4/17/15 Anchor Notes

Dear Region 2 Performing Providers and Stakeholders:

Please find attached two documents:

  • [A draft payment DSRIP] (only) payment schedule.  This does not include UC payments.
  • [Notes from the HHSC call with Anchors]. Important information included is highlighted and topics are below, but please always make sure to read all notes thoroughly.
  • New Statewide Learning Collaborative Date – Now August 27 – 28.
  • DY4 April Reporting – QPI, Category 3 and Category 4. As a reminder, Category 4 is required for UC only hospitals, as well.
  • 3-year Project Change Request Update
  • DSRIP Mid-Point Assessment Status
  • Waiver Renewal Planning
  • Value Based Payments Structure Note
  • DSRIP Statewide Event Calendar request

Please let us know if you have any questions or need additional information.  Thank you.
Craig S. Kovacevich, MA

Uncompensated Care Pool

Dear Region 2 Providers & Interested Stakeholders:

In our continued efforts for full transparency, I would like to share the e-mail below, including the [attachment].  This relates to the ongoing discussion between CMS and HHSC as it applies to Texas’ Uncompensated Care (UC) Pool in the 1115 Transformational Waiver.

As additional information becomes available from HHSC and/or CMS, we will share with our regional performing providers and interested stakeholders.  Thank you.

Craig S. Kovacevich, MA
***********************

We want to make you aware of a call HHSC had with CMS this week to discuss the attached letter CMS sent to Florida on April 14th regarding the future of Florida’s Low Income Pool, which serves a similar purpose to Texas’ Uncompensated Care (UC) Pool in the 1115 Transformation Waiver. CMS requested the call with Texas, and on the call from CMS were Vikki Wachino, Tim Hill, and a representative from their general counsel’s office.

CMS said the purpose of the call was to let Texas know that for future renewal requests for UC pools CMS intends to apply the same three principles laid out in the second to last paragraph of the letter to Florida, which are listed below. (They said they’re reaching out to all states with similar UC pools.)

  1.  First, coverage rather than uncompensated care pools is the best way to secure affordable access to health care for low-income individuals, and uncompensated care pool funding should not pay for costs that would be covered in a Medicaid expansion.
  2. Second, Medicaid payments should support services provided to Medicaid beneficiaries and low-income uninsured individuals. (CMS noted on the call that this is an acknowledgement that some low-income individuals remain uninsured even with Medicaid expansion.)
  3. Finally, provider payment rates must be sufficient to promote provider participation and access, and should support plans in managing and coordinating care.

CMS acknowledged that each state and its pool is different, but they want to apply these same principles across all states. Texas’ waiver goes through 9/30/2016 and our renewal request is due 9/30/2015. They said that to inform Texas’ waiver renewal negotiations, they want to understand our UC pool better to establish a framework for negotiation. As they required of Florida, they said they would like us to contract for an independent report to help inform discussions around renewing the UC pool. We asked about our other pool in the waiver – the Delivery System Reform Incentive Payment (DSRIP) pool, and they said that while there will be negotiations and perhaps some overlapping issues around renewing the DSRIP pool, the principles above are intended to be applicable to UC rather than DSRIP.

CMS also acknowledged in the Florida letter that transition time may be required. HHSC plans to continue to work with Texas leadership and waiver stakeholders to submit a renewal proposal to CMS in September 2015 that reflects what Texas wants for the renewal period. We plan to hold a number of public meetings across the state this July to get stakeholder input on the planned renewal request that’s due in September.

 

RHP2 DY4 April 2015 Reporting Webinar Notes

RHP2 Performing Providers,

Attached are the DSRIP PHI Tip Sheet and Webinar notes as seen on April 10, 2015.

If you have any questions related to these notes, please contact your respective Management Analyst.

Thanks,

RHP Anchor Team

Presentations for April DY4 Reporting Webinars

Message from HHSC regarding upcoming Webinar.

Dear DSRIP Anchors and Providers –

Attached is a zip file [AprDY5cAT3&4Webinar-20150407], [AprDY4DSRIPReportingWebinar_201501407] and [AprDY4QPIWebinar_20150417] containing the presentations for tomorrow’s DSRIP April DY4 Reporting Webinars.   We are working to have the reporting templates posted on the waiver website by tomorrow morning.

As a reminder, here is the log-in information for both webinars:

1.       General Reporting & Quantifiable Patient Impact (QPI): Tuesday, April 7, 2015, 10:00AM – 11:30AM Central Daylight Time To join the online meeting:

1) Go to Join WebEx meeting https://hlthmgt.webex.com/hlthmgt/j.php?J=733793836
2) Click on Attend Meeting
3) Enter Meeting Number: 733 793 836 4) Call 866-430-8535

2.       Category 3 & 4 Guidance: Tuesday, April 7, 2015, 2:00PM – 4:00PM Central Daylight Time To join the online meeting:

1) Go to Join WebEx meeting https://hlthmgt.webex.com/hlthmgt/j.php?J=730881279
2) Click on Attend Meeting
3) Enter Meeting Number: 730 881 279
4) Call 866-430-8535

For both webinars, to join the audio conference only: All participants should dial 866-430-8535 (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 difficulties logging in, please try again. You may reach the waiver staff at TXHealthcareTransformation@hhsc.state.tx.us<mailto:TXHealthcareTransformation@hhsc.state.tx.us.

Craig S. Kovacevich, MA
Associate Vice President,
Waiver Operations &
Community Health Plans
UTMB Health

281.806.0347 (Cell)
409.766.4047 (Office)

cskovace@utmb.edu

DY3 Provisional NMI Results and; April DY4 Reporting Update

Dear Region 2 Performing Providers and Stakeholders:

Please see the information below from HHSC.  Thanks.

*******************************

The April DY4 DSRIP reporting season is upon us.  Please note the updates below.

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 email the waiver mailbox if you have any questions: txhealthcaretransformation@hhsc.state.tx.us

 

Apr 22

4/17/15 Anchor Notes

Dear Region 2 Performing Providers and Stakeholders: Please find attached two documents: [A draft payment DSRIP] (only) payment schedule.  This does not include UC payments. [Notes from the HHSC call with Anchors]. Important information included is highlighted and topics are below, but please always make sure to read all notes thoroughly. New Statewide Learning Collaborative …

Continue reading »

Permanent link to this article: http://blogs.utmb.edu/1115/2015/04/22/41715-anchor-notes/

Apr 22

Uncompensated Care Pool

Dear Region 2 Providers & Interested Stakeholders: In our continued efforts for full transparency, I would like to share the e-mail below, including the [attachment].  This relates to the ongoing discussion between CMS and HHSC as it applies to Texas’ Uncompensated Care (UC) Pool in the 1115 Transformational Waiver. As additional information becomes available from …

Continue reading »

Permanent link to this article: http://blogs.utmb.edu/1115/2015/04/22/897/

Apr 14

RHP2 DY4 April 2015 Reporting Webinar Notes

RHP2 Performing Providers, Attached are the DSRIP PHI Tip Sheet and Webinar notes as seen on April 10, 2015. If you have any questions related to these notes, please contact your respective Management Analyst. Thanks, RHP Anchor Team

Permanent link to this article: http://blogs.utmb.edu/1115/2015/04/14/rhp2-dy4-april-2015-reporting-webinar-notes/

Apr 06

Presentations for April DY4 Reporting Webinars

Message from HHSC regarding upcoming Webinar. Dear DSRIP Anchors and Providers – Attached is a zip file [AprDY5cAT3&4Webinar-20150407], [AprDY4DSRIPReportingWebinar_201501407] and [AprDY4QPIWebinar_20150417] containing the presentations for tomorrow’s DSRIP April DY4 Reporting Webinars.   We are working to have the reporting templates posted on the waiver website by tomorrow morning. As a reminder, here is the log-in information for …

Continue reading »

Permanent link to this article: http://blogs.utmb.edu/1115/2015/04/06/presentations-for-april-dy4-reporting-webinars/

Mar 31

DY3 Provisional NMI Results and; April DY4 Reporting Update

Dear Region 2 Performing Providers and Stakeholders: Please see the information below from HHSC.  Thanks. ******************************* The April DY4 DSRIP reporting season is upon us.  Please note the updates below. 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 …

Continue reading »

Permanent link to this article: http://blogs.utmb.edu/1115/2015/03/31/dy3-provisional-nmi-results-april-dy4-reporting-update/

Mar 17

1115 Waiver Updates: Anchor Notes and Estimated DY4 IGT Commitments

Dear Region 2 Performing Providers and Stakeholders, Please see the attached information re: [anchor notes] from March 10, 2015 and the file with the estimated [DY4 IGT commitments]. You will notice an item in the notes that HHSC recently discussed the draft transition plan for the two pools (UC & DSRIP) with CMS in advance of …

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Permanent link to this article: http://blogs.utmb.edu/1115/2015/03/17/1115-waiver-updates-anchor-notes-estimated-dy4-igt-commitments/

Feb 17

1115 Waiver Success Story: Baptist Hospitals of Southeast Texas’ SMART Health Clinic/Patient Navigation DSRIP

Dear Region 2:   If anyone would ask me if I like my job, I would have to say, “No!”  Why would I say such a thing?  Because, I would be lying if I didn’t say, “I LOVE my job!”  While keeping up with the technicalities of the 1115 Healthcare Transformation Waiver can be rather …

Continue reading »

Permanent link to this article: http://blogs.utmb.edu/1115/2015/02/17/1115-waiver-success-story-baptist-hospitals-of-southeast-texas-smart-health-clinicpatient-navigation-dsrip/

Feb 10

1115 Waiver Success Story: A DSRIP Project to Enhance Interpretation Services and Culturally Competent Care

[Attached] is an article that I am extremely proud to share with performing providers and interested stakeholders within Region 2.  It showcases one of many successful DSRIP projects under the 1115 Medicaid Waiver within the 16-counties that comprise our region.  As you will read, The University of Texas Medical Branch (UTMB) Patient Services Department made its …

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Permanent link to this article: http://blogs.utmb.edu/1115/2015/02/10/1115-waiver-success-story-a-dsrip-project-to-enhance-interpretation-services-and-culturally-competent-care/

Jan 14

CMS letter lifting the UC deferral

Dear RHP 2 1115 Waiver Stakeholders – Yesterday, HHSC received the [attached] letter from CMS that formally removes the UC deferral issued in September 2014.  As we 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.  As outlined in …

Continue reading »

Permanent link to this article: http://blogs.utmb.edu/1115/2015/01/14/cms-letter-lifting-the-uc-deferral/

Dec 22

1115 Waiver Update: RHP level PPA and PPR Now Available

RHP 2: RHP level PPA and PPR data is now available for download and review on the HHSC Waiver website (http://www.hhsc.state.tx.us/1115-Waiver-Guideline.shtml.) This is Medicaid/CHIP data from calendar year 2012, along with a descriptive summary document.   On behalf of the UTMB/RHP 2 Anchor Office team, we want to wish you much peace and joy during …

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Permanent link to this article: http://blogs.utmb.edu/1115/2014/12/22/1115-waiver-update-rhp-level-ppa-and-ppr-now-available/

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