have highlighted some of the main points from the attached anchor call notes.

 

October Reporting and Review

·         HHSC staff is in the process of reviewing Provisionally Approved metrics. For Provisionally Approved metrics that need more information, HHSC will request additional information in mid-February (target date is Feb. 16) and ask that the information be provided by early March (target date is March 6).

 

Category 3

·         HHSC is reviewing baseline data submitted during the October reporting period. Currently, HHSC is identifying projects that need technical assistance or clarification.

·         HHSC expects a large volume of projects needing technical assistance or clarification on their reported baseline rate, and will prioritize projects eligible to report their DY4 achievement in April based on their baseline measurement period.

·         Next week HHSC will send out a RHP summary of Category 3 projects to the anchors in an excel file that will identify:

o   projects for which HHSC does not currently have any baseline concerns, and their DY4/DY5 performance goals and measurement periods.

o   those providers that we will be reaching out to for TA/baseline clarification (for the reasons listed above) and

o   projects that did not report baselines in October of DY3, status of carry forward, and carry forward projects that have received approval from HHSC to report baselines using DY4 data

·         HHSC  will be asking anchors to share this information with their providers to ensure the status (reported or carried forward) is accurate as reflected in the DSRIP automated reporting system.

o   HHSC will include specific instructions and response deadlines (targeting February 20th) for how to communicate any concerns with reporting or carryforward status noted in this excel summary.

·         HHSC will begin contacting providers for technical assistance and baseline clarifications after this summary is distributed to anchors. As this is anticipated to be a significant workload for HHSC staff, please encourage providers to hold off on sending any questions related to their Category 3 baseline until they are contacted by HHSC. For most scenarios, we will have a standard form for making corrections to baseline data.

·         During the last week of February and first week of March, after all needed TA/baseline clarification has been conducted, HHSC will send to the Anchors a zipped file with a PDF document for each Category 3 project with a baseline summary (including measurement period, approved subsets, etc.), DY4/DY5 goals and measurement periods and incentive allocation per milestone in DY4 and DY5.

 

Change Request Process

·         HHSC is reviewing the Round 2 change request submissions and Myers & Stauffer is reviewing the Round 1 submissions that required their review. HHSC plans to send HHSC's Round 2 preliminary determinations and Myers & Stauffer's Round 1 determinations to anchors/providers by mid to late February.

 

DSRIP Mid-Point Assessment

·         Meyers and Stauffer has contacted the RHP 10 Anchor to schedule the AnchorEntrance call. This call is scheduled for  Wednesday February 25th.

·         We have asked that each provider with a project in the mid-point assessment have 1 representative on the call.

·         Meyers and Stauffer indicated that the list of projects that will have on site visits will be sent out later this week.

·         Please be sure the check your spam, junk and deleted mail because other providers have indicated that the email from Meyers and Stauffer have not gone to their inbox.

 

Project Withdrawal Window

·         CMS approved the proposed timeframe of February 1, 2015 – May 1, 2015 for withdrawal of a project from DSRIP after the mid-point assessment per the PFM protocol.

·         To withdraw a project, providers should complete the attached Project Removal Form and submit it to the waiver mailbox.

·         Providers do not have to wait until the mid-point assessment process is complete.

 

Waiver Renewal Planning

 

·         The waiver Special Terms and Conditions (STCs) require two submissions to CMS related to waiver extension/renewal.

·          The first is a transition plan due to CMS by March 31, 2015 that must address the state's experience with the DSRIP pool, actual UC trends in the state and investment in value-based purchasing and other payment reform options.

·         Attached you will find a draft copy of the transition plan if you have any substantive suggestions or comments to the draft please send them to the RHP mailbox (rhp@jpshealth.org) by  5PM on Thursday February 12th.

 

Update on Unspent DY2 DSRIP Funds Amendment Request

 

·         CMS requested additional information to which HHSC responded.

 
January 27, 2015
DSRIP
 

Good Afternoon Region 10 Providers,

 

I have some learning collaborative information to share with you and a few reminders.

 

Learning Collaborative Information

 

 

  • The survey from our January 22 Learning Collaborative went out today. If you attended please take a few minutes to fill out this quick survey. Your feedback is important to making the learning sessions as applicable to providers as possible.

 

 

  • Save the date for our Learning Summit with RHP 9 May 27th and 28th. A calendar invite with additional information will be going out this week!

 

  • Several other regions are hosting learning collaboratives in February and March.

 

  • RHP 7 will host their Learning Collaborative on February 17th.
  • RHP 8 will be hosting their Learning Collaborative on February 19th from 1PM-4PM.
  • RHP 12 will be having their learning Collaborative February 26th from 8AM to 5PM.
  • RHP’s 11,13,16,19 will be hosting a Learning Collaborative on March 6th for rural providers.
  • Please let me know if you are interested in attending any of these events and I will send you registration information.

 

Important Reminders

 

October Reporting and Review

 

  • For Provisionally Approved metrics that need more information, HHSC will request additional information in mid-February (target date is Feb. 16) and ask that the information be provided by early March (target date is March 6).

 

Category 3

 

  • HHSC is reviewing baseline data submitted during the October reporting period and anticipates this process will require a couple of months to complete (target - end of February).

 

Change Request Process

 

  • HHSC is reviewing providers’ responses to change request NMIs and plans to send HHSC’s determinations to anchors/providers in early February.

 

Mid-Point Assessment

 

  • The review schedule may change to remaining site visits occurring in mid-February.
  • Myers and Stauffer will update HHSC on the current RHP review schedule. We will update anchors when we receive this information from the compliance monitor.

 

Please let me know if you have any questions.

 
 
January 12, 2015
DSRIP & UC
 

Good Morning Region 10 Providers,

 

I have quite a bit of very important information to share with you this morning. You will find a summary of the anchor call notes below and additional important information.

 

In the attached folder you will find:

 

  • Anchor Call notes from the 1/9/15 call
  • The UC deferral letter stating that it has been lifted
  • Reporting data by RHP
  • Clinical Champions workgroups spreadsheet
  • The behavioral health report from The Meadows Foundation

 

Learning Collaborative

I wanted to remind you that the first learning session for DY 4 will be held at the Riley Center on January 22nd. Registration for this event is now open! Please click Here to register and be sure to register everyone on your team who plans to attend. A draft agenda is now posted on the registration page.

 

 

Anchor Call Notes Summary

 

October Reporting and Review

 

  • For metrics marked "Need More Information," providers will have until 11:59 p.m. on Friday, January 16, to submit additional information using the Online Reporting System. 
  • Providers should enter additional comments as "NMI Update" in the Metric Progress Update field.
  • Previous progress update information should not be deleted or changed.
  • For Provisionally Approved metrics that need more information, HHSC will request additional information in mid-February (target date is Feb. 16) and ask that the information be provided by early March (target date is March 6).

 

Category 3

 

  • HHSC is reviewing baseline data submitted during the October reporting period and anticipates this process will require a couple of months to complete (target - end of February).
  • For those providers who have recognized errors in baseline data submitted in October, please send an email to the waiver inbox with subject line- "Updated baseline performance" and include an updated baseline template with the corrected data. In addition, providers should include in the email detail around how the error was recognized and what steps were taken to identify the correct numerator and denominator.
  • Any provider initiated requests to 'true-up' baseline data must be submitted to the waiver inbox by January 15th, 2015.

 

Category 4

 

  • There are some Category 4 reporting questions that are under review by CMS for providers that have requested variances from reporting requirements. In these cases, HHSC has designated Needs More Info until the determination from CMS is received.

 

Change Request Process

 

  • HHSC is reviewing providers’ responses to change request NMIs and plans to send HHSC’s determinations to anchors/providers in early February.

 

Mid-Point Assessment

 

  • The review schedule may change to remaining site visits occurring in mid-February.
  • Myers and Stauffer will update HHSC on the current RHP review schedule. We will update anchors when we receive this information from the compliance monitor.

 

DY 2 Unspent Funds

 

  • HHSC does not have further information from CMS on the waiver amendment request to access DY2 DSRIP funds. 
  • As we get later into DY4, HHSC believes it is less likely that CMS will approve this amendment

 

UC Deferral

 

  • On January 7th, HHSC received from CMS a letter (in documents library) that formalizes the lifting of the UC deferral issued in September 2014.
  • As anticipated, the letter notes that CMS plans to work with Texas to do further analysis related to its concerns around private hospital IGT financing arrangements.

 

Waiver Renewal

 

  • HHSC has sent out an email to nominees for the "Clinical Champions" workgroup to assist with renewal activities focused on review of promising practices.
  • A general Clinical Champions workgroup (list in document library) was formed along with a pool of experts in clinical subspecialties and a subgroup of persons with expertise in waiver administration and operations.
  • The first meeting is scheduled for January 22,2015.

 

Medicaid and CHIP Quality Improvement and Efficiency Improvement Website
 

 

Other Updates

You may remember early last year The Meadows Foundation sponsored an effort to review all DSRIP projects focused on behavioral health. The purpose was to provide a descriptive analysis to help identify opportunities for developing communities of practice in the region and across the State, and to highlight the innovative projects being implemented by Providers through the 1115 Waiver. Attached you will find the report from The Meadows Foundation.

 

Please let us know if you have any questions.

 
January 6, 2015
DSRIP & UC
 

Good Morning Region 10 Providers,

 

I have a few updates for you this morning.

 

Learning Collaborative

 

The first learning session for DY 4 will be held at the Riley Center on January 22nd. Registration for this event is now open! Please click Here to register and be sure to register everyone on your team who plans to attend. A draft agenda will be posted on the registration page soon.

 

Plan Modification Process

 

HHSC is reviewing providers’ responses to change request NMIs and plans to send HHSC’s determinations to anchors/providers in early February.

 

October Reporting Review

 

For metrics marked "Need More Information," providers will have until 11:59 p.m. on Friday, January 16, to submit additional information using the Online Reporting System.

 

DSRIP Mid-Point Assessment

 

The schedule for onsite visits and entrance conferences for the remaining regions has not changed since last Friday's email update (see below for most recent schedule). Myers and Stauffer will be contacting regions to schedule these.

  • So far RHP 10 has not been contacted by Meyers and Stauffer for the mid-point assessment.
  • Week of January 5th: RHPs 3,7,9,10,12,14 and 15 (tentative)

 

Please let us know if you have any questions.

 
 
 
December 15, 2014
UC
 

Good Afternoon Region 10 Providers,

 

HHSC Rate Analysis has sent out additional information on the UC Schedule 3 Costs. Please see the below email and attached spreadsheet.

 

HHSC sent the message below on Friday to allow providers to recalculate the RCC in Schedule 3 of the tool, as well as to recalculate organ acquisition costs that had been overstated using the original methodology in the tool. HHSC has added a table to the recalculation workbook for providers to also calculate revised per diems that include the allowable interns and residents costs. Please complete the table using the data requested from your cost report, insert the revised per diems and RCC's into the corresponding fields in your tool, and re submit to HHSC.

 

Please note that this revised methodology only affects hospitals who incurred Interns and Residents costs and Organ Acquisition/ Transplant costs. It does not affect the majority of providers or any TXPUC providers.

 

Please be aware that if you claimed organ costs, the new methodology established for calculating these costs established in the attached workbook is mandatory, and must be utilized for all organ acquisition costs claimed in the tool. Only Medicaid organ related costs can be reimbursed in the DSH and UC programs.

 

Providers who are amending their tool based on the revised methodology do NOT need to submit a new certification with the amended tool and support. Providers also do not need to resubmit all of their supporting documentation, just documents that were amended in an email formatted as directed below.

 

HHSC is correcting the methodology for several issues that pertain to the HSL calculation in Schedule 3 of the DSH/UC Tool. Specifically, HHSC is correcting the following:

 

  1. Erroneous instructions for calculating the ratio of costs to charges (RCC) for providers that had interns and residents costs that resulted in understated RCC: The instructions for completing the UC Tool gave providers the wrong direction for calculating a revised RCC that would have included the costs for interns and residents. If your hospital incurred these costs, please enter the total hospital costs from w/s B part I, column 24 (total cost before interns and residents costs are removed), as well as the charges from w/s C part I already submitted  into the corresponding cell in the “RCC Recalculation” tab in the attached workbook. This will produce a revised RCC that will need to replace the RCC currently in the tool. Please replace the RCC in the Cost Report Collection tab of your tool using the revised RCC and resubmit your tool and the workbook as support. Providers will also re-calculate their per diems to include interns and residents costs by taking days from w/s S-3 part I, col 8 (except for Adults and Pediatrics, which must come from w/s D-1, line 1), and dividing these days by costs from w/s B part I, column 24. Please take the revised per diems calculated in column H and copy and paste the revised amounts into the corresponding cells in your tool and resubmit.
  2. Incorrect Organ Acquisition Costs resulting in overstated RCCs: The current functionality of the Tool does not calculate organ acquisition costs by using only eligible Medicaid organ costs that can be included for DSH and UC and using an RCC to calculate actual costs as it should. Instead, total organ acquisition costs are directly added to the HSL, which grossly overstates the allowable costs. HHSC has derived a new methodology for calculating the eligible costs relating to organ acquisition for providers to use to calculate their costs correctly. This calculation will rely on using the total cost and organs from w/s D part 4, and the number of Medicaid eligible organs which will come from paid claims data and/or provider records. Please enter the data requested in the headings of each yellow column in the “Organ Costs” tab. There are two sections to complete, one for in state costs, and one for out of state costs. Once all data has been entered, the revised organ costs will be calculated in cells D60-D67 of the “Organ Costs” tab. Please overwrite the cost for each organ in section 7.8 of the Hospital Application tab of your tool with the revised costs produced by the “Organ Costs” spreadsheet and resubmit your tool, supporting documentation for the Medicaid organs, and the “RCC_OrganCost Recalculation” workbook as support to HHSC.

 

A number of providers have asked HHSC to consider revising the treatment of RCE adjustments in calculating the RCC.  HHSC is looking into this request and will advise providers in due course.  However, if there is a change in RCE treatment, it will only be effective in the 2015 program year at the earliest.

 

If this revised methodology affects your hospital, please re-calculate your RCC and/or organ costs, and input the revised RCC and organ costs in the correct fields in your tool. Do not attempt to insert the new “Cost Report Collection” tab into your tool as this will break formulas. Simply copy and paste (values) the newly calculated RCC and organ costs into the appropriate fields in your tool. When resubmitting, please use “Resubmission, TPI, Hospital Name” as the format for the subject line in your email. The revised tool, calculation workbook, and supporting documentation for organ costs are due to HHSC by 5:00 p.m. Friday, December 19, 2014. If you are a consultant who must complete this for multiple hospitals and need additional time, please contact the UC Tools mailbox.

 
 
December 15, 2014
DSRIP & UC
 

Good Morning Region 10 Providers,

 

Happy Monday! I have a lot (and I mean a lot) of important information to share with you this morning.

 

In the zip file in the documents library you will find several documents:

  • Anchor Call Notes
  • Category 3 Selections as of October 1, 2014
  • Anchor Annual Report and Appendices
  • UC Deferral Letter sent from HHSC to CMS
  • UC Only Hospital Category 4 Tracker
  • RCC UC Tool Recalculation

 

I have some highlights from the anchor call notes and UC information below.

 

Anchor Call Notes Highlights:

 

Category 3

  • HHSC is reviewing baseline data submitted during the October reporting period and anticipates this process will require a couple of months to complete (target - end of February). During this process HHSC will be reviewing and working with providers as needed who a) submitted requests for alternate achievement levels, b) reported a low volume denominators, c) baseline performance is significantly lower or higher than benchmarks, d) did not fully submit the required baseline data or whose baseline templates contain errors and e) did not submit the survey administration form for tool/survey based outcomes in ODs 6, 10 or 11.
  • For those providers who have recognized errors in baseline data submitted in October, please send an email to the waiver inbox with subject line- "Updated baseline performance" and include an updated baseline template with the corrected data. In addition, providers should include in the email detail around how the error was recognized and what steps were taken to identify the correct numerator and denominator. Please be as specific as possible.
  • Any provider initiated requests to 'true-up' baseline data must be submitted to the waiver inbox by January 15th, 2015.
  • Along with today’s anchor notes, attached is a list of most recent Category 3 selections for all projects statewide.

Category 4

  • There are some Category 4 reporting questions that are under review by CMS for providers that have requested variances from reporting requirements. In these cases, HHSC has designated Needs More Info until the determination from CMS is received. We will notify providers as soon as possible for the CMS determinations in these instances.

 

Plan Modification Process

  • HHSC is reviewing providers’ responses to change request NMIs and plans to send HHSC’s determinations to anchors/providers in early February.

 

October Reporting Review

  • At the request of providers and anchors, HHSC will also send a revised summary to RHPs that differentiates Approved metrics from Provisionally Approved metrics.
  • All “Needs More Information” metrics will be reviewed once the December/January provider response period closes based on information submitted to the online reporting system. If a provider has submitted documentation to the Waiver mailbox for re-review, they should instead upload this information to the online reporting system and expect a response after the Needs More Information HHSC review period closes.
  • For metrics marked "Need More Information," providers will have until 11:59 p.m. on Friday, January 16, to submit additional information using the Online Reporting System.
  • For metrics that were approved in the current round, or approved but unpaid in previous rounds, IGT will be due from IGT entities on Monday, January 5, and payments will occur on January 30. HHSC Rate Analysis will send out the IGT due based on our review the week of Dec. 15th using FMAP of 58.05. Please do not refer to the IGT amounts due that are currently listed in the online reporting system, as they are not accurate.
  • For metrics that are “provisionally approved,” the HHSC Signoff will show "Approved," but the HHSC Comment will indicate that the approval was provisional. The Performing Provider is eligible for full DSRIP payment for these metrics in January, and the IGT for these metrics will be included in the request for IGT that is due on January 5. After review of any “provisionally approved” metrics, HHSC will request additional information if necessary, most likely in late February or early March 2015. If the initial supporting documentation, and any additional information, does not form a sufficient basis for actual metric achievement, HHSC will recoup the associated overpayments from the Performing Provider. As described in waiver rules, HHSC will withhold future payments until the recoupment occurs.
  • Some providers have asked about the "Achievement Value" shown under each metric in the Online Reporting System. Please note that the achievement value shows 100% only after the HHSC signoff shows "Approved." During previous reporting periods, the reporting templates showed an achievement value of 100% when the provider reported "Yes-Completed" for the metric.

 

DSRIP Mid-Point Assessment

  • The schedule for onsite visits and entrance conferences for the remaining regions has not changed since last Friday's email update (see below for most recent schedule). Myers and Stauffer will be contacting regions to schedule these.
    • Week of December 8th: RHPs 4 and 5
    • Week of December 15th : RHPs 2
    • Week of January 5th: RHPs 3,7,9,10,12,14 and 15 (tentative)
    • Week of January 19th: RHP 6 (tentative- may be contacted earlier in January)

 

Project Withdrawal Window

  • Based on the PFM, performing providers will have a period of time after the mid-point assessment to determine if the provider wishes to continue with a project or withdraw a project from DSRIP.
  • HHSC will propose to CMS that that the window to withdraw the projects is from February 1 through May 1 of 2015.
  • HHSC will communicate any updates related to this timeline after discussions with CMS.

Waiver Renewal

  • HHSC received 318 responses to the waiver renewal survey, and we are reviewing them and will summarize the feedback and use for input as we work on waiver renewal. HHSC will share more information about that with you as soon as possible.

 

 

Other very Important Information:

 

Anchor Report

 

The anchor report and appendices that were submitted to HHSC on Friday are attached.

 

UC Deferral Update

 

We want to give you a brief update on the September UC deferral.  HHSC expects to receive from CMS next week the letter formalizing the lifting of the deferral.  This is very encouraging, and we want to thank those of you that helped get the deferral lifted by providing supporting documentation and/or helping HHSC to develop the position we conveyed to CMS.

 

Earlier this week, HHSC sent a more detailed letter to CMS outlining HHSC’s position on the issues presented in the deferral (attached).  CMS has indicated that in the coming weeks it will review the information HHSC sent in comparison to the supporting documentation that led to the deferral in order to begin more detailed discussions early next year.

 

UC Only Hospitals Category 4

 

The Category 4 PPA and PPR reports have been sent out to the UC Only provider. Attached you will find a tracker which includes notes on those UC Only providers who did not receive a PPA or PPR report in case questions arise. Those providers marked with "NA" in the "Reports Sent" column did not have a PPA or PPR report available, so they were not sent an email.  Please let us know if you did not receive Category 4 data from HHSC. If UC Only provider hasn't received their reports, please have them send a request to the Waiver mailbox at TXHealthcareTransformation@hhsc.state.tx.us. For questions related to the certification forms, please direct the providers to contact the HHSC Rate Analysis Department at uctools@hhsc.state.tx.us.

 

Revised Methodology for UC Costs

 

HHSC is correcting the methodology for several issues that pertain to the HSL calculation in Schedule 3 of the DSH/UC Tool. Specifically, HHSC is correcting the following:

 

  1. Erroneous instructions for calculating the ratio of costs to charges (RCC) for providers that had interns and residents costs that resulted in understated RCC: The instructions for completing the UC Tool gave providers the wrong direction for calculating a revised RCC that would have included the costs for interns and residents. If your hospital incurred these costs, please enter the total hospital costs from w/s B part I, column 24 (total cost before interns and residents costs are removed), as well as the charges from w/s C part I already submitted  into the corresponding cell in the “RCC Recalculation” tab in the attached workbook. This will produce a revised RCC that will need to replace the RCC currently in the tool. Please replace the RCC in the Cost Report Collection tab of your tool using the revised RCC and resubmit your tool and the workbook as support.
  2. Incorrect Organ Acquisition Costs resulting in overstated RCCs: The current functionality of the Tool does not calculate organ acquisition costs by using only eligible Medicaid organ costs that can be included for DSH and UC and using an RCC to calculate actual costs as it should. Instead, total organ acquisition costs are directly added to the HSL, which grossly overstates the allowable costs. HHSC has derived a new methodology for calculating the eligible costs relating to organ acquisition for providers to use to calculate their costs correctly. This calculation will rely on using the total cost and organs from w/s D part 4, and the number of Medicaid eligible organs which will come from paid claims data and/or provider records. Please enter the data requested in the headings of each column in the “Organ Costs” tab. Once all data has been entered, the revised organ costs will be calculated in cells D72-D79 of the “Organ Costs” tab. Please overwrite the cost for each organ in section 7.8 of the Hospital Application tab of your tool with the revised costs produced by the “Organ Costs” spreadsheet and resubmit your tool, supporting documentation for the Medicaid organs, and the “RCC_OrganCost Recalculation” workbook as support to HHSC.

 

A number of providers have asked HHSC to consider revising the treatment of RCE adjustments in calculating the RCC.  HHSC is looking into this request and will advise providers in due course.  However, if there is a change in RCE treatment, it will only be effective in the 2015 program year at the earliest.

 

If this revised methodology affects your hospital, please re-calculate your RCC and/or organ costs, and input the revised RCC and organ costs in the correct fields in your tool. Do not attempt to insert the new “Cost Report Collection” tab into your tool as this will break formulas. Simply copy and paste (values) the newly calculated RCC and organ costs into the appropriate fields in your tool. When resubmitting, please use “Resubmission, TPI, Hospital Name” as the format for the subject line in your email. The revised tool, calculation workbook, and supporting documentation for organ costs are due to HHSC by 5:00 p.m. Friday, December 19, 2014. If you are a consultant who must complete this for multiple hospitals and need additional time, please contact the UC Tools mailbox.

 

Please let us know if you have any questions.

 

 

December 8, 2014
DSRIP
 

Good Morning RHP 10 Providers,

 

I have some important information to share with you this morning.

 

October Reporting and Review

  • HHSC will complete its October reporting review by today.  Providers will be able to login to the DSRIP Online Reporting System to view the HHSC Signoff and HHSC Comments for each metric.  HHSC will also send summary information to anchors and providers during the week of December 8 with the signoff status of each metric.
  • For metrics marked "Need More Information," providers will have until 11:59 p.m. on Friday, January 16, to submit additional information using the Online Reporting System.  HHSC will provide additional instructions with the summary information this week.
  • For metrics that were approved in the current round, or approved but unpaid in previous rounds, IGT will be due from IGT entities on Monday, January 5, and payments will occur on January 30. HHSC Rate Analysis will send out the IGT due based on our review the week of Dec. 15th using FMAP of 58.05.
  • As noted previously, language has been added to the Program Funding and Mechanics Protocol (PFM) to specify that HHSC and CMS may determine that a subset of not less than half of the projects and metrics will be reviewed during the 30 days after a reporting period.  In such instances, HHSC and CMS will designate those projects and metrics that are not reviewed within 30 days as “provisionally approved.”  Such “provisionally approved” projects and metrics will be reviewed in full by HHSC prior to the next reporting due date in April 2015.
  • For metrics that are “provisionally approved,” the HHSC Signoff will show "Approved," but the HHSC Comment will indicate that the approval was provisional.  The Performing Provider is eligible for full DSRIP payment for these metrics in January, and the IGT for these metrics will be included in the request for IGT that is due on January 5.  After review of any “provisionally approved” metrics, HHSC will request additional information if necessary, most likely in late February or early March 2015.  If the initial supporting documentation, and any additional information, does not form a sufficient basis for actual metric achievement, HHSC will recoup the associated overpayments from the Performing Provider.  As described in waiver rules, HHSC will withhold future payments until the recoupment occurs.
  • Some providers have asked about the "Achievement Value" shown under each metric in the Online Reporting System.  Please note that the achievement value shows 100% only after the HHSC signoff shows "Approved."  During previous reporting periods, the reporting templates showed an achievement value of 100% when the provider reported "Yes-Completed" for the metric.

 

 

Mid-point Assessment

  • The schedule for onsite visits and entrance conferences for the remaining regions has not changed significantly since our last update (see below for most recent schedule). Myers and Stauffer will be contacting regions to schedule these.
    • Week of December 8th: RHPs 4 and 5
    • Week of December 15th: RHPs 2
    • Week of January 5th: RHPs 3,7,9,10,12,14 and 15 (tentative)
    • Week of January 19th: RHP 6 (tentative- may be contacted earlier in January)

 

We wanted to thank all the providers who filled out the survey to help us complete the annual Anchor Report. A draft of that report should be sent to the region today for your review and feedback.

 

Please let us know if you have any questions.

 

December 2, 2014
UC
 

Good Morning Region 10 Providers,

 

Below you will find updated information from HHSC on the UC deferral.  Please let us know if you have any questions.

 

1115 Waiver Stakeholders -

 

As you know, IGT for a December UC payment is due to HHSC by this Friday, December 5th. HHSC has been working diligently with the Centers for Medicare and Medicaid Services (CMS) to get the deferral lifted, and on a phone call with CMS Central Office and Regional Office this morning we learned that CMS plans to lift the current UC deferral and work with HHSC and Texas stakeholders in the coming year to understand and resolve concerns CMS has regarding Texas’ financing arrangements for supplemental payments to private hospitals. HHSC expects to get a letter from CMS within the next 1-2 weeks with written confirmation that the deferral will be lifted to afford the State and CMS time to work to resolve CMS’ concerns.  Based on today’s call, HHSC’s understanding is that UC and DSRIP payments made during the upcoming year will not be subject to deferral or disallowance based on the financing concerns raised in the UC deferral letter.

 

 

December 1, 2014
DSRIP
 
Good Afternoon Region 10 Providers,

I hope that everyone had a Happy Thanksgiving. We have some important dates coming up so I wanted to send out a few reminders to you.

 
  • October reporting initial feedback is expected the week of December 8th.

  • The RHP 10 Anchor office is very excited about the opportunity to hear from each of you and gather your feedback as input into the initial draft of the DY3 Anchor Report.  It is our goal to provide HHSC a comprehensive report that provides an exceptional representation of all the good work that has transpired as a result of our region’s DSRIP initiatives over DY3, as well as provide important feedback for HHSC to consider as they work with CMS on the prospects of renewing the waiver beyond the initial five-year term. Please take a moment to reflect on your responses and complete the short survey (8 questions) in the link below:
      https://www.surveymonkey.com/s/RHP10AnchorSurvey.  We ask that you return your feedback no later than 5:00 pm on Thursday, December 4

 
  • In Region 10, we should expect our mid-point assessment entrance calls/on-site visits to begin the week of January 5th.  I know that several providers are in multiple regions so I have the tentative schedule below:
  • Mid-point Assessment:
    • Many regions have been already contacted by Myers and Stauffer LC and scheduled entrance conferences.
    • Some regions will be contacted in the near future. We understand that with upcoming holidays even preliminary schedule may be helpful for planning purposes, so we wanted to share a tentativeschedule for onsite visits (and most likely entrance conferences) for the remaining regions.
      • Week of December 1st: RHPs 1 and 18
      • Week of December 15th: RHPs 2, 4, and 5 (all tentative)
      • Week of January 5th: RHPs 3,7,9,10,12,14 and 15 (all tentative)
      • Week of January 19th: RHP 6 (tentativ
  • Plan Modification Reminders:
  • If HHSC requested that a provider submit additional information, the provider should enter this information into the “provider comments” section on the tracking sheet and send the tracking sheet to the RHP mailbox (rhp@jpshealth.org) no later than December 4th at 5PM.
  • If a provider has questions, please submit them to the HHSC waiver mailbox at TXHealthcareTransformation@hhsc.state.tx.us with the following subject line: “Change Request Question – RHP 10 Anchor – Project ID#” by December 3, 2014.
 
I know that several providers joined the Navigators call on the 13th of November. The coordinator of the call is asking that any interested providers use this survey link to enter information about your program so that we can create a master list of the programs going on around the state – this will be distributed to facilitate opportunity for future conversation and collaboration. http://survey.constantcontact.com/survey/a07ea4rnl2yi2hqw3td/start

 
November 26th, 2014
UC
 

Good Morning Region 10 Providers,

 

Please see the email below and attachments. HHSC Rate Analysis has revised the DY 3 Advance payments and IGT amounts for each provider.

 

This e-mail revises the e-mail sent to you on November 14, 2014, and pasted below. 

 

The only difference between the November 14, 2014, e-mail and this e-mail is the attachment (in the documents library) "DY3 Advance UC Payments (Revised 11 25).xlsx".  This attachment should be substituted for the "DY3 Advance UC Payments (Final 11 14).xlsx" file that was attached to the November 14, 2014, e-mail.

 

The revised attachment differs from the original attachment in three ways:

 

  1. It includes a small number of providers that were not included in the original attachment;
  2. It corrects the public/private categorization of a small number of hospitals; and
  3. It reduces the DY 3 Advance Payment Amount and DY 3 Advance IGT Amount for all providers.

 

IGTs to be submitted to TexNet by 12/4/14 must be based on the revised attachment, not the original attachment.

 

Values included in the original attachment were based on 50 percent of each provider's total DY 2 UC costs prior to any haircut.  Values included in the revised attachment are based on approximately 30.81 percent of each provider's total DY 2 UC costs prior to any haircut.  These revised values will limit the total DY 3 advance payment to 50 percent of the available DY 3 UC funds which will significantly reduce the likelihood of any recoupments due to violations of the various UC Pool caps when final DY 3 payments are calculated.

 

Final DY 3 UC payments are currently scheduled for April 2015; all remaining DY 3 UC funds will be allocated at the time that final DY 3 UC payments are determined.

 

We apologize for any disruption this revision may cause.

 


 Providers, Government Entities, and Anchors:

 

Please read this entire message carefully and make note of the information provided below that failure by IGT entities and providers to submit the required forms may result in a delayed payment for the providers. 

 

HHSC is providing notice to IGT for the DY3 Advance UC Payment.

 

Dates pertinent to this payment:

12/4/14                Last day to submit your IGT into TexNet

12/5/14                IGT Settlement date

12/15/14              Pay Transferring Hospitals

12/31/14              Pay all other UC Providers- Public entities will be paid as soon as possible after 12/15/14, with the private entities also being paid as soon as possible but no later than 12/31/14.

 

Attached to this email are the following documents:

 

  • the DY 3 Advance UC Payment spreadsheet;
  • the Master Affiliation as of 11_14_14 for Distribution spreadsheet;
  • Learning Collaborative Certification;
  • Category 4 Reporting Certification Form
  •  the DY3 Advance UC Allocation Form

 

Pursuant to §354.1633(e) a UC hospital must participate in an annual learning collaborative and report on a subset of Category 4 measures. The attached certification forms are required by all hospitals to be eligible for DY 3 UC Payments. Please complete the forms and email a signed pdf copy to uctools@hhsc.state.tx.us by December 4, 2014.

 

Government Entities that are IGT'ing for multiple providers may submit one lump sum IGT for everyone.  However, HHSC requires that if you are submitting IGT for multiple providers you must complete the attached DY3 Advance UC Allocation form. This will provide the HHSC Rate Analysis Department necessary information to allocate and apply the lump sum IGT to each provider. You can identify the affiliation number for the provider that you are IGT'ing for on the Master Affiliation as of 11_14_14 for Distribution spreadsheet.

 

Once you have entered your IGT into TexNet you will receive a receipt that HHSC refers to as the Trace Sheet. HHSC asks that ALL IGT'ing entities send their Trace Sheets and Allocation Forms to the UC Tools mailbox at uctools@hhsc.state.tx.us .  Please designate your funds into the appropriate bucket, UC Hospital (for hospitals) or UC Physician (for physicians).  If you have any questions or require any assistance, please send a message to the UC Tools mailbox.


 
November 25, 2014
UC
 

Good Morning UC-Only Providers,

 

HHSC has sent out some additional guidance on the Category 4 certification for the DY3 advance UC payment.

 

  • UC-only hospitals will need to certify by December 4th that they have met the learning collaborative requirement in order to receive the DY3 advance UC payment. 

 

  • Cat 4 certifications are not required by December 4th in order to receive the DY3 advance UC payments, because hospitals will not have received their data at that point.  The waiver team will sent the hospitals the data in December, and the hospitals will certify to RAD that they have received them. RAD will need that certification prior to making the final UC payments tentatively scheduled for May 2015.

 

Please let  me know if you have any questions.

 

 
November 24th, 2014
DSRIP
 

Good Morning RHP 10 Providers,

 

I have an update on the mid-point assessment to share with you and a few reminders.

 
1. In Region 10, we should expect our mid-point assessment entrance calls/on-site visits to begin the week of January 5th.  I know that several providers are in multiple regions so I have the tentative schedule below:

 

  • Mid-point Assessment:
    • Many regions have been already contacted by Myers and Stauffer LC and scheduled entrance conferences.
    • Some regions will be contacted in the near future. We understand that with upcoming holidays even preliminary schedule may be helpful for planning purposes, so we wanted to share a tentativeschedule for onsite visits (and most likely entrance conferences) for the remaining regions.
      • Week of December 1st: RHPs 1 and 18
      • Week of December 15th: RHPs 2, 4, and 5 (all tentative)
      • Week of January 5th: RHPs 3,7,9,10,12,14 and 15 (all tentative)
      • Week of January 19th: RHP 6 (tentative)

 

2.  Plan Modification Reminders:

  • If HHSC requested that a provider submit additional information, the provider should enter this information into the “provider comments” section on the tracking sheet and send the tracking sheet to the RHP mailbox (rhp@jsphealth.org) no later than December 4th at 5PM.
  • If a provider has questions, please submit them to the HHSC waiver mailbox at TXHealthcareTransformation@hhsc.state.tx.us with the following subject line: “Change Request Question – RHP 10 Anchor – Project ID#” by December 3, 2014.

 

 

3. A few other reminders:

  • The DSRIP Renewal Survey is available until November 26th.  HHSC has encouraged (but not required) providers to fill out the survey as a group if at all possible. Here is the link  http://goo.gl/forms/vDC0RuuY5e
  • The RHP 10 Anchor Office will be sending out a quick survey this week requesting your input for the Annual Anchor Report.

 

Please let me know if you have any questions.

 
November 24th, 2014
UC
 

Good Morning UC Only Providers,

 

HHSC has sent out some additional guidance on the Category 4 and Learning Collaborative Certifications. Please see the information below:

 

 

The Program Funding and Mechanics (PFM)  Protocol requirements for UC only hospitals are stated in paragraph 8 “DSRIP and Uncompensated Care Pool.”

 

  1. Hospitals that receive Uncompensated Care payments are required to report on a subset of DSRIP Category 4 measures. The subset includes:      Potentially Preventable Admissions (PPAs); Potentially Preventable Readmissions (PPRs); and Potentially Preventable Complications (PPCs). Category 4 reporting begins in DY 3 for PPAs and PPRs and in DY 4 for PPCs and continues through DY 5. (Please note that certain hospitals are exempt from Category 4 (refer to paragraph 11.f.). The link for the Waiver STCs including the PFM are at this link: http://www.hhsc.state.tx.us/1115-docs/DSRIP-Protocols.pdf.  

 

  • The Texas Medicaid External Quality Review Organization, the Institute for Child Health Policy (ICHP), is providing the data for hospitals to report. For DY 3, the data is for Calendar Year 2012. HHSC DSRIP staff is scheduled to send the reports to hospitals in early-mid December.

 

  1. UC hospital participants are also to participate in learning collaboratives conducted annually during DYs 3-5.

 

Program Funding and Mechanics Protocol, paragraph 8.b states:

 

UC hospital participants shall also participate in learning collaboratives conducted annually

during DYs 3-5 to share learning, experiences, and best practices acquired from the DSRIP

program across the State.

 

  • One way to fulfill this requirement would be to participate in a regional learning collaborative event, which the 10 largest Regional Healthcare Partnerships are required to hold.  Another way to fulfill this requirement would be to participate in the Statewide Learning Collaborative Summit, which took place in Austin on September 9-10, 2014.  You can view videos from the Summit on RHP 12’s website (http://texasrhp12.com/index.php/news/141-hhsc-summit-sept-9-10th) or RHP 10’s website (http://www.rhp10txwaiver.com/).

 

  • Regardless of which learning collaborative event(s) a UC-only hospital opts to attend, the hospital should keep documentation of who from the organization attended, when/where they attended, and what they learned from the event.

 

  • We are informing CMS on this approach and also letting them know that there were technical issues with viewing the webstreaming, and therefore, viewing the recordings may be the only option for some hospitals and that the recordings were not available via websites until Oct. 15. We’ll provide any additional updates if needed.

 

  • We have had questions for whether hospitals that are performing DSRIP projects and are also receiving UC payments are required to submit the certification for learning collaborative participation. Certifications for DY 3 are only required for UC-only hospitals, as we already have the Category 4 PPE data covered for DSRIP hospitals and we know DSRIP providers are actively participating in their RHPs as part of the DSRIP program.

 

Please let me know if you have any questions.

 

 

 

November 19th, 2014
DSRIP
 

Good Afternoon Region 10 Providers,

 

As was mentioned in the plan modification email sent out the is morning, HHSC has posted the updated workbooks on their website at http://www.hhsc.state.tx.us/1115-round-1-P-D.shtml. Please be sure to double check these workbooks for updates that were made to your projects from the approved plan modifications.  Please note that 3-year projects have a separate file from the RHP 10 file containing 4-year projects. Both of these files are in the documet library for your reference. Please remember that any changes that were made by HHSC will be highlighted in green.

 

Please let me know if you have any questions.

 
 
 
November 19th, 2014
UC
 

Good Afternoon UC Hospitals,

 

Many of you have asked about the Category 4 certification and the measures that were to be reported. I have heard from HHSC that UC only providers just need to send in the Category 4 certification and do not need to send the measures. I have put the email from HHSC below for your reference.

 

Please let me know if you have any questions.

 
 
November 19th, 2014
DSRIP
 
Good Morning Region 10 Providers,

 

HHSC has completed its initial review of RHP 10 change requests.  In the document library you will find RHP 10 Change Request Tracking Sheet with HHSC’s preliminary determinations and comments and  the project narratives that were revised by HHSC. Also in the document library Mallory created a summary file to simplify your review of the information into 3 tabs:

 

  1. The first tab summary information shows a summary for the entire region on what was approved, approved with HHSC changes, not approved, or needs more information.  
  2. The second tab shows the summary broken down by provider.
  3. The third tab is the data from the original HHSC file but made to be user friendly with filters and conditional formatting.

 

I encourage each of you to review the spreadsheets and take the following steps to meet HHSC required deadline:

 

  • If HHSC requested that a provider submit additional information the provider should enter this information into the “provider comments” section on the tracking sheet and send the tracking sheet to the RHP mailbox (rhp@jsphealth.org) no later than December 4th at 5PM. We are asking that each provider complete and send one sheet with all comments.

 

  • HHSC may have requested that a provider revise the project narrative to reflect a change request, or a provider may wish to revise a project narrative based on feedback received from HHSC.  The revised narrative will be due to the RHP mailbox (rhp@jsphealth.org) no later than December 4th at 5PM.

 

  • We strongly encourage providers that have  a change request that is “approved with HHSC changes” to provide feedback in the “provider comments” box with their understand of the changes made by HHSC.

 

  • If a provider has questions please submit them to the HHSC waiver mailbox at TXHealthcareTransformation@hhsc.state.tx.us with the following subject line: “Change Request Question – RHP 10 Anchor – Project ID#” by December 3, 2014.

 

Key Points:

 

  • Please note that any change request that is a substantial reduction in a project’s scope, including a change to a quantifiable patient impact (QPI) metric goal and/or baseline, could require additional review by Myers & Stauffer and possibly the Centers for Medicare and Medicaid Services (CMS).   If a change request requires additional review by Myers & Stauffer (and possibly CMS), HHSC noted this in the “HHSC Comments” column of the RHP’s Change Request Tracking Sheet. 

 

  • HHSC has posted the revised milestones/ metrics workbooks to the HHSC Transformation Waiver website (under Tools and Guidelines for Regional Healthcare Partnership Participants/Change Requests (Plan Modification and Technical Change Requests)).  HHSC’s revisions are highlighted in green. 

 

  • HHSC also revised the milestones/ metrics workbooks to make the following changes to all projects’ QPI metrics (regardless of whether the provider submitted a change request for the project):

 

  1. Remove the cumulative goal from the Baseline/Goal cell.
  2. Change the goal in the Numeric Goal cell from the cumulative goal to the annual goal. 

 

 

I have provided the original email from HHSC below for your reference.

 


Dear RHP 10 Anchor,

 

Thank you for your RHP’s change request submission.  The Texas Health and Human Services Commission (HHSC) has completed its initial review of your RHP’s change requests. 

 

Attached please find the RHP 10 Change Request Tracking Sheet with HHSC’s preliminary determinations and comments.  Also attached are the project narratives that were revised by HHSC.  

 

Please note that any change request that is a substantial reduction in a project’s scope, including a change to a quantifiable patient impact (QPI) metric goal and/or baseline, could require additional review by Myers & Stauffer and possibly the Centers for Medicare and Medicaid Services (CMS).   If a change request requires additional review by Myers & Stauffer (and possibly CMS), HHSC noted this in the “HHSC Comments” column of the RHP’s Change Request Tracking Sheet.  If a change request is marked as “Needs More Information,” HHSC will review the provider’s response and then determine if the change request requires additional review by Myers & Stauffer (and possibly CMS). 

 

HHSC revised the milestones/ metrics workbooks to reflect the change requests, as appropriate.  HHSC also revised the milestones/ metrics workbooks to make the following changes to all projects’ QPI metrics (regardless of whether the provider submitted a change request for the project):

 

  1. Remove the cumulative goal from the Baseline/Goal cell.
  2. Change the goal in the Numeric Goal cell from the cumulative goal to the annual goal. 

 

HHSC has posted the revised milestones/ metrics workbooks to the HHSC Transformation Waiver website (under Tools and Guidelines for Regional Healthcare Partnership Participants/Change Requests (Plan Modification and Technical Change Requests)).  HHSC’s revisions are highlighted in green. 

 

HHSC may have requested that a provider submit additional information for a change request.  For these change requests, the provider should submit the requested information to the RHP anchor in the format specified by the RHP anchor.  The RHP anchor should compile the additional requested information submitted by all providers in the RHP into the “Provider Comments” column of the RHP 10 Change Request Tracking Sheet and submit a single Change Request Tracking Sheet for the entire RHP to HHSC.

 

HHSC may have requested that a provider revise the project narrative to reflect a change request, or a provider may wish to revise a project narrative based on feedback received from HHSC.  In these cases, the provider should revise the project narrative as appropriate and submit it to the RHP anchor.  The RHP anchor should forward all the revised narratives submitted by providers in the RHP along with the RHP Change Request Tracking Sheet to HHSC. 

 

The RHP anchor should submit the RHP 10 Change Request Tracking Sheet with all of the additional requested information, as well as any revised project narratives, to the Transformation Waiver mailbox at TXHealthcareTransformation@hhsc.state.tx.us by December 9, 2014.   The following should be used as the subject line of the email: Change Requests – RHP 10 – Round 2 Submission.

 

If the RHP anchor or a provider has questions related to HHSC’s feedback, please send an email to the Transformation Waiver mailbox with the following subject line: “Change Request Question – RHP 10 Anchor – Project ID#” by December 3, 2014.

 

 

Please let us know if you have any questions.

 
 
November 17, 2014
DSRIP and UC
 

Good Afternoon RHP 10 Providers,

 

I have several very important pieces of information to share with you this afternoon and a few reminders!

 

Statewide Navigators Call

 

  • I know that several providers joined the Navigators call last Thursday. The coordinator of the call is asking that any interested providers use this survey link to enter information about your program so that we can create a master list of the programs going on around the state this will be distributed to facilitate opportunity for future conversation and collaboration. http://survey.constantcontact.com/survey/a07ea4rnl2yi2hqw3td/start
  • The notes from this call are also attached.

 

 

RHP 10 Financial Overview

 

  • Attached you will find a financial overview for October DY 3 Reporting for RHP 10. Please review this document for accuracy and let me know if any updates need to be made by Friday November 21st, at 5PM.
  • All of the DY 3 October reporting information came from the online reporting tool.

 

Reminders

  • The waiver renewal survey for HHSC is due by November 26th. HHSC has encouraged (but not required) providers to fill out the survey as a group if at all possible. Here is the link http://goo.gl/forms/vDC0RuuY5e.
  • The Anchor Survey for DY 2 Unspent Funds is due to the RHP mailbox rhp@jpshealth.org by 5PM TODAY.

 

UC Providers and Hospitals

  • HHSC Rate Analysis provided the below information on the DY3 Advance UC Payment/IGT Notification.

 

Please read this entire message carefully and make note of the information provided below that failure by IGT entities and providers to submit the required forms may result in a delayed payment for the providers. 

 

HHSC is providing notice to IGT for the DY3 Advance UC Payment.

 

Dates pertinent to this payment:

12/4/14                Last day to submit your IGT into TexNet

12/5/14                IGT Settlement date

12/15/14              Pay Transferring Hospitals

12/31/14              Pay all other UC Providers- Public entities will be paid as soon as possible after 12/15/14, with the private entities also being paid as soon as possible but no later than 12/31/14.

 

In the document library are the following documents:

 

  • the DY 3 Advance UC Payment spreadsheet;
  • the Master Affiliation as of 11_14_14 for Distribution spreadsheet;
  • Learning Collaborative Certification;
  • Category 4 Reporting Certification Form
  •  the DY3 Advance UC Allocation Form

 

Pursuant to §354.1633(e) a UC hospital must participate in an annual learning collaborative and report on a subset of Category 4 measures. The attached certification forms are required by all hospitals to be eligible for DY 3 UC Payments. Please complete the forms and email a signed pdf copy to uctools@hhsc.state.tx.us by December 4, 2014. Please cc the RHP 10 box (rhp@jpshealth.org) on this email also.

 

Government Entities that are IGT'ing for multiple providers may submit one lump sum IGT for everyone.  However, HHSC requires that if you are submitting IGT for multiple providers you must complete the attached DY3 Advance UC Allocation form. This will provide the HHSC Rate Analysis Department necessary information to allocate and apply the lump sum IGT to each provider. You can identify the affiliation number for the provider that you are IGT'ing for on the Master Affiliation as of 11_14_14 for Distribution spreadsheet.

 

Once you have entered your IGT into TexNet you will receive a receipt that HHSC refers to as the Trace Sheet. HHSC asks that ALL IGT'ing entities send their Trace Sheets and Allocation Forms to the UC Tools mailbox at uctools@hhsc.state.tx.us .  Please designate your funds into the appropriate bucket, UC Hospital (for hospitals) or UC Physician (for physicians).  If you have any questions or require any assistance, please send a message to the UC Tools mailbox.


Please let me know if you have any questions.



November 10, 2014
DSRIP
 

Good Morning RHP 10 Providers,

 

I have lots of great information to share with you today!  I have highlighted a few points below from the Anchor call notes.

 

 

Plan Modifications

  • HHSC estimates that feedback on plan modifications will be coming out the week of November 17th.
  • Responses to the feedback from HHSC will be requested the week of December 8th.

 

October Reporting and Review

  • If any providers have feedback for HHSC on the online reporting system please send it to the rhp@jpshealth.org by Thursday November 13th.
  • IGT entities have until November 14th to approve and comment on their affiliated providers’ October reporting progress on metrics using the “IGT info” tab for each project in the online reporting system.  Instructions are included in the “user Guide for the DSRIP Online Reporting System,” pages 19-20.
  • If there are no issues, comments do not need to be submitted and HHSC will assume the IGT Entity has approved the reported information.
  • HHSC Has 30 days (December 5) to review the information submitted by providers.
  • During the HHSC review process, users who login to the DSRIP online reporting system will be able to see HHSC’s preliminary comments and signoff of “approved” or “needs more information.” We want to caution that the review process may include multiple levels of review, and that comments and signoff are not final until the review period closes on December 5.
  • Also, due to the volume of projects and metrics, and the requirement to review reports within 30 days to ensure that payments can be made in January, HHSC and CMS have agreed to a new approach for managing the volume of reports.
  • Language has been added to the Program Funding and Mechanics Protocol (PFM) to specify that HHSC and CMS may determine that a subset of not less than half of the projects and metrics will be reviewed during the 30 days after the reporting period. In such instances, HHSC and CMS will designate those projects and metrics that are not reviewed within 30 days as “provisionally approved.” Such “provisionally approved” projects and metrics will be reviewed in full by HHSC prior to the next reporting due date in April 2015.
  • For metrics that are “provisionally approved,” the Performing Provider will receive full DSRIP payment in January 2015. After review of any “provisionally approved” item, additional information regarding the data reported for each milestone/metric will be requested if necessary, most likely in late February or early March 2015. If the initial supporting documentation, and any additional information, does not form a sufficient basis for actual metric achievement, HHSC will recoup the associated overpayments from the Performing Provider. As described in waiver rules, HHSC will withhold future payments until the recoupment occurs.

 

Mid-Point Assessment

  • Communication regarding mid-point assessment is coming from a new mailbox: TXHealthcareTransformationDSRIP_Compliance@hhsc.state.tx.us.
  • Myers and Staffer LC (MSLC) is reviewing projects based on the reported information and is finalizing the request for additional information for the following RHPs: 8, 11, 13, 16, 17,18, 19, 20.
  •  MSLC will also be contacting anchors and providers regarding site visits. Tentative dates are available for the following regions:
    • RHP 13- site visit week of November 17-November 20
    • RHP 16- site visit week of November 17-November 20
    • RHP 19 - site visit for the week of Nov 17
    • RHP 18 - site visit for the week of Dec 1
    • RHP 8 - site visit week of December 1-December 5

DY 2 Unspent Funds

  • CMS has indicated that the waiver amendment would not be considered while the UC Deferral is under review.
  • We are asking RHP 10 Providers to still respond to the  with the survey but November 17th at 5PM, so that HHSC will have the information on next steps should we be able to move forward.

 

Waiver Renewal

  • HHSC sent out the DSRIP Waiver renewal survey to our stakeholder lists on Monday, November 3rd. Stakeholders include anchors, performing providers, EWC members, IGT entities, UC-only hospitals, and general stakeholders who have ever requested information on the 1115 waiver.
  • It is fine for multiple people within an organization to complete surveys, or for an organization to submit a more coordinated response (preferred, but not required).
  • The survey will close November 26, 2014.
  • An initial step with communication to CMS on waiver renewal is through the STC 48, which is a pool (both UC and DSRIP) transition plan due March 31, 2015. HHSC presented a draft outline to the EWC and this outline is attached. HHSC has requested feedback on the outline from EWC members, and other entities may also provide input to the waiver mailbox.

 

RHP 7  Navigation Coordinators Call
  • Dayna Fondell of the Community Care Collaborative in RHP 7 is hosting a statewide call for navigation project coordinators to compare notes on best practices.
  • The purpose of this call is to start a broader discussion about what we are learning as a state about Navigation best practice, as well as facilitating a space for Navigation Program coordinators to meet each other to create an opportunity for more off-line coordination and conversations.
  • The phone call will be held November 13th, from 3:30PM – 4:30PM.
  • If you are interested in attending please let me know and I will email you the call in information.

 

 

 

 
November 4, 2014
All Providers and Stakeholders
 

Good morning, RHP 10 stakeholders,

 

HHSC has created an 1115 Waiver survey to gather stakeholder feedback about Waiver renewal or extension.  The survey HHSC has created is specific to DSRIP; however, all interested stakeholders are able to complete the survey. HHSC is requesting stakeholders to complete the survey by Wednesday, November 26th. This survey is optional and you are not required to compete the survey.  The survey is available at this link: http://goo.gl/forms/vDC0RuuY5e.

 

Below are a few questions the survey asks – the questions will alter based on the role(s) you select, so you may not see all questions listed below. These questions have been included to help you consider your responses before starting the survey. When you are on the last question, be sure to click the blue, Submit button to complete the survey.

 

I would like to extend a huge thank you to Region 8, Jennifer LoGalbo for kindly sharing her summary of the intent of the survey!

 

Example questions from the survey:

  • Do you currently participate in the Waiver? If yes, which region?
  • Indicate your role(s): Anchor, DSRIP, hospital, UC-only, IGT, health department, etc. (you are able to select more than one)

o   If you select hospital, you will be asked to identify which type you identify with: non-profit, children’s, rural, private, etc. (you are able to select more than one)

  • If you are a DSRIP Provider, how many Cat 1/2 projects are you implementing?
  • In how many RHPs do you participate?
  • If IGT, what do you support: UC, DSRIP, both
  • After this five year waiver period ends, would you support continuing the projects that are active at that time to improve healthcare delivery in Texas? (yes/no)

o   If yes, explain…

  • Would you recommend any changes to the DSRIP program after September 30, 2016?
  • What structural changes would you recommend for the program?

o   Regional Healthcare Partnership boundaries

o   Regional Healthcare Partnership governance

o   Role of the anchor

o   Requirements to get stakeholder input and hold public meetings

§  Describe any structural changes you would recommend for the program.

  • What administrative changes would you recommend for the program?

o   Reporting process and requirements (web-based reporting system, Excel spreadsheets)

o   Mid-point assessment and compliance monitoring

o   Dissemination of information (state and regional communication)

     Describe any administrative changes you would recommend for the program.

  • What changes would you recommend for the DSRIP menu or related to demonstrating program achievements?

o   Changes to Category 1 projects

o   Changes to Category 2 projects

o   Changes to Category 3 outcomes

o   Changes to Category 4 reporting

o   Minimum requirements for each individual project

§  Describe any changes you would recommend for the DSRIP menu or related to demonstrating program achievements.

  • Do you have recommendations on how to further align DSRIP with Medicaid managed care?

Considerations: Does your health system have a Medicaid Managed Care Organization (MCO) affiliated with it? Do MCOs in your service delivery area and DSRIP performing providers deploy the same or similar patient models of care? Are you aware of any collaborations between MCOs and DSRIP performing providers in your service delivery area? What data currently exist for MCOs and providers that could be used to better coordinate care? (yes/no)

o   If yes, explain…

  • Do you have recommendations on how best to evaluate DSRIP successes and challenges in order to sustain and replicate the most promising DSRIP projects, including methods of sharing best practices? (yes/no)

o   If yes, explain…

  • Do you have recommendations on ways to include more consumer and patient involvement? (yes/no)

o   If yes, explain…

  • What financing changes would you recommend for the program?

o     Regional DSRIP funding allocation in the Program Funding and Mechanics (PFM) Protocol

o     Provider-specific DSRIP funding allocations established in the PFM protocol (how each provider's Pass 1 allocation was determined)

o     Project valuation methodology and valuation limits

o     Anchor administrative cost reimbursement

§  Describe any financing changes you would recommend for the program.

  • Describe any changes you would recommend regarding DSRIP requirements for large vs. small providers.
  • Describe any changes you would recommend regarding DSRIP requirements for urban vs. rural providers.
  • What collaborations, if any, have you engaged in as a result of the waiver?

o     New collaborations with other DSRIP providers

o     New collaborations with non-DSRIP providers (community partners)

o     Pre-waiver existing collaborations that were expanded as a result of the waiver

  • If you have engaged in new collaborations with other DSRIP providers as a result of the waiver, were any of these collaborations initially proposed as a collaborative DSRIP project in which your DSRIP allocations were going to be combined?

o     Yes

o     No

o     Have not engaged in new collaborations with other DSRIP providers as a result of the waiver

§  If so, please describe how the project and/or collaborative effort was impacted by not being able to combine the allocations.

  •  Would you support a requirement that each RHP have at least one collaborative project? (yes/no)
  • Would you support funding for multi-site, multi-RHP projects around common issues or initiatives? (yes/no)
  • Should new DSRIP projects be included (possibly under a more limited project menu)? (yes/no)
  • If you are a performing provider that withdrew a project or are considering withdrawing a project, please explain the barriers you faced in implementing the project and what changes to the program might have allowed you to continue the project.
  • Would you support an incentive bonus pool on the RHP level for projects with particularly strong achievement? On the state level? (yes/no)

o   If so, what type of measures would you recommend for demonstrating regional or statewide achievement?

  • Will your project be sustainable after the five year waiver ends without continued DSRIP funding? (yes/no)

o   Please explain.

  • If you are a current DSRIP provider, will you participate in DSRIP again? (yes/no/Not a current DSRIP provider)

o   Why/why not?

  • If you are not a current provider, are you interested in participating in DSRIP if the waiver is renewed? (yes/no)

o   Why/why not?

  • If you currently participate in UC only, why did you not participate in DSRIP?
  • Do you have any other comments or recommendations regarding the DSRIP program that you would like HHSC to consider as it develops the renewal request? (yes/no)

o   If yes, please explain.

 
 
 
October 29, 2014
DSRIP Providers
 

Good morning, Region 10 Providers,

 

HHSC has communicated a potential opportunity for use of $352 million in unspent DSRIP funds from DY2 and plans to submit a waiver amendment to propose the following framework:

 

  • DSRIP projects that appear to be on track may add certain defined metrics in the 5th year of the waiver to enable them to earn additional DSRIP funds to: 1) serve additional Medicaid/low-income uninsured (MLIU) individuals than planned in the 5th year of the waiver, demonstrated by adding a MLIU specific QPI metric in DY5 if there isn't already one or increasing the existing MLIU metric; 2) increase data exchange to support the project; and/or 3) evaluate the success of the project. For options #2 and #3, a provider could choose from a subset of the stretch activities already approved for Category 3 (3, 5, 6, 7 and 8 at http://www.hhsc.state.tx.us/1115-docs/CAT3/Cat3ProposedStretchActivities_01082014.pdf), as long as the selection is not already a part of your Category 3 metrics.
  •  Depending on how many projects are interested in doing one or more of these additional metrics (and have an IGT source), HHSC will adjust those projects’ valuation upward for DY5 to enable Texas providers to earn the unused DY2 DSRIP funds.

 HHSC is still awaiting feedback from CMS on this concept, but plan to move forward with the public notice process (to be published in the Texas Register October 31, 2014) and amendment submission.  We want to go ahead and get information on which projects are interested in adding one or more of the above additional activities in DY 5 and have IGT to support additional project funding.  HHSC is collecting this information to help understand how many projects are interested with available IGT in order to help develop an allocation method for the remaining funds, and to be ready to move as quickly as possible to amend project metrics for DY5 once the amendment is approved.   We are requesting information within the following parameters:

 

  • Project areas are eligible with the exceptions of areas 2.4; 2.5, 2.8 and 1.10 – these are the project areas that were either removed from the 3-year project menu or limited in the 3-year menu and are not included in the attached spreadsheet.
  • We will await the results of the Mid-Point assessment before determining any projects not considered on track.  These projects will not be eligible to earn additional funds.
  • IGT may not be diverted from existing commitments to fund the additional metrics in DY 5.

 

Within the above framework, HHSC may prioritize the additional funding for projects related to primary/preventive care, behavioral healthcare, and chronic care management, and particularly projects in those areas being done by DSRIP providers who also receive General Revenue Funds through the Department of State Health Services either for behavioral healthcare or Primary Health Care.  The State would like to build on these GR investments as much as possible to serve additional low-income individuals and improve care in the areas of primary and preventive care, behavioral healthcare, and chronic care management.  There are 58 DSRIP providers (designated with an * next to the provider’s name) in the attached file that also receive BH or Primary Health Care funds through DSHS.  HHSC encourages these providers, for their projects related to primary/preventive care, BH care, and chronic care management, to carefully review whether they have additional funds that could be used as DSRIP IGT to serve more of the waiver’s target population and strengthen their projects.

 

We are attaching the RHP 10 – DY2 Anchor Survey spreadsheet that includes the RHP, Provider, Project ID, a column for each of the 3 activities above, and a column for IGT source. In the activities columns, the provider should indicate “yes” or “no” for interest in adding a metric related to 1) serving more MLIU individuals; 2) data exchange; and/or 3) project evaluation.  You may check “yes” for one or more of these metrics for each project.  In the IGT column, the provider should indicate as “yes” or “no” whether they have a confirmed IGT source that would commit to put up the non-federal share for additional project valuation for one or more of these DY5 metrics.   At this time, providers that do not have self IGT capabilities may not be able to complete this column. 

 

This is an initial request, and we will follow up to request additional details once we’ve received feedback from CMS on the amendment request and more of the details of the funding allocation are known.  The information being submitted at this stage is not binding, so if a provider opts in or out at this point, they will have another opportunity to change their response once more is known about how these funds may be earned.  HHSC is trying to get a sense of how many DSRIP projects likely would seek to add on to their projects in DY5 to have the ability to earn additional funds and also which projects have IGT available to do so.  HHSC will work at a later date to confirm IGT commitments with IGT entities.  

 

We are requesting that providers return this information to rhp@jpshealth.org  no later than November 17, 2014, at 5:00 pm.

 

The RPH10 Anchor office will host a webinar on November 6, at 2:00pm – 3:00pm to share current information available and address any questions that you may have at that time. 


 

October 28, 2014
DSRIP Providers
 

Good Morning RHP 10 Providers,

 

Anchors had our formal Anchor call with HHSC last Friday afternoon. As always, more details are included in the anchor call notes section but some highlights are as follows:

 

October DY 3 Reporting

  • Given the complexity and volume of the October reporting, we want to remind you to NOT report achievement unless you're confident you've achieved a metric by September 30, 2014.

 

Category 3

 

Baseline Exemption Forms
  • Many providers have reached out for technical assistance with baselines for those projects with less than 6 months' worth of baseline data by the end of DY3. In the reporting companion document, HHSC described a baseline policy exemption form that providers could submit with their baseline templates. In the last several weeks HHSC received a high volume of providers requesting this TA and have prioritized these discussions and are determining appropriate resolutions for these requests. We encourage providers not to delay reporting while waiting for exemption forms. HHSC does have a record of these conversations and will refer to them during the reporting review, so providers should stay on track with reporting deadlines. HHSC is still continuing to work through the list of providers who have requested TA. In the attached notes HHSC has given specific guidance on shorter measurement periods, proxy populations and carry-forward baseline measurement periods. These sections include lots of information and are too long to include in and email. We encourage you to please read this information especially if you have a shorter measurement period, proxy population or carry-forward baseline.

 

 

Baseline Templates

  • Since providers from the following RHPs had delays in receiving their Category 3 baseline templates, HHSC is providing the following extension dates only for the submission of the Category 3 baseline templates.  This will occur outside of the online reporting system.
  • RHPs 9 & 10:  Due Nov. 7
  • RHPs 12, 14, 15, 17 & 18:  Due Nov. 12
  • RHPs 16, 18, 19 & 20:  Due Nov. 13
  • For the regions receiving extensions for their Category 3 baseline templates, the online reporting system will not allow uploads after 11:59 p.m. on Nov. 5.  Therefore, if you submit your Category 3 baseline template after Nov. 5 (but no later than the extended deadlines above), please submit the template by email to DSRIP@deloitte.com or by mail to Tim Egan, 50 South 6th Street, Suite 2800, Minneapolis, MN 55402 by 11:59 p.m. on the applicable date above.
  • Category 3 baseline templates for all other RHPs will be due through the online reporting system by Nov. 5th, along with all other DSRIP reporting for all 20 regions.

 

QPI Templates Larger than 30MB

  • For DSRIP projects with DY3 Quantifiable Patient Impact (QPI) metrics (metrics marked "Yes" for QPI), the QPI Template must be completed for each project as a requirement of semi-annual reporting (SAR), regardless of whether the QPI metric is being reported for payment, was reported in April, or is being requested for carryforward.
  • Because files larger than 30 megabytes (MB) cannot be uploaded onto the online reporting system at this time, HHSC recommends that large files such as the QPI template be zipped before uploading.  Instructions for how to zip a file using Microsoft Windows are available on Page 16 of the User Guide for the DSRIP Online Reporting System that is available on the Tools and Guidelines page of the Medicaid Transformation Waiver website:  http://www.hhsc.state.tx.us/1115-Waiver-Guideline.shtml. For those providers who are not using Microsoft Windows, there are free programs (e.g. WinZip) which can be downloaded in order to zip your files. Please check with your IT department to see what is available to you.
  • HHSC has heard that in rare cases the completed QPI template may be larger than 30 MB, even when zipped.
  • If your completed QPI template is larger than 30 MB, even when zipped, please submit the QPI template only by email to  DSRIP@deloitte.com or by mail to Tim Egan, 50 South 6th Street, Suite 2800, Minneapolis, MN 55402 by Nov. 5, 2014, 11:59pm.
  • Documentation other than large QPI templates should still be uploaded to the online reporting system.

 

 

Plan Modifications and Technical Change Requests

 

  • We estimate we will provide comments/preliminary determinations to the anchors in early to mid-November. Providers will be asked to respond to HHSC comments on change requests in late November to early December. We understand that providers would like information as soon as possible and so we are prioritizing the plan modifications over the technical changes.

 

DSRIP Mid-Point Assessment

  • Myers and Stauffer is conducting a detailed desk review of the projects in the first regions and will be contacting selected providers about site visits. Prior to on-site visits, Myers and Stauffer will  give each region an option to meet for an entrance conference to provide an overview of the reviews on site, explain what supporting documentation may be required, and to answer questions related to site reviews. The entrance conference may be conducted at the anchor site and have teleconference capabilities for providers who cannot join in person.
  • We are requesting that you please send your letters to rhp@jpshealth.org  so that we can best assist you through the mid-point assessment process.
 
 
 
 
 
 
October 20, 2014
DSRIP Providers
 

Good Afternoon RHP 10 Providers,

 

We have a few updates for you from HHSC on October reporting  and the mid-point assessment. I have included the email from HHSC below and a few high highlights.

 

 

October DY3 Reporting

  • DSRIP Online Reporting System
    • Because the online reporting system is successfully allowing providers to report progress and upload supporting attachments, the system will continue to be the official reporting tool for the October DY3 reporting period.
    • Previously, providers discovered that the upload button was not active for QPI metrics that were reported and approved during the April reporting period.  The upload button for these QPI metrics is now active, so providers may now upload the required QPI template for previously approved QPI metrics.  HHSC will send notification to providers that this issue has been resolved.
    • All of the regional Category 3 Baseline Templates have been sent to anchors to be distributed to providers, and are posted on the waiver website (Category 3 Baseline Reporting Templates).
    • The recorded webinar on QPI Reporting has been posted, and the webinars on Cat 3 Baselines and General Reporting Guidance should be posted on the waiver website today on the Recorded Webinars/Conference Callspage. 
    • A revised October DY3 Reporting Companion should be posted on the website today and is attached to this email.  The changes have been highlighted, and are minor (clarifies that IGT changes are still due on October 31st, and adds the updated and previously communicated guidance on Category 4 RD-4).
    • A revised QPI Reporting Companion Document was posted to the Waiver website on 10/16 and is attached.  Updates to the document are highlighted in yellow and include a section on troubleshooting QPI Template issues. We ask that if you are having trouble with the QPI template to read the revised companion document prior to emailing the Waiver mailbox.
    • HHSC is receiving a high volume of questions regarding October DY3 reporting. In order to allow HHSC staff members to respond in the most efficient manner possible,  we are asking the following of anchors and providers:
      • Please include the RHP number, as well as the project ID, in the subject line when sending questions specific to a project to the Waiver mailbox.
      • If asking about a metric, please include the metric ID.
      • When submitting questions regarding technical issues with the online reporting system or an HHSC template, please include a screenshot when possible, as this helps team members better identify and understand the issue.  Also provide as much information as possible about the issue (e.g., the cell number if the issue is with a particular cell not working properly in a template, the version of Excel you are running if you receive an error message when using a template, etc.).
      • Just one quick remind that October 24th is the last day to send in questions to HHSC about October reporting.

 

 

Mid-point Assessment

  • Communication regarding mid-point assessment is coming from a new mailbox: TXHealthcareTransformationDSRIP_Compliance@hhsc.state.tx.us.
  • HHSC has sent out emails with letters for the mid-point assessment review to providers in RHPs 1, 2, 4, 8, 13, 16, 18, 19, 20. Letters to other regions to follow soon.  We expect that the RHP 10 letters will be coming out soon, we ask that when you receive a letter please share it with the Anchor office. This will help us to best assist you through the mid-point assessment process.
  • HHSC notified anchors about projects selected in their regions for the Mid-Point Assessment review prior to the Summit.  At this time we are not copying anchors on the letters, since providers are receiving information specific to their project (the reason why the project was selected). It is up to providers to share this information with anchors.
  • We are sending out the summary to each anchor informing them about what was sent to providers. RHPs 1, 2, 4, 8, 13, 16, 18, 19 and 20 should have received this summary today.
  • Myers and Stauffer is conducting a detailed desk review of the projects in the first regions and will be contacting selected providers about site visits. Prior to on-site visits, Myers and Stauffer will give each region an option to meet for an entrance conference to provide an overview of the reviews on site, explain what supporting documentation may be required, and to answer questions related to site reviews. The entrance conference may be conducted at the anchor site and have teleconference capabilities for providers who cannot join in person.

 

Other information

  • Thanks to RHP 12 for hosting the link to videos from the Statewide Learning Collaborative Summit (HHSC Summit Videos from Sept. 9-10th LC Event)!  We have also linked to it on our website.  If any other Anchors are interested in having these videos on their website, we would be happy to send you the link to access them.
  • Attached is an updated Active DSRIP Projects list that includes Cat 3 selections and valuations and a tab for Cat 4 values. The Cat 1-4 values are broken out by DY. Please note that this spreadsheet does not reflect changes from the most recent round of Plan Modifications.  As this list reflects, there are a total of 1489 active projects (1273 4-year and 216 3-year). We will post this on the website soon.

 

 

Please let us know if you have any questions

 
 
October 13, 2014
UC Providers
 

Good afternoon RHP 10 Providers – HHSC Rate Analysis released an email today regarding UC tools and confirmation of UC Tool submissions.  As instructed below, please confirm with individuals in your organizations who submitted UC tools that HHSC did in fact receive your submissions and they were within an allowable file size to be emailed. 

 

Please let us know if you have any questions!

 

Mallory

 

Providers,

 

As of this morning, we have replied to all Tool submission emails with an acknowledgement of receipt. The acknowledgement would have gone to the person that sent the email and would have been sent from the UC Tools Mailbox.

 

There have been several instances of providers submitting emails that we did not receive because the email attachments exceeded HHSC's 10mb size limit.  Providers might not have received a notification in these instances. If you have not received an acknowledgement of receipt, please assume that HHSC did not receive the submission and resubmit it in emails that are under 10mb in size, or send an email to the UC Tools mailbox so that we can explore different methods of submitting your tool. Please ensure that the confirmation email was not received before resubmitting to avoid duplicate submissions.

 

 

 

October 10, 2014
 

Good Afternoon RHP 10 Providers

 

This email contains vital information pertaining to DY3 October reporting – please read ALL notes accordingly.

 

The Zip folder contains the following documents:
  • October 10 Anchor Call  Notes
  • DY2-DY3 Historical Reporting Project Payment Summary
  • REVISED October DY3 Companion Document
  • Potential Questions for Waiver Renewal Survey
  • Statewide Learning Collaborative Participating Reporting Template this document needs to be utilized if you are using attending the SLC as part of your metric achievement documentation for learning collaboratives!

 

October Reporting

  • An updated companion document has been attached and will be posted on websites early next week.  All changes from the original document are highlighted in yellow
  • All final templates have been released from  HHSC as of Friday October 10
  • HHSC will allow providers to report through midnight on Wednesday, November 5th instead of the original October 31 deadline. HHSC cannot push the deadline back further without putting at risk the January payment schedule. We hope this additional time helps your providers
  • QPI Template: HHSC has revised the QPI Reporting Template instructions regarding the pasting of patient names into the Patient ID field. The scrambling methodologies may not, however, be sufficient to adequately de-identify certain patient names. As such, HHSC is asking providers not to paste names in the template and instead assign more generic values to individuals (e.g., Patient 1, Patient 2, etc.) or assign a de-identifiable patient ID prior to pasting this information into the QPI Template. Please see the revised QPI Reporting Companion Document for additional details.
  • Do not report achievement unless you can clearly document achievement by 9/30/2014
  • There are 3 issues noted in the attached Anchor Call notes for the online reporting system.  Please review.
  • HHSC is re-seeding DY2 carry forward information in the online tool over the weekend.  Please note ANY projects that have DY2 carry forward metrics – all information will be re-written for all DY2 and DY3 reporting FOR THESE PROJECTS ONLY.  HHSC encourages providers not to work on projects THAT HAVE DY2 CARRY FORWARD until the reseeding occurs.  All other projects that don’t have DY2 carry forward metrics should be fine during the repopulation of data.

 

Category 3:

  • Revisions to the Compendium documents have been completed and they have been posted on the waiver website: http://www.hhsc.state.tx.us/1115-Compendium.shtml. In addition to the individual measure documents, HHSC has posted a table describing the summary of changes between the draft version and these final versions as well as an updated Master Outcome Summary file (Excel list of measures).
  • We were notified in the last week about some additional providers who have baseline concerns (less than 6 months by the end of DY3). We will be working next week to reach out to these providers. In addition, we will be populating the Baseline Exemption forms and sending them to providers that we have provided TA. If the Exemption forms are received in time to include with October reporting, please do so; otherwise HHSC will provide as soon as possible to use as a basis for DY 4 & 5 Category 3 reporting.
  • Notes address template issues with P4R measures with a population focused priority (PFP) measure – see if applicable to you.

 

Category 4: RD-4 Medication Management

  • CMS has agreed to the following for several hospitals that have indicated their medication reconciliation process differs from NQF-0646. We will update the October DY3 Reporting Companion with this information:
    • Instructions to hospitals regarding reporting on Medication Reconciliation for RD-4
      • Several hospitals have communicated that they have a comprehensive medication reconciliation process, but it deviates from the NQF 0646 measure because they do not provide patients a list of “do not take” medications on discharge. In these limited cases only, providers may report their medication reconciliation for RD-4 as follows:
      • In the quantitative field, put a zero (“0”) because the provider’s medication reconciliation process differs from NQF 0646.
      • In the qualitative field, include 1) the quantitative measurement relevant to your medication reconciliation process and also include information to describe 2) what the quantitative measurement represents; 3) that you have a comprehensive reconciliation process; 4) why you have opted to use this process; and 5) what information you have to show that the process is effective.
      • Providers that deviate from NQF 0646 will be subject to compliance monitoring for this measure.

 

Plan Modifications Timeline

  • We estimate we will provide comments/preliminary determinations to the anchors in late October/early November. Providers will be asked to respond to HHSC comments on change requests in mid-November. We understand that providers would like information as soon as possible and so we are prioritizing the plan modifications over the technical changes.

DY2 CMS Financial Review and Mid-Point Assessment

  • Updates can be found on page 4 of the Anchor notes for both of these items

 

If you continue to have any questions or concerns around reporting please let us know. Have a great weekend!




October 2, 2014
 

Good Afternoon Region 10 Providers,

 

I hope that everyone attended the Category 3 baseline webinar this afternoon. I wanted to share all of the documents that HHSC showed you this afternoon and the link that you saw HHSC go to is here.

 

 

  1. Cat. 3 DY 2 Status Reporting Template- use this template if you had carried forward milestones.
  2. Cat. 3 DY 3 Status Reporting Template- Use this template to report a status update on Cat. 3 measures
  3. Cat. 3 Pre/Post Guidance –For OD-10 and OD-11 guidance.
  4. Cat. 3 Risk Adjustment Guidance- Guidance on risk adjusting Category 3 rates.
  5. Cat. 3 Deviation from Standard Achievement Methodology Request Form- In order to request this deviation, providers must include a compelling case for why the achievement levels for DY4 and DY5 established per HHSC policy are not an appropriate fit for this Category 3 project. 
  6. Cat. 3 Tool Administration Template- For OD’s 6,10 & 11

 

Please let us know if you have any questions.



October 2, 2014
 

Good Morning Region 10 Providers,

 

I hope that you all attended the QPI webinar yesterday, HHSC gave a lot of great information on reporting QPI and the logistics of the template. I have several documents to share with you this morning and the link to all of these documents is here.

 

  1. The October DY 3 Companion Document. This document is full of lots of information on reporting and I ask that each of you read it.
  2. The Reporting coversheet. Each Category 1 and 2 project will be required to submit a coversheet. The coversheet includes boxes for up to 9 metrics. If there are more than 9 metrics for a project a second coversheet will be required.
  3. The QPI Reporting Companion Document. This includes the information from yesterday’s webinar and step-by-step instructions for the QPI reporting template.
  4. Category 4 Reporting template. This document may not be required for all hospitals just those who are reporting on Category 4 measures.
  5. The User Guide for online reporting. There will be a webinar on  October 6th to review the material in this document.

 

Please be sure to attend this afternoons webinar on Category 3 baseline reporting. We will be sending out all of the documents for Category 3 as soon as they are available. The information for the webinar is below:

 

Thursday, October 2 from 2 to 3:30 p.m.: Category 3 baselines

 

To join the online meeting:

1) Go to Join WebEx meeting

2) Click on Attend Meeting

3) Enter Meeting Number: 280 429 402 (no password necessary)

4) Call 800-396-3172

To join the audio conference only: All participants should dial 800-396-3172 (no password necessary). You will be placed directly into the audio conference.

 
 
 
 
 
 
 
 
 
 
 
 
October 1, 2014
 

Good MorningDSRIP Providers,

 

By now you should have received a message titled "Welcome to DSRIP" with your initial login information for the DSRIP Online Reporting System from our new "Do Not Reply" email address.  The e-mail is legitimate and future emails concerning the DSRIP Online Reporting System will use this address. The link to the DSRIP Online Reporting System is https://dsrip.hhsc.texas.gov/dsrip/login.

 

Please note that recent contact changes were not included in the initial email send out and HHSC will be adding them to the system over the next few days. If you need to add new contacts, please complete a RHP Contact Change Form (http://www.hhsc.state.tx.us/1115-docs/RHP/Plans/Contact-Change.pdf) and submit it to the waiver mailbox. These new contacts should then expect to receive login information.

 

The webinar scheduled for October 6, 10:30-12:00, will provide an overview of the new system.  In the meantime, HHSC will  be posting a User Guide on the waiver website either today or tomorrow.  Questions may be directed to the waiver mailbox at TXHealthcareTransformation@hhsc.state.tx.us

 

Thank You!


 
 
September 24, 2014
 

Just a couple of updates:


Webinars for October Reporting


Please see the dates and times. HHSC has decided to break the QPI and Category 3 baseline topics into two different webinars. We will follow up with the call-in information on the calendar invites to follow by the end of the week and also post the information on the HHSC & Region 10 websites.


  1. Wednesday, October 1 from 10:30 a.m. to 12 Noon: Quantifiable Patient Impact (QPI)

  1. Thursday, October 2 from 2 to 3:30 p.m.: Category 3 baselines

  1. Monday, October 6 from 10:30 a.m. to 12 Noon: Method of reporting – stress and load testing is occurring with the automated system this week, which is the final test to confirm using this system for reporting. HHSC plans to have the log in information in advance of the webinar along with user instructions. If the stress and load testing does not pass, the webinar will focus on the spreadsheet system we have used in the past.

Statewide Learning Collaborative Follow-Up


  • As part of the Summit, HHSC is distributing a survey to all attendees to better understand successes and challenges with the DSRIP program as we plan for waiver extension/renewal.  In case you did not fill out a paper copy of the survey at the Summit on September 9th and 10th, it is available to be completed online.  Please click on the provided link to answer the questions and click "Done" when complete: https://www.surveymonkey.com/s/dsripslcsummit. The survey link will remain live until October 6th.
  • HHSC is working to process the recordings of sessions from the event and plan to post to HHSC website as soon as possible. We will follow up with a message once that is complete.


Region 10 Learning Collaborative is tomorrow!  We are looking forward to everyone joining us there and the great work and shared learning that will take place.  Please let the valet know that you are with Region 10 as we will be covering your parking expenses.  Let us know if you have any questions leading up to then. 

 
 
 
September 22, 2104
 

Just a few updates from HHSC for you this week:


Category 4 Reporting Guidance for optional RD-6


  • CMS provided guidance that for a hospital that elected to participate in RD-6, all the CMS Adult and Child Core Measures must be reported. If a measure cannot be reported, then a justification must be provided. There is no minimum number or set of measures that must be reported.
  • Acceptable rationale for not reporting on a measure include:
    • The hospital does not serve the population that is being measured.
    • The hospital does not provide outpatient services that is being measured.
    • There is not a statistically significant population to report the measure – defined as at least 30 cases included in the denominator.
    • The hospital’s current data systems do not allow for the measure to be reported; if so, include information about what the hospital is doing to be able to report it in later years.
    • The identical data is being reported as a Category 3 outcome (including same denominator as Category 3).

Webinars for October Reporting


HHSC is finalizing dates for two webinars to provide guidance for October reporting and will provide specific dates as soon as we confirm with our webinar vendor.


  1. Webinar to focus on QPI and Category 3 baseline submissions – we had breakout sessions at the Summit and this webinar will refine guidance for these two areas 
  2. Webinar to focus on method of reporting – stress and load testing is occurring with the automated system next week, which is the final test to confirm using this system for reporting. HHSC plans to have the log in information in advance of the webinar along with user instructions. If the stress and load testing does not pass, the webinar will focus on the spreadsheet system we have used in the past.

Statewide Learning Collaborative Follow-Up


  • HHSC has received the recordings of sessions from the event and plan to post to HHSC website as soon as possible. We will follow up with a message once that is complete.

Category 3 Appendixes

  • HHSC is nearing the completion of updating the Category 3 Appendixes and expect to be finished by next week.
  • Updates of the detailed description of measure specifications include: a.) further clarify measure specifications for many of the outcomes, b.)  reformat the structure of the compendium document to create a more user friendly document, c.) include additional content around goal calculations, d.) update links to measure specifications, e.) update performance methodology type (IOS vs. QISMC) and performance benchmarks as appropriate, and f.) remove any erroneous content or discrepancies with the approved measure specifications. 
  • A summary will be provided of changes or modifications to any measures from the initial compendium draft released in March of 2014 to identify revisions.

Category 3 Guidance on Risk adjustment

  • Please find guidance around allowable risk adjustment methodologies attached as well as the normative data that can be used to use the Indirect Standardization method described in the document.
  • HHSC anticipates additional questions and TA needs for this information and will continue to work with providers as needed.  In addition, they will maintain a FAQs document as questions are submitted.

As always, thanks for the work you do, and let us know if you have any questions.  Don’t forget about the Learning Collaborative event on Thursday and that DY3 ends next week!

 
 
September 8, 2014 

Hope everyone is excited about the Statewide Learning Collaborative this week.  HHSC has released the web-streaming information.  UC ONLY HOSPTIALS: Please remember it is vitally important that you participate in the Learning Collaborative.  Please keep sign in sheets within your organization and document lessons learned from different sessions. 

 

HHSC has also released the RHP 10 projects that will be evaluated as part of the Mid-Point Assessment.  Myers & Stoffer will be hosting two Mid-Point Assessment sessions at the Summit, and it is highly suggested that providers make an attempt to make one session (one offered each day) to understand the expectations and process of the MPA. Providers do not need to bring their project narratives and/or workbooks to the overview sessions. 66 projects from RHP10 were selected, so please review the attachment. More details will be provided next week.

 

Projects were selected based on the following: a) project options that were requested to be reviewed by CMS - 1.10, 2.4, 2.5 and 2.8 and projects that were approved under "other" project option, b) projects identified by HHSC during approval, plan modification and reporting reviews, and c) projects selected via random sampling.

 

After the Summit, HHSC will send letters to providers with selected projects with additional information about the mid-point assessment process.

 

For those providers who will be participating in the Summit via webinar, please note that the mid-point assessment breakout session will not be streamed during the webinar, but will be recorded and the link will be posted on our website at a later date.

 

If you have providers who are not travelling to the Summit, and prefer to listen to the presentation prior to it being posted on the website, we can provide a conference line for Tuesday session, September 9th, from 3:45-5:00 pm. Providers will need to respond to the Waiver Mailbox to request access to the conference line.  

 

Information for Web Attendees at the HHSC Statewide Learning Collaborative Summit / September 9-10, 2014

 

Thank you for your interest in participating in the HHSC Statewide Learning Collaborative Summit on September 9-10, 2014. 

 

In order to allow interested individuals to watch the proceedings, HHSC has arranged for the Summit to be available for viewing on-line, in real-time.  To access the Summit via webcast on September 9th and/or 10th, please click on the HHSC Live Webcast link: HHSC LIVE WEBCAST. When you access this site, please press play to begin watching on-going sessions.  If at any time a participant leaves the webcast and returns later, please click on the same link and press play to re-join.  During the webcast, participants may submit questions through an online chat function. Questions will be answered after the Summit concludes.

 

For technical difficulties accessing the webcast, please send an e-mail to: TXHealthcareTransformation@HHSC.state.tx.us.                                                                                                  

Please feel free to share the webinar information with other interested individuals.

 

As part of the Summit, we are distributing a survey to all attendees to better understand successes and challenges with the DSRIP program as we plan for waiver extension/renewal. The survey can be accessed through the following link https://www.surveymonkey.com/s/dsripslcsummit.

 

If you have any questions or comments, please send an e-mail to: TXHealthcareTransformation@HHSC.state.tx.us.

August 27, 2014
 

HHSC has provided a brief update regarding Plan Modification timeline and CMS staff who will attend the Statewide Learning Collaborative.  With all that HHSC has on their plate right now we will not have an Anchor call this week, but should receive an email update from them at the end of the week.

 

From HHSC:

  • Thank you for the plan modification submissions from your RHP. We received almost 2,000 change requests from over 200 providers. Given the volume of requests, we are revisiting the timeline we have communicated and will provide another update later in the week. We are also taking into account the October reporting period and the midpoint assessment.
  • Thank you for the additional communication on registration for the Statewide Learning Collaborative Summit. The additional registrations have filled the remaining slots. We have been notified by CMS that Cindy Mann, Director, will be traveling to Texas to attend the Summit and she will be here for the first half of Sept. 9th!  We plan to present the RHP Snapshot information that morning while Cindy Mann is here, and really want to have all RHPs represented.

 

Region 10 Learning Session 2 for Learning Collaborative will be September 25th at the Hilton in Fort Worth, Texas.  This is for both the Care Transitions and Behavioral Health.  Please register and let us know you are attending: http://rhp10txwaiver.com/informationresources/registration92514.html

 

Have a great week and please let us know if you need anything!

 
August 18, 2014

 
Good Monday Morning Region 10 –
 
Heather and I just wanted to take a moment to remind you of upcoming events in the Region and across the state.  As the Demonstration Year comes to a close it’s going to be a busy time!

HHSC is hosting a webinar on DSRIP Risk Adjustment Methodology for Category 3

Date: Thursday, August 28, 2014

Time: 1:00 – 2:30pm, Central Daylight Time

Speaker(s):  Jennifer Woodard (HHSC) and Lisa Lyons (3M)

To join the online meeting:
1) Go to www.webex.com
2) Click on Attend Meeting
3) Enter Meeting Number: 803 411 043 (no password necessary)
4) Call 800-396-3172

To join the audio conference only: All participants should dial 800-396-3172 (no password necessary). You will be placed directly into the audio conference.

Participants can choose to log in online to view the slides and listen to the audio conference OR to call in only for the audio portion. Participants should dial in to the audio portion of the meeting 15 minutes prior to the start of the Webinar. They automatically will be connected to the meeting room and will hear music until the start of the webinar.
 
If you experience technical difficulties accessing the webinar or should you have any questions, please email waiver staff at: TXHealthcareTransformation@hhsc.state.tx.us.
August 13, 2014
UC Program Update 
 
 

Good morning Region 10 UC Only Hospitals: 

 

HHSC has asked anchors to communicate with UC only hospitals to make sure each of you understand the requirements per the Program Funding and Mechanics Protocol (PFM) of the 1115 Waiver and your needed participate in one Learning Collaborative per year. Region 10 UC Only Hospitals include: Baylor Grapevine, Baylor Waxahachie, Navarro Regional Hospital, North Texas Community Hospital, and Lake Granbury Medical Center.

 

The Program Funding and Mechanics Protocol, paragraph 8.b states:

 

UC hospital participants shall also participate in learning collaboratives conducted annually

during DYs 3-5 to share learning, experiences, and best practices acquired from the DSRIP

program across the State.

 

Based on the language in the PFM Protocol, UC-only hospitals must participate at least once a year in DYs 3-5 in a DSRIP learning collaborative event.  Since DY3 will end on September 30, 2014, HHSC wants to be sure that UC-only hospitals are aware of and complying with this requirement.

 

One way to fulfill this requirement would be to participate in a regional learning collaborative event. Region 10 will host our second Learning Session of DY3 on September 25th 2014 at the Hilton Hotel in downtown Fort Worth.  You can register for this event here if you wish to participate in this day: http://rhp10txwaiver.com/informationresources/registration92514.html

 

Another way to fulfill this requirement would be to participate in the Statewide Learning Collaborative Summit, which will take place in Austin on September 9-10, 2014.  While there are limited in-person slots that are focused on DSRIP participants, the summit will be accessible via the web and HHSC encourages UC-only hospitals to participate in the summit online. The draft agenda of the Summit is on the Statewide LC page for your review.

 

Regardless of which learning collaborative event(s) a UC-only hospital opts to attend, the hospital should keep documentation of who from the organization attended, when/where they attended, and what they learned from the event.  HHSC has not yet determined how it will collect this information, but this is the type of information that would be requested from UC-only hospitals to show that they met this requirement of the PFM Protocol.

 

Please be sure to attend one of these sessions so that you are complying to the regulations set forth in the PFM to receive UC funding.  If you have any questions regarding the requirement or either the Region 10 or HHSC hosted events please let me know.

August 8, 2014


 
Good morning Region 10 Providers,

 

Have lots of updates for you today!  The Anchor Call notes are posted on the RHP10 website along with other new updates for you there as well!

 

Anchor Call Note highlights:


 
  • As a reminder, the expedited rules to align DSRIP administrative rules with the most recent PFM Protocol will go to MCAC and the HHSC Council as information items next Thursday and Friday for adoption by September 30, 2014.
  • We have a new project officer at CMS for the waiver, Brenda Blunt, RN. She, Paul Boben, Rob Nelb (now with MACPAC), Rene Spencer (CMS regional office) and hopefully Cindy Mann, will be at the Statewide Learning Collaborative Summit.
  • HHSC has posted an updated descriptive project list on the website. It includes tabs for 3-year and 4-year projects, and tentative Cat 1 & 2 values for DYs 4-5 along with the approved Cat 1 & 2 values for DYs 2-3.

 

  • April DY3 Reporting
    • NMIs have been reviewed and the final review files have been sent to anchors and providers.
    • Payment for metrics achieved in April reporting (and for which IGT was received) was sent out by July 31st. Providers received approximately $693 million all funds for DY2 and DY3 metrics reported and achieved (for a total of over $2.5 billion all funds paid so far for DY1-3).

 

  • Category 3 ReviewSeptember 9-10, 2014, Learning Collaborative Summit
    • HHSC is reviewing provider responses to HHSC feedback and will notify providers whether protocol requirements have been met.
    • We have had many providers request to participate in the 3M/HHSC TA call around risk adjusting. We are working to schedule that call now and will send notification as soon as the date has been confirmed. We anticipate the webinar will be scheduled for late August . If you wish to participate in the webinar please email HHSC.
  • The latest working draft agenda is on the Statewide Learning Colalboartive page
  • HHSC used information from the recent survey to help determine panelists from the RHPs and also are using it to finalize which posters will be exhibited at the event. (Congrats to Wise Regional who will represent Region 10!)
  • THA is assisting to pull together a Snapshot of the 20 RHPs that we plan to include in the opening session of the Summit. Please see the  template that is just 3 slides per RHP to complete. The anchor will complete and submit, however if you have something you would like included please email rhp@jpshealth.org and we will include it in our submission on August 25th.
  • Some Anchors have communicated that they have a "theme song." We would like to have music at the event to play during breaks, so please send us a song representing your RHP, if you would like. If you have ideas for an RHP10 song please send them our way. We can use it at our RHP10 Learning collaborative as well!
  • There is an updated list of provider and anchor attendees registered to date for the SLC Summit.  Based on the numbers enrolled so far, we are distributing four additional slots to each RHP for allocation to providers as needed.  It would be very helpful if you could let us know who will be registering for those four slots in your region so that we can monitor their registrations on our end.  Please have them register by COB this Friday, August 15th. 

 

  • CMS DY2 DSRIP Financial Management Review & Midpoint Assessment
    • It appears that many (potentially up to 70) of the DSRIP providers in these four regions that are performing certain types of projects (Options 1.1.1, 1.1.2, 1.9.2, 1.12.2, 2.1.1, 2.2.1, 2.6.1, 2.9.1, 2.10.1, 2.13.1, 2.16.1) may have site visits. At the site visits, CMS will ask that the provider demonstrate how it achieved its DY2 metrics (those that HHSC approved for payment either based on August 2013 or October 2013 reporting) for select projects.
      The goal is for CMS to provide HHSC a draft report by late October/November. HHSC will have the opportunity to comment on the draft report, and then it will continue through the CMS approval process.
    • HHSC has gotten some questions as to how the CMS DY2 Financial Management Review relates to the DSIRP mid-point assessment. They are two separate reviews. Providers are not yet being contacted regarding the mid-point assessment.
    • Myers and Stauffer will provide an overview of the mid-point assessment during breakout sessions for both days of the summit.
  • IGT and DSRIP Payment Dates
    • The following are updated payment dates received from Rate Analysis.  This should help address the issue brought up in last week’s anchor call regarding the IGT due date being 12/30 of each year.  We do not yet have dates of when the IGT request notices will go out. 

      • A calendar invite and email have been sent regarding the Learning Session 2 for DY3.  The event will take place September 25th at the Hilton in downtown Fort Worth.  Please check the website for more information as well as register so we have an accurate number for food, seating, poster sessions, etc.  Thank you in advance for registering: http://rhp10txwaiver.com/informationresources/registration92514.html

 

DY 3 DSRIP 2 of 2

1/2/2015              IGT Due

1/20/2015            Transferring & Top 14 Paid

1/30/2015            DY 3 DSRIP Payment

 

DY 4 DSRIP 1 of 2

7/8/2015               IGT Due

7/21/2015             Transferring & Top 14 Paid

7/31/2015             DY 4 DSRIP Payment

 

DY 4 DSRIP 2 of 2

1/4/2016               IGT Due

1/15/2016             Transferring & Top 14 Paid

1/29/2016             DY 4 DSRIP Payment

 

DY 5 DSRIP 1 of 2

7/6/2016                IGT Due

7/19/16                  Transferring & Top 14 Paid

7/29/16                  DY 5 DSRIP Payment

 

DY 5 DSRIP 2 of 2

1/3/2017              IGT Due

1/13/2014            Transferring & Top 14 Paid

1/31/2014            DY 5 DSRIP Payment

 

  • Region 10 Learning Collaborative Learning Session 2:
    • A calendar invite and email have been sent regarding the Learning Session 2 for DY3.  The event will take place September 25th at the Hilton in downtown Fort Worth.  Please check the website for more information as well as register so we have an accurate number for food, seating, poster sessions, etc.  Thank you in advance for registering: http://rhp10txwaiver.com/informationresources/registration92514.html

 

Upcoming Dates & Events:

  • -          Anytime: Feedback regarding Category 3 provider responses – approval from HHSC
  • -          August 21: Care Transitions Monthly Webinar
  • -          August 25: Behavioral Health Site Visit at MHMR Tarrant County (please email if you plan to  attend)
  • -          September 9 & 10: Statewide Learning Collaborative and Summit
  • -          September 12: First round of feedback regarding Plan Modifications and Technical Changes
  • -          September 12-26: Providers respond to HHSC feedback from Plan Modifications (providers will have a due date to RHP10 prior to September 26th)
  • -          September 20: Region 10 Networking Event – NAMI Walk in Fort Worth (see website for details)
  • -          September 30: Deadline for achievement of DY3 milestones and metrics
  • -          October 14: Second round of HHSC feedback regarding Plan Modifications and Technical Changes
  • -          October 31: Deadline for DY3 October reporting submission
  • -          Late October/ early November: CMS report to HHSC on DY2 financial audit
  • -          August- December: mid-point assessment takes place, should wrap up by December 31, 2014

August 6, 2014

UC Program Update
 
Providers, Government Entities, and Anchors,

               

In a recent correspondence, HHSC stated the DY 3 Tool would be sent to all providers who requested one beginning July 30th.  To avoid systemic issues, HHSC sent the data to pre-populate the DY 3 tools to several consultants throughout the industry to review.  After receiving feedback, we found several minor issues with the queries used to gather the data.  We are working to ensure that all issues are resolved before populating and dispensing the DY 3 tools.  All tools will be sent to providers beginning Monday, August 18, 2014.  HHSC will modify all submission deadlines in accordance with the release date, and will communicate the revised timeline to providers when the tool is released. Thank you for your patience and participation in the supplemental payment programs

July 24, 2104

 

Region 10 Providers,

 

I just wanted to remind you that tomorrow is the deadline to register for the HHSC hosted Statewide Learning Collaborative in Austin, Texas on September 9 and 10th

 

Also, the rule hearing for the expedited DSRIP rules was held from 10:30-11:30 a.m. on Wednesday, July 23rd in the Brown-Heatly public hearing room.  These changes bring the rules into line with the most recent version of the Program Funding and Mechanics (PFM) Protocol from May 2014.  The preamble and rules are attached and were published in the July 11, 2014, issue of the Texas Register. 

http://www.sos.state.tx.us/texreg/archive/July112014/index.html We have an opportunity to submit written comments through August 11th if necessary.

 

 

  • Other deadlines regarding Category 3 feedback, Section 1 Tables, Medicaid/ Low Income Impact, and Plan Modifications/ Technical Changes:

 

Item

Due Date

Submit to

Category 3 Feedback

July 28, 2014 5:00 pm

Directly to HHSC with a copy to the Anchor

Percent Impact on Medicaid/ Indigent

July 28, 2014 8:00 am

Anchor

Registration for Statewide Learning Collaborative

July 25, 2014 based on number of slots you were allotted

Through HHSC registration link

Last day to ask questions to HHSC regarding Plan Modifications & Technical Changes

 August 1, 2013 end of day

 Anchor or HHSC with a copy to the Anchor

Section 1 Table Updates

August 1, 2014  8:00 am

Anchor

Plan Modification & Technical Updates

August 4, 2014 12:00 noon

Anchor

July 22, 2014

 

Good afternoon RHP 10,

Thank you to those that joined the HHSC Technical Assistance Call this afternoon.  It was really helpful for me to hear HHSC respond to your questions and hope you found the time valuable as well. Here are the notes I took from the call, text in red, and hope that I have done your questions and HHSC’s comments justice. 

I also wanted to bring to your attention the following documents

1)      Updated Plan Modification and Technical Changes companion document (here, updates from HHSC highlighted in yellow)

2)      QPI Metrics Summary – a document of all QPI metrics for DY3-5 also clarifying if there is an additional Medicaid/ Indigent percentage requirement with your QPI

3)      Updated Plan Modification and Technical Summary Excel worksheet - http://www.hhsc.state.tx.us/1115-Waiver-Guideline.shtml --> this has been updated from HHSC to fix a prior bug.  This file may be too large to email so I am sending you the link.  If you have problems downloading the file from the HHSC website, please let me know and I will get it to you somehow. 

Learning Collaborative Documents:  The July combined Care Transitions and Behavioral Health Risk Stratification Webinar from last week with sign in sheets for your records.

July 14, 2014

 

Good morning Region 10 Providers,

 

I have an extremely large amount of information for you today on a variety of topics.  Please recognize the multiple items of information and upcoming due dates included in this communication.

 

Upcoming Due Dates:

 

Item

Due Date

Submit to

DY3 NMI Metrics, DY2 Carry Forward NMI Metrics

TODAY July 14, 2014 5:00 pm

Deloitte, copy Anchor

Category 3 Feedback

July 28, 2014 5:00 pm

Directly to TXHealthcareTransformation@hhsc.state.tx.us, with a copy to the Anchor

Percent Impact on Medicaid/ Indigent

July 28, 2014 8:00 am

Anchor

Registration for Statewide Learning Collaborative

July 25, 2014 based on number of slots you were allotted

Through HHSC registration link

Section 1 Table Updates

August 1, 2014  8:00 am

Anchor

Plan Modification & Technical Updates

August 4, 2014 12:00 noon

Anchor

 

 

Detailed Information from Anchor notes as well as additional comments:

Section 1 Table Updates:

 

  • Early this week, HHSC will be sending out our current file from Section I of the RHP plans to collect any changes to Provider, IGT Entity, and Anchor contacts since our first update in February 2014. This is in preparation for our second round of data seeding in the new automated reporting system. We are also requesting that UC Only Hospital contacts be updated in preparation for the UC Hospital ICHP report send out. The due date for these contact updates will be Friday, August 1st with a submission from the Anchor.

 

Category 3 Feedback:

 

  • Region 10 has begun to receive Category 3 feedback from HHSC.  There is a summary of the responses required for the 8 providers we have received feedback for to date.  HHSC will be sending out the remainder of the provider files early this week.
  • We are working on setting up a TA call between HHSC and all of the providers in Region 10
  • Feedback will continue to be emailed to the contact listed in the Cat 3 selection tool with a copy to the anchors. The email will specify which projects require a response and will include a deadline for responses. I will update this as more providers receive their feedback.
  • Based on TA calls with providers HHSC has heard concerns about baseline measurement periods. Per the guidance in the Category 3 companion and PFM providers should collect baseline for a minimum of 6 months and the measurement period should be complete by the end of DY3. HHSC is asking that any provider that will not have 6 months’ worth of baseline data for a Cat 3 measure by the end of DY3 (e.g. baseline of no later than 4/1/14-9/30/14) or anticipates a baseline rate of "0" to notify HHSC by sending an email to the Waiver box with subject line BASELINE MEASUREMENT PERIOD'. In these cases, we will work with you to determine next steps.
  • HHSC has had many providers request to participate in the 3M/HHSC TA call around risk adjusting. We will be scheduling that call at the end of July once all providers have received initial feedback on their Category 3 selection.

 

Medicaid/ Low-income Uninsured (LIU) Percentages:

 

  • As discussed on the webinar and in the companion document, HHSC strongly discourages providers from reducing QPI or the % of Medicaid/low-income uninsured impact of a project because that may affect valuation and will require review by the compliance monitor.
    • If changes need to be made to QPI and/or the % of Medicaid/low income uninsured served by a project:
  • QPI changes or changes to the combined % of Medicaid/LIU require a plan modification.
    • If the QPI or combined M/LIU % isn't changing, but the breakdown between the % Medicaid and % low-income uninsured has changed, that is a technical change (unless it impacts a milestone/metric, in which case it's a plan mod).

 

Legislative Request Regarding the Estimated Impact of the Waiver on the Low-Income Uninsured Population:

 

  • Separate from the change request process, HHSC needs to get some additional information for 457 projects (20 in Region 10) on what % of the project is estimated to benefit the low-income uninsured population.
  • Responses will not impact valuation or project approvability. It is needed to respond to a legislative request.
  • If you have a project requiring this information, please complete and send into the anchor so we may submit for you.
    • For each project, Column H contains the Combined Medicaid/Low Income Uninsured % that HHSC has on record for the project.  (This information matches the information in the Summary of QPI Metrics & Medicaid/Low-Income Uninsured Percentages(7/11/14) posted on the HHSC website for providers to reference as they’re working on change requests).
    • Providers should break out this percentage between Medicaid and Low Income Uninsured populations in the preceding columns (F & G).  The sum of those two percentages should match the combined percentage, and there is a check for this in Column I.  We ask providers to do their best to provide this breakout, knowing these estimates include future years.
    • This exercise is not intended for the provider to request to change its Combined Medicaid/Low Income Uninsured % for the project (i.e., you cannot change the % in Column I).  If a provider needs to change the Combined %, it should do so as a plan modification through the Change Request process.  Optionally, a provider may indicate in the Provider Comments column (Column J) if it is planning to request a change to the Combined % through a plan modification request.  It also can provide other comments for explanation

 

July/August Change Request Process (Plan Modification Requests and Technical Change Requests):

 

  • Region 12 out of Lubbock recorded the HHSC webinar from last week and has it posted at the following link: Plan Modification & Technical Change Webinar
    •  The Anchor Call notes contains high level information, but I suggest everyone refer to the Companion document and templates for this process.
    • All documents will be required to be submitted to the anchor by 12:00 noon on August 4th, we will then submit to HHSC.

 

September 9-10, 2014, Learning Collaborative Summit

 

  • Registration closes July 25th.  Everyone was allocated a certain number of slots based on the number of projects you have.  If you have questions regarding these numbers please let me know.
  • HHSC is working on determining if additional slots will be provided to providers who are selected to present on a panel or a poster.  Please register for the session regardless of this selection timeline, HHSC will let providers who are selected know if there are more slots available for these at a later date.

 

Also: There is a combined monthly webinar for our Learning Collaboratives this Thursdays July 17 from 10:00 am – 12:00 noon.  This is a combined session for both Care Transitions and Behavioral Health.

July 1, 2104

 

Good morning Region 10 Providers

 

 

Some highlights from the Anchor call notes are as follows; please refer to the document as there are more details and information in them.

 

April Reporting/ NMI

  • HHSC has sent April reporting review results to anchors and providers. Providers will have three weeks from the date the coversheet is sent to respond to NMI requests (July 14).

 

Category 3 Review

  • HHSC continues to review Category 3 selections and is adhering to timelines as much as possible
  •  Feedback for the rest of the regions will proceed in the following order: RHP 10, 17, 14, 13, 12, 11, 8, 5, 2, 20, 15, 4, 19, 18, 7, 16.
  • All regions will receive feedback by mid-July and will have 14 days to respond to HHSC’s requests for additional information.

 

3M/ HHSC Technical Assistance

  • HHSC is looking to offer a TA call with providers who are using 3M for risk adjusting.  If you are one of these providers and would like a TA call please let the Anchor know and we will communicate that to HHSC  

 

July/August Change Request Process (Plan Modification Requests and Technical Change Requests)

  • HIHSC plans to post the instructions and other information relating to the submission of change requests (plan modification requests and technical change requests) to the waiver website on Monday, July 7, or Tuesday, July 8.
  • HHSC plans to hold a webinar on Thursday, July 10, 2:00 - 3:30 pm CST, to explain the change request process.
  • HHSC is moving the due date for submitting change requests back to Friday, August 8 to give us and providers more time to complete this important task.
  • More detailed information on what will be allowed for plan modifications is included in the anchor notes

 

For 3-year project funds: With the redistribution of funds from other Regions, Region 10 can fully fund all 3-year projects as approved by CMS in May.  

 

 

Due date today: HHSC sent out surveys to providers to complete seeking information on what you would like to see as agenda items and if you would be interested in having a project be represented/ discussed either on a panel discussion or at a poster session.  Please complete the survey and submit to HHSC, and we encourage you to apply to share all of the great work you are doing on your projects through the survey!

June 18, 2014

 

Good afternoon Region 10 providers,

 

I wanted to make you aware that today, June 18th, HHSC updated the April reporting companion document on their website.  The document contains updates around:

 

  • July 11, 2014 as the due date to submit responses to HHSC for any NMI on April reported achievements and Semi-Annual Reporting requirements.
  • More guidance on supporting documentationAugust 15, 2014 – HHSC and CMS will approve or deny the additional information submitted in response to HHSC comments on April reported milestone/metric achievement. Approved reports will be included for payment in the next DSRIP payment period, estimated for January 2015.
    • No PHI/confidential information
    • Staff names should not be redacted
    • File format for supporting documents

 

Also the finalized updated 1115 Waiver Standard Terms & Conditions as well as updated Program Funding and Mechanics Protocol, which was also released on HHSC’s website.

 

There are two presentations from the House Appropriations Committee on Monday June 16 regarding Behavioral Health activities both within and outside of the Waiver in Texas.

 

Quick Learning Collaborative Update:  There will be a Care Transitions and Patient Navigation webinar at 10:00 am tomorrow, June 19th.  Please let us know if you do not have the calendar invite and link to join us.  The Behavioral Health meeting this month will be a site visit on June 27th at JPS Viola Pitts Clinic, no webinar will be held for Behavioral Health tomorrow.

June 16, 2014

 

Good afternoon Region 10,

 

The summary of the Anchor Call notes from June 13, 2014.

 

April DY3 Reporting

  • HHSC has completed the review of DSRIP April reporting. Coversheets are being developed and are scheduled to be sent to providers on June 20th. Providers will have three weeks from the date the coversheet is sent to respond to NMI requests.

New 3-year projects

  • HHSC continues to work with anchors to confirm the valuation for each project so that HHSC can confirm project values with CMS and do the redistribution among regions. Once that is done, we will know which of the 3-year projects have funding.
  • Please review the notes regarding how HHSC is handling the Category 3 dollar allocation for 3-year projects

Category 3 Review

  • Once RHPs are sent feedback, HHSC is coordinating with the anchor entity to schedule a TA call with providers to inform the provider response period.
  • Feedback will continue to be emailed to the contact listed in the Cat 3 selection tool with a copy to the anchors. The email will specify which projects require a response and will include a deadline for responses.
  • Each Category 3 outcome has one of the three following statuses, which is listed in the email to the provider
    • Approved as described- no response required:
    • Approved with additional clarification- response required:.
    • Measure is not currently approved as described- response required

July Change Request Process ( Plan Modification Requests and Technical Change Requests)

  • HHSC is moving the due date for submitting change requests (plan modification requests and technical change requests) back to late July to give us and providers more time to complete this important task.
  • The July 2014 change request period will be the last time for providers of 4-year projects to initiate plan modification requests and technical change requests for DY4-5 for most issues.
  • While HHSC hasn't sent out the change request information yet (coming soon), you should begin to think about plan modifications and technical changes you’ll want to request now as July will be the last opportunity to make these requests
  • If a provider is achieving QPI goals two years early (i.e. achieved DY5 goal in DY3), HHSC recommends that the provider proactively increase its future QPI targets through a plan modification request rather than having the compliance monitor require that change as part of the midpoint assessment.

September 9-10, 2014, Learning Collaborative Summit

  • HHSC will be sending out soon (likely next week) a survey for anchors and DSRIP providers regarding the September Statewide Learning Collaborative Summit. We want to get input on topics for speakers and panels, and also want to get a sense of which strong projects are interested in being represented at the Summit either on a display poster or as part of a panel.

DSRIP Automated System

  • HHSC continues to work with Cooper Consulting on the development of an automated system for DSRIP reporting. The new system should be deployed in time for October DY3 reporting.

 

Learning collaborative Monthly Webinar’s & Site Visit

  • Thursday June 19: Care Transitions Monthly Webinar 10:00 am – there should be a WebEx link in the calendar invite.
  • Friday June 27: Behavioral Health Site Visit (taking place of webinar).  This is a site visit only.  Hosted by JPS Health Network at Viola Pitts Clinic.  Lunch will be provided, please make sure your RSVP is accurate.

June 10, 2014

 
Good afternoon Region 10 Providers,
 

Heather and I wanted to take an opportunity to share with you some general highlights of activities going on across the Region. There will be a communication update coming out this week for the upcoming Learning Collaborative webinar / Behavioral Health cohort site visit, as well as updates from HHSC after the Anchor call on Friday.

 

Category 3 Feedback and Approval:
Region 10 is slated to receive our feedback this week, or early next week. Our colleagues and friends at THR-Kauffman from Region 9 have graciously shared and provided permission for us to share this file with you, so you may see a preview of what is to come, thanks THR! The document is comprehensive and does take some time to read through.  It appears HHSC is providing feedback on Category 3 outcomes at the project level, so you should see a tab per project when you receive your files.  I believe there will be further instruction and information provided when we get our feedback, but wanted to share this great example with you. 

 Audit/Midpoint Assessment workgroup:
A quick update on this working group – the THR lead is currently out of the country, but will be meeting with us next week when he returns.  We will plan our next steps, action items, and meeting then and
communicate those to you.  The Region 10 providers we have documented as interested in participating are: JPS, THR, UNTHSC, Wise/ Wise PG, TCPH, MHMRTC,Dallas Children’s, and Baylor. Stay tuned!

PCMH Conference with Region 9:
We will be working closely with Region 9 to plan this exciting learning opportunity for February of 2015.  Current providers interested are: JPS, Wise/ Wise PG.  If you are interested in learning more about
this conference or attending please let us know.  As more is planned we will share those details with you.

Website Updates:
We have made a number of updates to the website, including but not limited to a DSRIP patient impact stories page (still under construction, more updates to come), information on the NAMI Walk and Linked in Group. We encourage you to use the website as a resource and please let us know your feedback so we can make it better for you.


June 2, 2014

UC Program Udpdate
 

Providers, Government Entities, and Anchors,

 

HHSC has resolved the issues with the spreadsheet and is asking all government entities to begin submitting (or re-submitting) their IGT into TexNet based on these new payment amounts.

 

Attached to this email you will find a workbook titled "DY2 Uncompensated Care Final Payment Amounts" that contains two tabs. The tab titled "IGT Commitment Amount" contains all of the amounts submitted by governmental entities in the IGT commitment forms and the final IGT amounts after the haircut applied by HHSC. As these amounts are by affiliation; providers with multiple affiliations will have one row for each affiliated entity that shows the IGT amount from this affiliated entity.  The other tab is titled "HHSC DY 2 UC Payment" and lists the final UC amounts by provider.  This tab also shows the data and methodology HHSC used when applying the haircut.

 

Government Entities need to reference column H (Final Waiver Year 2 IGT Amount or Annual IGT Recoupment) in the "IGT Commitment Amount" tab and column AR (Final Waiver Year 2 IGT Amount or Annual IGT Recoupment) in the "HHSC DY 2 UC Payment" tab for their final IGT amounts.

 

HHSC is asking that all Government Entities submit their IGT's into TexNet no later than 6:00PM, Tuesday, June 3rd, and when the IGT is entered, select a settlement date of Wednesday, June 4th. The settlement date is the day that the comptroller will draw the funds from the entities account, and it is very important to select the correct settlement date when entering the IGT transaction into TexNet.

 

While Government Entities that are IGT'ing for multiple providers may submit one lump sum IGT, HHSC asks that if you are submitting IGT for multiple providers to complete the attached allocation form. This form is very simple to populate using the "IGT Commitment Amount" tab, and will give  the HHSC Rate Analysis Department an allocation of the  lump sum IGT so we will know how much of the lump sum to apply to each provider.

 

We are also attaching the TexNet IGT Payment Instructions for ease of reference.

 

Once you have submitted your IGT into TexNet you will receive a receipt that HHSC refers to as the Trace Sheet. HHSC asks that ALL IGT'ing entities send their Trace Sheets and Allocation Forms to the UC Tools mailbox at uctools@hhsc.state.tx.us . If you have any questions or require any assistance, please send a message to the UC Tools mailbox, and thank you for all of your help and dedication in making the final DY2 UC payments.

 
June 2, 2014

 

Anchor call notes from May 30 call have been sent out, along with
    • Updated list of Behavioral Health projects from Meadow’s Foundation
    • Updated STCs and protocols from HHSC as approved by CMS
    • a. UC IGT entities were included on this email due to there being information regarding UC protocols in this document.
    • CMS letter regarding financial monitoring
  • TexNet IGT instructions

 

HHSC Items to note:

 

  • 3 Year Project Approval
    • For RHPs that submitted more projects than had allocation to fund (RHP10 was one of these regions), please make sure you are away, that just because a project received CMS approval, that does not mean it has full funding or even partial funding.
    • HHSC is still reviewing the valuation amounts in the CMS letters (which reflect DY3 for Category 1 & 2 only). There were some issues because some providers requested their maximum value from the prioritized list, while others submitted projects at lower values.
    • HHSC will be working with anchors soon to confirm the valuation for each project so that HHSC can confirm project values with CMS and do the redistribution among regions. Once that is done, we will know which of the 3-year projects have funding. Likely to be done in the next 2-3 weeks.
  • Category 3 review
    • RHPs 3 & 9 should expect to receive feedback on their Category 3 selections next week, with Regions 1 and 10 to be next.
    • Feedback will be emailed to the contact listed in the Cat 3 selection tool with a copy to the anchors. The email will specify which projects require a response and will include a deadline for responses.
    • We may schedule a Region 10 webinar to review the Category 3 response feedback information and instructions if providers feel that would be beneficial.  Please communicate your needs to us.
  • Plan Modifications
    • The July 2014 plan modification request period will be the last time for providers of 4-year projects to initiate plan modification requests for DY4-5 for most issues. There will be some additional plan modifications initiated by HHSC/the compliance monitor during the midpoint assessment review (e.g. if a project achieved its DY5 QPI goal in DY3, it will need to increase its future goal(s)).
    • If a provider is achieving QPI goals two years early (i.e. achieved DY5 goal in DY3), HHSC recommends that the provider proactively up its future QPI targets through a plan modification rather than having the compliance monitor require that change as part of the midpoint assessment.
  • Meadow’s Foundation List
    • attached is the list of projects that currently are part of the Meadows/UT BH project analysis (for 4-year projects).  The projects  shaded in grey are ones that have been withdrawn, are duplicates, or were replaced with a non-BH focused project, so they will be removed from the final list. 
    • HHSC has identified a handful of other projects we recommended Meadows should add to their list that are not yet included.
    • Just to clarify, because it was confusing, the most recent Meadows BH project files sent to you included only a subset of all BH-focused projects, and are in addition to those that you had already reviewed a few months ago. It was not the complete list of BH projects that Meadows is reviewing.
    • Please review this list for accuracy of your Behavioral health projects and let us know at rhp@jpshealth.org if one of your projects is missing so we may get the correct information to HHSC to post on their website.
    • CMS Financial Letter
      • A letter CMS issued to State Medicaid Directors on May 9, 2014, providing guidance to states concerning Federal statute and regulations related to the allowable and unallowable use of provider-related donations and the use of certain types of public-private arrangements.
      • CMS plans to go onsite to large IGT entities in Dallas, Fort Worth, and Austin.  More details are provided in the attached anchor notes.
      • HHSC Funds Expenditure Survey
        • Here is a link to the HHSC Rate Analysis page: http://www.hhsc.state.tx.us/Rad/hospital-svcs/index.shtml. Providers may find it helpful to look at the results of past expenditure surveys to get a sense of how they are filled out.  HHSC is required to collect the survey information per Rider 43 from the FY14-15 General Appropriations Act. The survey went out to all DSRIP providers (both hospitals and non-hospitals), along with DSH, UC, and Indigent Care providers. 

 

Region 10 Items to note:

 

  • Patient Centered Medical Home Conference with Region 9
    • In working with the Anchor for Region 9 we have identified a great opportunity to partner with this Region and host a combined PCMH focused conference slated for February 2015.
    • If you are interested in attending such an event, or even would be interested in helping plan or prepare please let us know at rhp@jpshealth.org
    • We are excited about this opportunity and looking forward to the exciting time to bring two large regions together.
    • Mid-Point Assessment/ Audit workgroup
      • Thank you to the providers who have stated they were interested in participating in the workgroup (so far: THR et. al., JPS, Wise/ Wise PG, MHMR TC, Tarrant County Public Health)
      • A formal meeting will likely not occur until after 6/15 – if you are interested in participating with this group please let us know.
      • NAMI Walk
        • Please join us for the National Alliance on Mental Illness (NAMI) Walk on Saturday, September 20th at Trinity Park in Fort Worth
        • Register Online at NAMI Walk Registration. Our team name is RHP10Providers
        • You can find out teams webpage at http://namiwalks.nami.org/RHP10Providers
        • LinkedIn
          • Region 10 now has a LinkedIn group and encourages you to engage with each other as providers and stakeholders in the Waiver.  Click here to join the group and start further connecting with each other

 

Uncompensated Care

 

HHSC will be sending the revised final payment and IGT information out today.  We thank you for your patience and flexibility as HHSC has worked very hard to ensure that everyone is receiving accurate information and payments.  IGT’s must be entered by 6:00 pm Tuesday June 3rd with the Comptroller to sweep accounts on Wednesday June 4th.  The TexNet instructions are attached should anyone have questions.  Please look out for the final information later today.

 

As always, thank you to everyone for your participation in Region 10 and the 1115 Waiver and let us know if you have any questions about material in this communication.

 

May 30, 2014

UC Program Udpdate

 
Providers, Government Entities, and Anchors,

 

HHSC has discovered an error in the DY2 Uncompensated Care Final Payment Amount spreadsheet that was emailed to providers and government entities yesterday. The correction of the error will change each entity's IGT amount. Correcting the error will not change the original IGT commitment. However, the IGT amounts communicated in yesterday's email will be affected, as some IGT amounts may go down and others may increase.

 

We are working to correct this error and a revised DY2 Uncompensated Care Final Payment Amount spreadsheet will be released this afternoon.

 

Several Government Entities have already submitted their IGT Trace Sheets. If you have submitted an IGT, please log into TexNet, cancel the submission, and re-submit the new amounts from the revised spreadsheet that HHSC will send later this afternoon. As long as you had selected the settlement date of Wednesday, June 4th you may cancel the IGT to prevent any funds from being transferred.

 

If you have not submitted, please do not take any action until you have received the revised final payment and IGT amounts this afternoon.

 
May 29, 2014

 

As you know, per a recently adopted rule (1 TAC 355.8204), HHSC may request from DSRIP IGT entities up to $5 million each year to support the non-federal share of DSRIP monitoring contract costs.  This year, HHSC plans to request $4 million IGT to support two forthcoming contracts – one for DSRIP compliance monitoring and one for DSRIP financial monitoring.  The rule specifies that HHSC will proportionately allocate the monitoring IGT based on the official DSRIP DY3 project values as of January 1.  HHSC has done that in the attached spreadsheet and will request these monitoring amounts at the time of the July DSRIP payment. This document has been distributed via email and will be posted in the document library.

 

If an IGT entity has any questions about its monitoring amount on the attached spreadsheet, please email the Transformation Waiver email box at TXHealthCareTransformation@hhsc.state.tx.us and include “Monitoring IGT” in the title of the email message and copy the anchor.

 
May 27, 2014

UC Program Udpdate

 

HHSC sent out correspondence last week that all IGT's would be due next Monday, June 2nd, and that  final payment amounts would be sent today, May 27th.

 

Due to an issue that will impact the haircut percentage that will not be resolved until close of business tomorrow (Wednesday, May 28th), HHSC will not be sending out the final IGT amounts until Thursday, May 29th. To give Government Entities sufficient time to submit IGT's into TexNet, HHSC has decided to move the IGT settlement date from Monday, June 2nd until Wednesday, June 4th. This means that the last day to enter IGT into TexNet will be Tuesday, June 3rd , since an IGT must be entered the day before the requested settlement date at the latest. Please note that the settlement date changing will not change the expected payment dates of June 11-27.

 

Please do not enter any amounts into TexNet until you have been instructed to do so by HHSC, as the IGT amounts submitted on the IGT commitment forms will change once the haircut has been applied.

 

If you have any questions, please contact the UC mailbox at uctools@hhsc.state.tx.us , and thank you for your patience as we complete DY 2 Uncompensated Care.

 

May 27, 2014

 

Thank you for joining us on the call today. Slides from today’s meeting and the three Category 3 documents referenced (IOS, Master Outcomes List, revised Category 3 Protocol) have been posted in the documents library.

 

For ease, we also have included the link to the NAMI walk and LinkedIn group.  We encourage you to use both of these opportunities to network with other providers. 

 

NAMI Walk: http://namiwalks.nami.org/RHP10Providers

LinkedIn: Region 10 Health Partnership

 

Thank you for the questions asked today, we have followed up with HHSC and will communicate those answers when they are received.  We appreciate your time today and the continued transformational efforts.  If you have any further follow up questions please don’t hesitate to contact Heather or I.   

 

May 22, 2014

 

Region 10 has received communication from HHSC and CMS that all 24 proposed 3-year projects are initially approved within the Region. The formal CMS letter is located in the documents library for your review and will be available on our website in the coming days, along with all recent updates from HHSC. HHSC asks providers to note, that project approval does not mean that the projects have full or partial funding; this will be determined when the final redistrubution of funds is completed prior to the end of June 2014.

 

As with the four-year projects, the DY4-5 values will be formally approved after the mid-point assessment later this year. Please let me know if you have any questions and congratulations on this major milestone of achievement. 

 
May 21, 2014

UC Program Udpdate

 
UC IGT Entities and UC Providers,              

 

The DY2 UC IGT Commitment form was submitted to HHSC yesterday and emailed to the RHP 10 distribution list.  Please be aware that the IGT commitment amounts are NOT the final IGT amounts. These final IGT's will be calculated based on the cap reduction (haircut) and sent out.

 

HHSC will review all of the IGT commitments and inform providers and IGT entities of the haircut amount and final IGT amounts needed to draw down payment.  The latest dates are again below for your reference.  If you have any follow up questions or concerns please let us know and you are always welcome to contact Rate Analysis as well.

 

Tuesday, May 27th-IGT Notification Date. HHSC will email a spreadsheet to all providers and government entities containing final DY 2 UC payment amounts based IGT availability provided in the IGT commitment forms.

Friday, May 30th-Last day to enter IGT into TexNet. Because the settlement date for all IGTs is Monday, June 2nd, all IGTs must be entered the day before at the latest.

Monday, June 2nd- IGT Settlement Date. All providers can enter their IGT into TexNet anytime during the week of May 23rd-May 30th, but must enter a settlement date of Monday, June 2nd. Similar to setting up direct payment for a bill, the settlement date is the date the Comptroller draws the funds from an IGT transferring entity’s bank account.

June 9th-June 27th-Providers will receive DY 2 UC payments. All providers will receive their DY2 UC payment no later than June 27, 2014.

 

Thank you for your cooperation during these next few weeks.  Please send any questions regarding DY2 UC to uctools@hhsc.state.tx.us.

 

May 19, 2014

 

Anchor Call notes from May 16 have been posted in the Anchor Call page, a draft copy of the updated Program Funding and Mechanics Protocol (PFM), updated Category 3 documents, and the IGT for Monitoring contracts have been posted on the Documents Library.

 

Some highlights from the Anchor Call notes are as follows:

 

General:

  • See PFM Protocol changes - July will not be the last opportunity to request plan modifications in all instances.
  • We also mentioned previously that projects that report in October 2014 may not be able to be paid as late as July 2015 due claiming limitations. See PFM Protocol changes below - we have clarified in the PFM that providers will be able to be paid for DY2 achievement in July 2015. So there will be an opportunity for NMI requests for carry-forward metrics.

 

DY3 IGT for DSRIP Monitoring:

  • HHSC sent an email letting anchors know that HHSC plans to request $4 million IGT to support two forthcoming contracts – one for DSRIP compliance monitoring and one for DSRIP financial monitoring. The spreadsheet sent with the email shows the proportional allocation of the monitoring IGT based on the official DSRIP DY3 project values as of January 1, 2014.
  • The IGT for monitoring will be requested at the time of the July DSRIP payment regardless of whether IGT is due for DSRIP payments. If the full monitoring amount is not submitted in July, then HHSC will request the remaining amount in January 2015.
  • IGT changes submitted by April 30, 2014 will not impact the DY3 IGT monitoring amounts.
  • If an IGT entity has any questions about its monitoring amount on the attached spreadsheet, please email the Transformation Waiver email box at TXHealthCareTransformation@hhsc.state.tx.us and include “Monitoring IGT” in the title of the email message.

 

PFM Protocol Changes:

  • Please see attached Anchor Call notes for key updates to the DRAFT PFM updates. 

 

April DY3 Reporting :

  • The deadline for IGT Feedback has been extended to May 23rd (from May 16).
  • HHSC has highlighted a number of issues they have found with supporting documentation.  Please review the anchor notes for detailed descriptions.
  • As a reminder, in June HHSC Rate Analysis will notify IGT Entities of the IGT required for DSRIP payments and DSRIP monitoring. The file will allow IGT Entities to enter the actual IGT amount to transfer and calculate the amounts for DSRIP payments versus DSRIP monitoring. IGT Entities must enter the correct IGT amounts in two separate categories in HSAS by RHP, otherwise payments may be delayed.

 

3-year project:

  • The majority of projects across the state should have been submitted to CMS on Friday May 16.
  • Indications from CMS are that they may be able to issue approvals for the projects submitted by May 16 by the end of May. Each RHP will get a single letter as before, listing all projects, which are initially approved, and which still need review.
  • Soon (sometime in May), HHSC will do the final (formal one-time) redistribution of funds across RHPs that is allowed in the PFM Protocol for the three-year projects based on a handful of additional projects that are being withdrawn. For the purposes of project submission to CMS, HHSC will leave the workbook valuations as they are currently but on the valuation and technical review spreadsheet will indicate to CMS the maximum value the provider is hoping to get for the project if funds are available. HHSC will work to update the workbooks once the final redistribution is done.

 

Category 3 review:

  • HHSC continues to review Category 3 selections and staff is providing TA as needed to prepare for the next step of establishing baselines for October reporting. Much of this TA will be provided in the feedback forms that all providers will receive from HHSC specific to the outcomes selected for each Category 1 or 2 project.
  • HHSC has submitted an updated version of the Category 3 RHP Planning Protocol to CMS for approval, detailing the framework and outcome measures list that has been previously distributed to DSRIP stakeholders.

 

DY4-5 Valuation:

  • CMS has confirmed that they do not have any concerns with the DY 4-5 valuations for projects that were not flagged as state or CMS outliers. However, DY 4-5 values for any project may change based on the findings of the mid-point assessment. HHSC has received email confirmation from CMS to this point.
  • CMS recommended that the compliance monitor ("independent assessor") review the qualitative justifications of the remaining 14 projects with outlier valuations as part of the mid-point assessment and make a recommendation to HHSC. If both HHSC and the independent assessor agree on a determination, then it is considered final. If HHSC and the independent assessor disagree on a determination, then CMS will make the final determination.

 

Linked In:

  • Region 10 now has a LinkedIn group and encourages you to engage with each other as providers and stakeholders in the Waiver.  Click here to join the group and start further connecting with each other.

 

 
May 16, 2014

UC Program Udpdate

 

Region 10 UC IGT entities and UC recipients,

 

Many of you have received individual communications from HHSC regarding the IGT commitment form for the final payment for DY2 Uncompensated Care.  HHSC Rate Analysis is collecting the IGT commitments regarding UC for the final DY2 payment as the next step in processing these payments.  Once these IGT commitments are received, they will evaluate the funds available and determine if any ‘haircut’ will need to be applied prior to processing final payments.

 

Region 10 has pre-populated the IGT commitment form with Provider Names, Governmental Entity Names, Affiliation Numbers, DY2 maximum payment amount, and DY2 IGT needed and sent this via email this afternoon. If you did not receive the communication and believe you need it please email rhp@jpshealth.org and we will send it to you.

 

UC IGT Entities: Please fill in Column K on the DY2 UC IGT Commitment form attached and return to rhp@jpshealh.org by close of business on Monday May 19, 2014.

UC IGT Entities: Please complete the contact information on the Governmental Entities Contacts tab and return to rhp@jpshealh.org by close of business on Monday May 19, 2014.

UC Receiving Providers: Please complete the contact information on the Providers Contacts tab and return to rhp@jpshealh.org by close of business on Monday May 19, 2014.

 

Rate Analysis wants to stress the strict turnaround time so that they can process all payments by the end of June. Region 10 would ask that you review the UC IGT Commitment form for accuracy of the prepopulated information. If you believe something is incorrect or missing, please contact us so we can update the master copy.

 
May 7, 2014

Learning Collaborative Update

JPS Health Network is hosting monthly webinars on the third Thursday of each month in 2014 for the two respective Learning Collaboratives:

 

Care Transitions and Patient Navigation Collaborative

Behavioral Health-Primary Care Integration Collaborative

 

The time schedule for the webinars this month is as follows:

Care Transitions: May 15th, 2014 from 10:00-10:50 am CST

Behavioral Health: May 15th, 2014 from 11:00-11:50 am CST

 
 
 
May 1, 2014
Learning Collaborative Update
 

Behavioral Health Collaborative Providers,

As previously discussed, one main way that Learning Collaboratives drive better performance is through participating organizations’ sharing their successes and struggles with one another. In doing so, every group doesn’t have to reinvent the wheel. To this end, we would like a few organizations to consider hosting learning visits at their location(s) in June, July or August of 2014. The goal would be for you to share your successes and opportunities so that we might all learn. We imagine these visits would last 90 minutes and include a site tour, an informal presentation of your efforts and plans, and a discussion period.

 

To identify two to three hosts, we invite you to submit a letter of interest, via email to RHP@jpshealth.org. Please contact us with your interest by May 8, 2014 and let us know the following:

 

  1. The name of your organization.
  2. Lead contact name, email, and phone for a site visit.
  3. The name(s) of your Learning Collaborative-related DSRIP project(s).
  4. A list of some of your project outcomes to date.
  5. What you would teach visitors: A list of the success and challenges so far in your project(s).
  6. Indicate whether you have done any measure(s) reporting to the Learning Collaborative website in the past two (2) months.
  7. Confirmation of your organization’s capacity to host 15-25 guests, and senior leader approval.
  8. Your preferred month or dates to host a visit, if you have a preference. 

 

The Region 10 Learning Collaborative Host Team will be happy to answer any questions you might have regarding the hosting of a session. Please email questions to RHP@jpshealth.org.

Wayne Young, Vice President, Behavioral Health will be your point of contact for all inquiries and correspondences. He can be reached at 817-927-3639, Email: Wyoung@jpshealth.org.

 
April 28, 2014

Please find attached the Anchor Call Notes from April 25, 2014.  Highlights from the notes:

 

  • HHSC is still considering whether or not July will be the last opportunity for plan modifications for DY4-5.
  • April DY3 Reporting
    • As a reminder, reports are due to Deloitte by 5:00 p.m. CST on April 30th.
    • As a reminder, do not report a Category 1 or 2 metric as completed until it is completed. For any metric/milestone that HHSC does not find sufficient evidence of achievement in the documentation, the provider will only have one opportunity in June to submit additional information. If the provider cannot demonstrate during the June “needs more information” (NMI) period that the metric/milestone was completed by March 31, 2014, the provider will no longer be eligible for payment for that metric/milestone. In addition, if a metric/milestone is reported as completed and is approved by HHSC and CMS, but during the compliance monitoring, it is found that the metric was not completed as reported, the associated DSRIP payment may be subject to recoupment.
    • New 3-year projects
      • HHSC would like to remind anchors and providers that the summary tab for Cat 1 or 2 may have inaccurate information. Providers should not be using the summary tab to view projects' valuation for a specific DY, but should instead review the corresponding tab for the DY.
      • Since the priority is for providers to resubmit projects in good shape, HHSC recommends that providers update only the narrative with the most recent information for Category 3. Providers do not need to update Category 3 information in the workbook.
      • HHSC is planning to submit two large batches of 3-year projects to CMS in May - around May 1 and May 16. Projects that are not in good shape and cannot be submitted on May 16 will be revisited in June, when HHSC completes its reporting review. These lagging projects will be approved by CMS later than June, as CMS has 45 days from when HHSC submits the projects.
      • HHSC will send final versions of the projects to providers and anchors after they are submitted to CMS.
      • Category 3
        • HHSC will continue Category 3 selection review and will continue with TA as needed to prepare for the next step of establishing baselines for October reporting.
        • The final Category 3 compendium versions will be released with the revised RHP Planning Protocol, which is targeted for mid-June.
          •  Updates will include benchmarks where possible, shift of measures from QISMC to IOS and minor clarifications to specifications based on the questions we have received.
          •  When possible HHSC will provide any updates when measures are categorized as QISMC or IOS as well as any updates to benchmark values during the review period in the Category 3 feedback to providers.
          • Category 4
            • RD 5: We have received some questions from providers on this measure and have found a discrepancy in the RD 5 measure specifications on the NQF site.
              • More information available in the attached notes
              • Statewide Learning Collaborative
                •  The event is scheduled for September 9 & 10 at the AT&T Center in Austin.
                •  We are planning for 500 participants at the Center and web-streaming for those not attending in person and will work with Anchors on the number of in-person participants that will be invited from each RHP. At this time Anchors and DSRIP providers can plan for 1 in-person participant each, at a minimum.
                • A survey is in development for DSRIP participants and other stakeholder feedback for the agenda and look forward to your insights.

April 16, 2014

 

Some reminders about April reporting for your documents and templates:

  • Reporting is due to Deloitte by 5:00 pm on April 30 – late reports won’t be accepted.  There are 3 methods of submission (email, CD, or FTP site – refer to the companion document for detailed information on both)
    • Also sending, at a minimum, the April & DY2 reporting templates
    • Do not report anything as achieved unless you can clearly document it was achieved prior to March 31, 2014.
    • All projects, milestones and metrics, including DY2 Carry-forward, are required to report bi-annually on a status of performance, accomplishments, lessons learned, etc.
      • If this is not provided, future payments may be delayed.
      • Clearly highlight and showcase the dates of achievement in your supporting documentation.  This is a new requirement and something that can easily be overseen, but will be important to HHSC.
      • Don’t forget to reference the page numbersin your supporting documentation in your HHSC coversheets – this is also new and will be important to HHSC.
        • HHSC cover sheets are only required for projects submitting supporting documentation for payment (be sure to use the newest version with the QPI metric as number 1)
        • For DY2 – Category 3 carry-forward milestones please complete the DY2 Category 3 Status report
        • Refer to the Companion document and posted recordings of the webinar on HHSC’s perspective of milestones that can and can’t be reported in April
        • Review the PHI information in the companion document for what to exclude from supporting documentation
        • If reporting on learning collaborative milestones, be sure to include your lessons learned  from your participation
          • If you do not have the items (agendas, sign in sheets, etc.) from any RHP 10 activity please let us know so we can re-provide that for you.  

 

Linked In:

Region 10 now has a LinkedIn group and encourages you to engage with each other as providers and stakeholders in the Waiver.  Click here to join the group and start further connecting with each other.

 

Learning Collaborative Webinars:

The PowerPoints for the two webinars being held on April 17th at 10:00 and 11:00 am are attached.

 

Care Transitions:

Meeting Number: 570 156 394

Meeting Password: CareTransitions1

1. Go to https://jpshealth.webex.com/jpshealth/j.php?MTID=md0dc9ed5e8254b3dd8dc784c8fd10ec2

2. If requested, enter your name and email address.

3. If a password is required, enter the meeting password: CareTransitions1

4. Click "Join".

5. Follow the instructions that appear on your screen.

6. Provide your phone number to receive a call back to hear the audio for the session.

 

Behavioral Health:

Operational Integration – Strategies for Developing Workflows; Maturing your Program – QI

Meeting Number: 576 975 243

Meeting Password: Integration123

1. Go to https://jpshealth.webex.com/jpshealth/j.php?MTID=mcd6ebe6dca21109b25ece65a350a51f5

2. If requested, enter your name and email address.

3. If a password is required, enter the meeting password: Integration123

4. Click "Join".

5. Follow the instructions that appear on your screen.

6. Provide your phone number to receive a call back to hear the audio for the session.

 

 
April 11, 2014

 

Anchor Call notes from 4/11/14 have been posted.  Below are some key areas to reference:

 

  • July may be the last opportunity for a project to submit a plan modification for DY4 - 5. 

April DY3 Reporting

 

  • April DY3 reporting instructions and templates, including the QPI template, have been posted on the waiver website. As a reminder, reports will be due to Deloitte by 5:00 p.m. CST on April 30th
  • An updated version of the DY 2 Carryforward Template has also been posted today (noted as updated 4/11/14).  If you have DY2 carry forward metrics please access the revised template.
  • As a reminder, do not report a Category 1 or 2 metric as completed until it is completed.

IGT for DSRIP monitoring

  • In June, HHSC Rate Analysis will notify IGT Entities of the IGT required for DSRIP payments and DSRIP monitoring. The file will allow IGT Entities to enter the actual IGT amount to transfer and calculate the amounts for DSRIP payments versus DSRIP monitoring. IGT Entities must enter the correct IGT amounts in two separate categories in HSAS by RHP, otherwise payments may be delayed
  • HHSC plans to send DY3 monitoring amounts by DSRIP IGT entity to Anchors soon. HHSC may determine that the full $5M is not required for DY3 and will keep you informed once we have a final determination. For the monitoring amount for DY3, HHSC is planning to request all of it in July (this is an update from what we included in the April reporting webinar

New 3-year Projects

  • Region 10 is scheduled to receive feedback this week so please be prepared for that
  • CMS will not be reviewing Category 3  for 3-year projects at this time.
  • If an RHP returns a project to HHSC with significant changes (not requested by HHSC) or without addressing the issues raised by HHSC, that project's CMS approval likely will be delayed as HHSC works with the provider to further explain and clean up the project.

Category 3

  • The review has started and preliminary review should come out late April to late May
  • Providers will have 10 business days to respond to this initial round of feedback, either providing the additional information requested by HHSC -or- confirming HHSC’s understanding of the use of the measure. (Providers may request extensions due to competing deliverables).  All providers will receive feedback and will be required to respond, even if just to confirm the measure selection.
  • The final Category 3 compendium versions will be released with the revised RHP Planning Protocol, which is targeted for mid-June

Category 4

  • For Domains 1 & 2 (PPAs and PPRs), HHSC will receive the reports from the Texas EQRO (ICHP) by April  15 and we will send individually to providers to the email we have on file for you as soon as possible after that date. The data will include all Medicaid (FFS and managed care) and CHIP.
  • RD 5: We have received some questions from providers on this measure and have found a discrepancy in the RD 5 measure specifications on the NQF site. The intent of the measure per the measure steward is to find “the median time from admit decision time to time of departure from the emergency department (ED) for ED patients admitted to inpatient status.” NQF incorrectly states this measure as having a traditional numerator and denominator, both of which are described as the same continuous variable and, if used as described, would always result in a rate of 100% and not provide any detail about the number of admissions from the ED considered in the calculation. We are posting a revised template and are asking for the following information.
    • Median Time (in minutes) from admit decision time to time of departure from the emergency department for admitted patients
    • Number of emergency department (ED) patients seen and used to calculate median time in minutes from admit decision time to time of departure from the ED for admitted patients.
    • UC hospitals are also required to send Domains 1 & 2 to be eligible for DY 3 UC payments. We will advise the date for those reports to be provided to HHSC.
    • UC hospitals are also required to send Domains 1 & 2 to be eligible for DY 3 UC payments. We will advise the date for those reports to be provided to HHSC.
    • UC hospitals are also required to send Domains 1 & 2 to be eligible for DY 3 UC payments. We will advise the date for those reports to be provided to HHSC

Category 4- RD-6

HHSC is working to clarify with CMS if providers may report on only the minimum required measures in Domain 6 of  Category 4 – or ALL measures in Domain 6.  At this time, HHSC recommends to all providers to hold off on reporting Domain 6 in April and waiting until October when a concrete decision and guidance has been given.  Providers may still report on Domains 1, 2, 4 and 5 in April if they are ready.  Providers may reference the Category 4 information in the DY3 Reporting Companion document.

 

Region 10 LC Measures Reporting

This is a reminder that monthly measures for the Learning Collaboratives are due this week.  The website was down briefly this morning, but has been fixed now.

 

DY3 Reporting Webinar by HHSC

Region 12, anchored in Lubbock, recorded the DY3 Reporting Webinar hosted by HHSC.  It is available here: http://www.texasrhp12.com/index.php/news.  HHSC also had the webinar recorded, however, their vendor won’t have the recording available until the next week or two on the HHSC website.

 

RHP 6 Learning Collaborative and Summit

Region 6 is hosting a two day learning collaborative and summit in San Antonio in May.  Below is their email invitation and here is a link to their website www.TexasRHP6.com.  There looks to be a robust agenda prepared.  You will find a draft attached.  Region 10 provides are welcome to attend.

 

April 8, 2014

I hope you were able to join the HHSC webinar this morning regarding DY3 April Reporting.  HHSC has updated 3 of the documents since last Friday.  Please note these are the most recent versions of these particular documents and should be used:

 

-Companion Document

-DY3 Reporting HHSC coversheet (with Metric 1 for QPI use only)

  • This only needs to be completed for projects that are reporting for payment only

-Cat 3- DY2 Status Report template

 

General Reporting Reminders:

 

  • Please provide the Anchor access to your reporting templates and supporting documentation after they are submitted to Deloitte.  This allows us to understand the general performance of the RHP as well as produce required reports for HHSC.
  • To make sure your templates automatically calculate payment performance and all elements of the Reporting Workbooks function correctly make sure to set your formulas to automatically calculateIf you have had one-off communication with HHSC regarding subsets or plans for certain Category 3 outcomes make sure to highlight this communication and decisions in the Cat 3 selection tool
    • File - Options - Formulas - Calculation Options -  Workbook Calculation - Select Automatic
    • DY3 – Category 3 Status template
      • Be sure to include thoughtful and thorough responses in this template
      • Make sure you are referencing the recently selected new Category 3 templates
        • You only reference DY2 Category 3 outcomes if you have a DY2 carry forward milestone
  • Know these tools will be utilized in the final approval of selected Category 3 outcomes in March
  • Dates & baseline (pre-DSRIP)
    • HHSC wants to ensure that supporting documentation clearly shows the dates milestones were achieved as well as provides a clear vision of the baseline / pre-DSRIP activities
    • The companion document gives detailed information and examples of these items
    • If you have a DY2 milestone that was reported as achieved, and approved for payment, and now the project has had a change for some reason à be sure to highlight and changes or updates from previous DYs in the current reporting template “Challenges” section of each project tab
    • QPI template will be posted on the HHSC website later this week – HHSC is encouraging but not requiring providers to use this template in April (will be required in October).  This template would be filled out once per project per provider.
    • If you submit reporting questions directly to HHSC, please copy the Anchor so we can understand what questions you have and how HHSC responds.
      • Please note that April 23 is the final date to ask HHSC questions regarding April reporting or to alert them of problems/ errors in your reporting workbooks.
      • If you are not requesting payment for a metric you are not required to provide supporting documentation
      • For Category 4 – place “All payer” numbers in the actual cells for reporting; place “Medicaid only” information in the narrative portion.  Remember there will be a certification process for Category 3 and 4 information in October DY3 reporting.
      • Do not submit QPI or any metric if you have not fully achieved it by March 31, 2014

 

If you would like the Waiver Office to review any supporting documentation prior to turning it in, please make that request to rhp@jpshealth.org and schedule time with us to review that information.  This is not required. 

 

As always, please let us know if you have any questions or concerns.

 
April 4, 2014

As of this morning, HHSC has posted the reporting documents for DY3 April Reporting.  You can access all of the files at this link: http://www.hhsc.state.tx.us/1115-Waiver-Guideline.shtml

 

  • April DY3 Reporting Templates. Within each region's zip file are individual provider templates.
    • http://www.hhsc.state.tx.us/1115-Waiver-DY3-Templates.shtml#April2014
    • April DY3 Reporting Companion Document
      • Attached
      • April DY3 Reporting Workbook Instructions
        • Attached
        • Reporting Coversheet Template  
          • All providers should complete the coversheet at the project level, for each Category 1 or 3 project being reporting during the DY3 reporting period. This coversheet may include DY3 carry-forward metrics as well as DY3 metric achievements. Providers will use this template to clearly explain where supporting information can be found and how supporting documentation submitted during this period demonstrates achievement of metrics. Providers do not need to submit a coversheet for Category 3 or Category 4 projects, but will need to complete the required templates for those Categories.
          • Category 3 DY3 Status Update Template
          • Category 4 Reporting Template  
          • DY2 April Carry-forward Reporting Template
          • Category 3 Carry-forward – Cat 3 DY2 Status Report Template
          • IGT Entity Feedback Template

 

  • All providers are required to provide semi-annual report information in the April DY3 Reporting Template for every project regardless of whether the milestone/metric is being reported for payment in April. DSRIP payments may be withheld until the complete report is submitted.
  • Performing Providers must report 100 percent completion of a metric on projects to be eligible for payment. Refer to the April DY3 Reporting Companion Document for calculation examples.
  • Refer to the April DY3 Reporting Companion Document for details on reporting on each Category.

  • April 30, 5:00pm – Due date for providers’ April DY 3 DSRIP reporting using the DY 3 Reporting Template and/or DY2 Carryforward Reporting Template and applicable QPI, Category 3, and Category 4 templates. Late submissions will not be accepted. Please submit the completed template and supporting documentation using one of the following:

  • Email the completed files to DSRIP@deloitte.com (files may not exceed 5MB, please zip large files) with SUBJECT: RHP [XX], Provider [TPI: XXXXXXXXX]; or
  • Email a link(s) to the files to DSRIP@deloitte.com if you have access to an FTP site (e.g. SharePoint, Dropbox) with SUBJECT: RHP [XX], Provider [TPI: XXXXXXXXX]; or
  • Mail a CD containing all files to:

 

Tim Egan

50 South 6th Street, Suite 2800

Minneapolis, MN 55402

 
April 3, 2014

 

Learning Collaborative Webinars:

 

Care Transitions: 10:00-11:00 à Provider Presentations: THR Azle and Baylor

Meeting Number: 570 156 394

Meeting Password: CareTransitions1

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To join this meeting (Now from mobile devices!)

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1. Go to https://jpshealth.webex.com/jpshealth/j.php?MTID=md0dc9ed5e8254b3dd8dc784c8fd10ec2

2. If requested, enter your name and email address.

3. If a password is required, enter the meeting password: CareTransitions1

4. Click "Join".

5. Follow the instructions that appear on your screen.

 

Behavioral Health: 11:00-12:00 à Dr. Miller to present

 

Meeting Number: 576 975 243

Meeting Password: Integration123 

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To join this meeting (Now from mobile devices!)

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1. Go to https://jpshealth.webex.com/jpshealth/j.php?MTID=mcd6ebe6dca21109b25ece65a350a51f5

2. If requested, enter your name and email address.

3. If a password is required, enter the meeting password: Integration123

4. Click "Join".

5. Follow the instructions that appear on your screen.

 

Hope you can join us for these presentations!  Thank you as always for your engagement and support of the Learning Collaboratives in respect to your DSRIP projects! 
 
March 25, 2014

 

Monitoring Contracts

HHSC has released two solicitation documents HHSC has issued to procure DSRIP monitoring contract services.   HHSC is working to procure two separate DSRIP monitoring contracts through the Comptroller’s TXMAS (Texas Multiple Award Schedule) pre-approved vendors list. 

  • The first contract will be for the required mid-point assessment this year and ongoing compliance monitoring of the DSRIP projects.   HHSC is working to get that contract in place by May. 
  • The second contract will be for financial monitoring related to the certifications required in instances where IGT is put up for a private DSRIP provider. This contract is scheduled to be in place by October.

 

Both of these documents are also in the document library page.

 

In the next couple of weeks, HHSC will be distributing information on each DSRIP IGT entity’s share of the $5 million IGT that will be collected for monitoring for DY3.

March 23, 2014

 

The final results of the Phase 4 Plan Modifications and Priority Technical Corrections (this has updated mielstone tables for all years DY3-5). The file include all dispositions, from the initial Phase 4 submission in December 2013 as well as responses to HHSC requests for information (NMI) in February 2014. HHSC has also attached the Final Phase 4 Master Summary file for RHP10. The Final Phase 4 Master Summary for each RHP will be posted this week on the HHSC website on the Tools and Guidelines for Regional Healthcare Partnership Participants page under Phase 4 Regional Folders and Documents. 

 

Notes regarding final Phase 4 results:

  • HHSC did not approve changes to QPI goals without a Plan Modification request. If a provider indicated that they will submit a Plan Modification at a later time, then HHSC changed the QPI goals back to what was originally submitted in Phase 2 – QPI. 
  • HHSC has also updated the Phase 4 QPI metrics to include the increased Medicaid/low income uninsured percentage that was included in the DY4-5 valuation coversheets. During DY4-5 reporting, the QPI goal as well as the Medicaid/low income uninsured percentage must be met for the metric to be eligible for payment.
  • CMS may still review certain plan modification requests and add additional projects to the midpoint assessment review.
  • DY3 milestones and metrics are final and may not be changed at this time. Providers may submit Plan Modifications for DY4-5 milestones and metrics in July 2014. This may include changes to Category 1-4 as well as narrative changes. 

 

Category 4:

Please review the Category 4 Contact file for those that should receive Category 4 information for Domains 1 and 2 for your organizations. These hospital contacts were pulled from the updated Section I contact information gathered earlier this year. This list will only be used for the purpose of distributing the Category 4 PPA and PPR data reports for each hospital provider.  

 

Please include all contacts that will need to receive this report and delete those who will not. HHSC does not plan to send encrypted, so no individual PHI is included. However, if a hospital requests that HHSC send encrypted, HHSC will accommodate the requests.

 

Please submit your updated Category 4 Contact list the Region by 12:00 noon Friday, 4/4 with subject: Category 4 Contacts. HHSC plans to notify the anchors when the  Category 4 PPA and PPR data reports are sent to the providers to help ensure delivery.

 
March 21, 2014

Anchor call notes are posted on the Anchor Call Notes page

 

Hightlights:
April DY3 Reporting

•  HHSC is currently finalizing the April DY3 reporting templates and updating the Companion document that contains instructions and examples.

•  Providers will also be able to report on DY2 metrics that were carried forward for late achievement. Providers will report that on a separate reporting template from the DY3 reporting template.  Both templates will be provided in the coming weeks.

• There will be separate forms to attach for reporting on QPI metrics, Category 3 Status reports (DY2 and DY3), and Category 4.

• HHSC plans a webinar for early April (likely Tuesday, April 8th) to specifically focus on reporting of carry-forward, QPI metrics, Category 4, and Category 3 status update. The webinar will not include information on documentation for specific metrics. We ask that providers send these types of questions to the waiver mailbox.

 

Phase 4

• HHSC plans to provide results of Phase 4 NMIs in late-March along with the final milestones and metrics tables for each region.  Note that HHSC did not approve changes to QPI goals without a Plan Modification request. If a provider indicated that they will submit a Plan Modification at a later time, then HHSC changed the QPI goals back to what was originally submitted in Phase 2 – QPI. 

 

New 3-year projects

• HHSC plans to send feedback for other RHPs over the next month. Providers should plan to address the HHSC feedback in March - April.

• HHSC has gotten some questions from providers regarding when CMS will approve 3-year projects.  All RHPs will receive CMS feedback by June if HHSC is able to submit them by early May, which is our goal.  CMS prefers that HHSC submit all the 3-year projects in either 2 or 3 batches (which triggers the CMS 45-day review timeframe).  HHSC plans to submit the projects for the first 4 RHPs to CMS next week.

  • HHSC believes that most projects will receive CMS approval (as was the case for replacement projects and also initial projects), but it's up to each provider to decide whether to begin implementation prior to formal CMS approval.
    • HHSC is going to look into flexibility around implementation in DY3 requirement vs. the delayed approval timelines.  They do not have a definitive answer yet, and remind providers of the carry forward policy as well as plan modification opportunities.
    • There is much more detailed information in the attached notes

 

Category 3

• Given the volume of Category 3 measures that require prior authorization, HHSC will not be able to review by April 1st as planned. HHSC will review Category 3 measures over the next several months and will provide feedback to providers either confirming selection or requesting additional information.  During this feedback period, providers may make changes to their Category 3 selections at the request of HHSC. 

• Those providers who did not submit by the 3/10 deadline will submit by March 31st to report status in the October reporting period.

• HHSC will continue review and will continue with TA as needed to prepare for next step of baseline for October reporting.

 

Category 4

•HHSC is working on templates and additional guidance for Category 4 reporting for April 2014 on domains 1, 2, 4, 5 and 6, if applicable.

• For Domains 1 & 2 (PPAs and PPRs), HHSC will receive the reports from Texas EQRO (ICHP) by April  15 and we will send individually to providers to the email we have on file for you as soon as possible after that date. The data will include all Medicaid (FFS and managed care) and CHIP.

• Given the delay in providing data CMS has agreed for domains 1 and 2, providers will not be required to include a qualitative report.  Reporting for Domain 3 begins DY 4. (Potentially Preventable Complications). The qualitative report will be required for Domains 4 and 5; as well as 6, if applicable.

• UC hospitals are also required to send Domains 1 & 2 to be eligible for DY 3 UC payments. We will advise the date for the reports to be provided to HHSC

 

Attached also is the list of Category 4 RD 6 optional measures for adults and children.  Many of the measures are ambulatory and hospitals may not be collecting this data.  In this draft, HHSC has marked those measures with an asterisk (*).   HHSC plans to propose to CMS that only hospitals that have outpatient clinics would report these measures, so this is not yet finalized.   A link to the measure specifications is also included in the file for both adult and child measures.

 

 

Key Upcoming Waiver Dates

o By March 28, 2014 – HHSC submits New 3-Year Projects to CMS (those that will be eligible for April reporting – limited number of regions).

o April 2014 – First DY3 (or carry forward DY2) reporting opportunity.

o April 30, 2014 – April DY3 milestone/metric achievement (or carry forward DY2) reporting and Semi-Annual Progress Reports due from providers. IGT Entity Change Forms for July DSRIP payments due from providers.

o May 16, 2014 – Due date for IGT entities to notify HHSC of any issues with affiliated providers’ reports.

o By mid-May 2014 - HHSC submits last batch of 3-year projects to CMS for review.

o Early June 2014 – HHSC approves April reports or requests additional information from providers.

o By June 2014 - CMS approves 3-year projects.

o July 2014 – RHPs submit plan modifications for DY4-5.

o TBD – Full RHP Plan submission to HHSC (July 2014 or later).

o July 9, 2014 – Estimated IGT due date for approved April milestone/metric achievement and DY3 monitoring.

o Mid-July 2014 – Providers supply additional information if necessary following April reporting.

o July 31, 2014 – Estimated payment date for April reporting.

o Mid-August  2014 – HHSC reviews and approves or disapproves additional information submitted by providers following April reporting.

o  September 9-10, 2014 - Tentative dates for annual statewide learning collaborative in Austin.

 

Other opportunities around the state of interest:

 

  • RHP 12 Learning Collaborative Event in Lubbock – April 16: http://www.texasrhp12.com/index.php/regional-learning
  • RHP 9 Learning Collaborative Cohort Meetings in Dallas – March 26-27 (If you would like more information let me know)
    • March 26, 9am to 12pm:  Access Cohort
    • March 26, 1pm to 4pm:  Behavioral Health Cohort
    • March 27, 9am to 12pm:  ED/Readmissions Cohort
    • March 27, 1pm to 4pm:  Chronic Disease Cohort
    • RHP 9 Speaker Series – May 28 -  Local speakers will address 4 topics common to our DSRIP projects.  (Agenda Attached)
    • RHP 6 Summit & Learning Collaborative: May 21-22 http://www.texasrhp6.com/rhp6-summit/

 

RHP 6 makes a song about Category 3!!!

 

In appreciation for Region 6’s continued commitment to improving health and transforming care through the 1115 waiver, RHP 6 has put together a special treat we think you will enjoy. Technical note: Video and sound are best viewed on a PC since it is a wmv file. If you are viewing on an iphone or ipad you may just hear the sound-- which is good, but the experience is much more fulfilling when the video is also playing. 

 

http://texasrhp6.perflogic.com/document?s=PFN0cj4KMDA1Ni8wMDAwMDAxMjIyLzI3NC93bXYKPC9TdHI%2bCg%3d%3d

 

 
March 19, 2014
 

The Region 10 email distribution list received calendar invitations for the two Learning Collaborative Webinars scheduled for tomorrow March 20, 2014.

 

  • 10:00-10:50 will be the Care Transitions webinar
  • 11:00-11:50 will be the Behavioral Health webinar

 

Going forward, these webinars will occur on the 3rd Thursday of every month, except September.  You can follow up on the website for more information as well!

 

Everyone is welcome to join for both, or just the one that best fits your project needs.  * Please note: to join both, you will have to call in again and join a separate WebEx session * This is to encourage a clean start and end to each content session as well as hopefully avoid call-in interruptions during the webinars.

 

The specific call-in and WebEx information is located in the calendar invitations.  If you do not have this information please let us know and we will get it to you.

 

Thank you in advance for joining the webinars and your continued involvement in the Region 10 Learning Collaboratives.  As always, your feedback is welcomed and valued so please let us (Gillian, Rehana, and I) know how we can best serve you as your Anchor in this experience.

 
March 7, 2014
Anchor call notes from today have been posted.  Some key items to note are:
 
April DY3 Reporting:
  • Will not move to online reporting; this change will most likely occur in October.  HHSC will stay with Excel templates as in August and October for April reporting.
  • HHSC will provide an updated companion document and instructions
  • There will be separate forms to attach for reporting on QPI metrics, Category 3, and Category 4
Phase 4:
  • HHSC plans to provide results of Phase 4 NMIs in mid/late-March along with the final milestones and metrics tables for each region. 
  • Additional plan modifications for DY4-5 will be accepted in June/July 2014, including for Category 3 if needed

3-year Projects:

DY4-5 Valuation:
  • Projects that provided qualitative justification for original DY 4/5 valuation are still under review.  A formal CMS decision on these 14 projects is expected in March, and HHSC has sent those CMS outlier projects that sought to justify their original valuation to CMS for review.

Category 3:

  • There is substantial information regarding the Category 3 submission process, Category 3 next steps, and general FAQs from all of HHSC’s Category 3 technical assistance over the last week. 
  • Review and  please submit any questions you may continue to have. 
  • Category 3 is due to Deloitte by 11:59 pm Monday March 10 and please copy the anchor rhp@jpshealth.org.  if you are not going to submit by March 10 please email HHSC and alter them as well as copy the Anchor.
 
 
March 4, 2014

The HHSC Waiver team continues to send outcome measure compendium information to Anchors as soon as batches are completed. This information is  to assist providers in completing the Category 3 selection tool. HHSC is also updating the waiver website on a regular basis (http://www.hhsc.state.tx.us/1115-waiver.shtml). As another resource for providers, RHP 6 has made their website available with the latest Category 3 information, including the updated measure compendium information : http://www.texasrhp6.com/category-3/.

 

Many Anchors have requested TA sessions with HHSC. In addition, HHSC has scheduled  2 TA calls as follows for providers in RHPs without a scheduled call:

 

  • 9 - 10 am Wednesday, March 5
  • 9-11 am Friday, March 7

 

Conference Call-in Number

 1 877 226-9790

Access Code: 3702236

 

Questions can be submitted in advance by sending to Sandra.Frazier@hhsc.state.tx.us. We will respond to these questions first, then take additional questions as time permits.

 

As a reminder, Category 3 selection tools timeline is as follows:

****In order to be able to earn a portion of Category 3 DY3 funds in the April 2014 reporting period, providers will submit the completed template for all Category 1 and 2 projects to Deloitte no later than Midnight (CST) on March 10, 2014 (cc Anchor). Otherwise, the completed template must be submitted to Deloitte not later than Midnight (CST) on March 31st. Submissions should be emailed to DSRIP@Deloitte.com with a cc to the Anchor. Email subject lines must follow this format: TPI. Provider Name. Category 3 Selection Tool. Date of submission.

 

 
February 28, 2014
If you had to report more information for DY2 October reporting, HHSC has finished reviewing resubmitted inforamtion and should contact providers by email.  If you were expecting an email and did not receive one, please let us know at RHP@jpshealth.org
 
 
February 26, 2014
HHSC has released the Companion Document for Category 3.  This is available via email as well as in the documents library.
 
 
February 24, 2014

HHSC has distributed the Category 3 selection template.  Use the first tab to populate the rest of the tool for your organization.  The recorded webinar from HHSC as well as the selection tool can be found on the HHSC website here: http://www.hhsc.state.tx.us/1115-waiver.shtml

 

 
February 21, 2014

The latest Anchor Call notes have been posted and are available for reivew.  Some major points to note are:

DY2 October Reporting Review

  • October DY2 reporting review of responses to the metrics that were in need of more information (NMI) has been completed.

Phase 4 Review

  •  HHSC is currently working on finishing reviewing NMI metrics and will respond to providers soon.

3-year Projects

  • HHSC is currently working to review 3-year project plans.  Two RHPs will receive feedback this week.

Category 3

  • The Anchor call notes have many detailed updates regarding Category 3, including date, time, and log-in information for multiple Category 3 Technical Assistance Calls coming up.
  • The powerpoint for the state-wide TA webinar can be found on the documents library along with a summary of key points regarding Category 3 changes.
  • HHSC has created a 'brief' Category 3 menu, which has been emailed out to the Region and can be pulled down from HHSC's website here: http://www.hhsc.state.tx.us/1115-Waiver-Guideline.shtml 


February 18, 2014

The latest Category 3 information available is in a PowerPoint in the Document Library titled Category 3 Updates and Reporting Tool Overview.  HHSC and the Texas Council hosted a webinar today for Community Mental Health Centers; this webinar was recorded and should be available on the HHSC website this week.  In this webinar they reviewed the Category 3 protocol updates and provided a preview of the HHSC selection tool that will be used to select and validate Category 3 outcomes in the coming weeks.

 

HHSC has not released the tool for each provider yet, and expects the tool and other supporting documents for Category 3 (Compendium, revised PFM, etc.) to be available by this Friday February 21. 

 

In this presentation there is an outline of the protocol information you have as well as an overview of the selection tool.  HHSC will walk through the protocol, selection too, and supporting documents on their webinar next Monday February 24, at 1:30 pm. 

 

If providers within the Region feel there is a need for more technical assistance and support from the Waiver office after the HHSC webinar we can schedule a conference call or webinar for the group next week.   

 

HHSC has not decided if tools will be submitted through the Anchor or from providers straight to Deloitte.  HHSC has said they will make this decision by this coming Monday.  Please note that if tools must be submitted through the Anchor your deadline will be prior to March 10 so that the Anchor can combine all of the tools and submit to HHSC accordingly. 

 

Please review the document and let the Waiver Office know if you have any questions.

 

February 14, 2014

 

Category 3

  • Category 3 Alternate Improvement Activities: a description of Stretch Activities and one for Priority Population Focused Measures are availble online. The new Priority Population Focused Measures spreadsheet includes tabs for Hospital PPE measures, Community Mental Health Center (CMHC) specific measures, and Physician Practice specific measures. These documents will also be updated on the website. 
  • The selection tool, companion document and additional resources around outcome selection, measurement and reporting will be available next week from HHSC.

 

3-year Projects

  • As mentioned previously, HHSC is prioritizing review of new 3-year projects from the four RHPs not able to use much of their DSRIP allocation in the original plan submission (RHPs 5, 8, 17 and 20).
  • RHPs 8 and 17 will be receiving feedback today (2/14/14) and the other two early next week.  The feedback will be provided to anchors with the expectation that anchors will coordinate with providers (providers will also be receiving a copy of the email from HHSC). Workbooks will be posted on the waiver website as soon as possible once an RHP has been notified.  Feedback will be at the provider level and project level.  Please read and follow the instructions carefully! 
  • There is still no specific target date for other regions