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
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
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:
- Please check http://www.hhsc.state.tx.us/1115-waiver.shtml for information about the upcoming webinars on 4/7/2015.
- 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: email@example.com
Dear Region 2 Performing Providers and Stakeholders,
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 the formal submission (by March 31, 2015). I anticipate being able to send a more detailed update soon.
If you have any questions, please do not hesitate to contact me personally.
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 arduous at times and the reporting process somewhat grueling, the benefits and outcomes of the waiver projects are truly beginning to positively impact healthcare delivery for many of our region’s most vulnerable individuals. And, I also LOVE my job because of the people in the region that my team and I support each and every day in our role as anchor–dedicated providers and community stakeholders who are eager to work together to find innovative solutions to real, concrete needs. And, rightfully so.
Of the nearly 1.5 million individuals residing within the 16-counties that comprise Region 2, 25% of the population is uninsured and another 27% are Medicaid or Medicaid/Medicare (dual eligible) recipients. The region covers some 14,500 square miles, and much of its densely rural areas are often referred to as “Deep East Texas.” While a large portion of Region 2 is widely known for picturesque images of tall Pines, blooming Dogwood trees and freshwater lakes, the fact remains that more than 50% of the geography is designated as a Health Professional Shortage Area in primary care and mental health services. These statistics amplify the importance of waiver projects and reconfirms why performing providers within our Regional Health Partnership continue to be focused on executing well-defined, purposefully-crafted, measurable outcomes.
In traveling extensively through the region since the inception of the waiver, many similar themes have surfaced. Regardless if visiting with providers practicing in more populous counties, like Galveston or Jefferson, or trying to understand challenges from practitioners in more rural parts, like Angelina or San Augustine County, the need for better coordinated healthcare is always at the top of the “wish list.” One might think that coordinating care for people with complex, chronic conditions isn’t as difficult of a process in more metropolitan markets; but, while admittedly easier, coordination is only as successful as the system put in place. This was one of the most obvious opportunities identified in the comprehensive Region 2 Community Needs Assessment, and a key strategic focus for many regional providers like Beaumont-based, Baptist Hospitals of Southeast Texas. During the planning process, Baptist leadership quickly committed to utilizing the waiver as a means to identify, evaluate, prioritize various processes to help their most at-risk patients better navigate the healthcare system. Part of this commitment was to hire, train and deploy patient navigators: individuals who are knowledgeable about the community and its resources, sensitive to the cultural diversity of the individuals they support and capable of shepherding patients throughout the continuum of care. As a result of Baptist’s foresight to the improvement of clinical outcomes through better coordinated care, and, by their support of the 1115 Healthcare Transformation Waiver, two (2) Delivery System Reform Incentive Payment (DSRIP) projects were designed to turn the vision into reality. Within the projects, a variety of milestones and metrics were carefully crafted over a four-year period, including measures to educate and encourage targeted patients to properly utilize the appropriate healthcare channels (right care, right place, right time). As reported in the Beaumont Enterprise in November 2014 (http://www.beaumontenterprise.com/news/article/Local-navigators-steer-patients-toward-better-5920009.php#photo-7196542), individuals like Anthony Joseph, a Baptist Beaumont patient and triple-bypass survivor, have benefited from the waiver through the creation of the Baptist Smart Health Clinic and the Baptist Patient Navigation Program, both of which emphasize patient-centered care.
So, I am proud to report that it’s stories like this that provide a tangible look at the impact the waiver is making in our region and across the state each and every day. And, furthermore, it’s stories like this that make me say, “I LOVE my job!”
Permanent link to this article: http://blogs.utmb.edu/1115/2015/04/14/rhp2-dy4-april-2015-reporting-webinar-notes/
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 …
Permanent link to this article: http://blogs.utmb.edu/1115/2015/04/06/presentations-for-april-dy4-reporting-webinars/
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 …
Permanent link to this article: http://blogs.utmb.edu/1115/2015/03/31/dy3-provisional-nmi-results-april-dy4-reporting-update/
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 …
Permanent link to this article: http://blogs.utmb.edu/1115/2015/03/17/1115-waiver-updates-anchor-notes-estimated-dy4-igt-commitments/
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 …
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/
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 …
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/
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 …
Permanent link to this article: http://blogs.utmb.edu/1115/2015/01/14/cms-letter-lifting-the-uc-deferral/
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 …
Permanent link to this article: http://blogs.utmb.edu/1115/2014/12/22/1115-waiver-update-rhp-level-ppa-and-ppr-now-available/
Given the approaching holidays, I wanted to share a quick snapshot of upcoming dates and deadlines for January 2015. Please feel free to share with others in your organization who may be responsible for certain aspects of the 1115 Waiver. January 2015 – Important Upcoming Dates and Deadlines January 1 – IGT Entity Change Form …
Permanent link to this article: http://blogs.utmb.edu/1115/2014/12/22/rhp-2-january-2015-important-upcoming-dates-and-deadlines/
Dear Region 2: Thank you to our amazing and dedicated performing providers in Region 2 who collectively submitted $71,600,633 (total value) for metric achievement during the recent DY3 October Reporting Period. 169 of the 243 total submitted metrics were “approved,” with 59 “provisionally approved” and 15 flagged for “Needs More Information.” Please see additional details …
Permanent link to this article: http://blogs.utmb.edu/1115/2014/12/16/waiver-updates-and-important-information-region-2/