Monthly Archive: May 2016

May 27

5/27/16 Anchor Update

Good afternoon Region 2,

HHSC cancelled the Anchor Call for this week, but did send out the email below.  Please note that MSLC is currently sending out notification of newly selected Category 1 and 2 projects being selected for review, with Category 3 selections coming shortly.

Of special interest is the information regarding the upcoming Statewide Learning Collaborative.  Please see the notes below regarding the call for nomination to highlight while we’re in Austin, as well as the attachment needed to submit a project for consideration.

As a reminder, the Anchor Office will be closed on Monday for Memorial Day.  We’ll be back Tuesday morning and able to assist if needed.

 

Susan Seidensticker, BSIE, MSHAI, CPHQ, CSSBB, PMP
Director, Waiver Quality Operations
University of Texas Medical Branch (UTMB)
409-766-4041
smseiden@utmb.edu

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

Anchors –

Happy Friday!  Just a couple of updates for you today.

Compliance Monitor

  • MSLC started sending out notifications to providers for Cat 1 & 2 Validation Round 2 (DY3 carryforward and DY4 metrics).
  • You provided a lot of feedback on how to improve communication with MSLC, and based on that, MSLC will be providing the following updates to anchors:
    • MSLC will send anchors a list of projects selected for Cat 1 & 2 Validation Round 2 around June 1st.
    • MSLC will send anchors a list of outcomes selected for Cat 3 Performance around the first week of June.
    • MSLC will provide a monthly update to anchors for both Cat 3 Performance and Cat 1 and 2 Validation at the end of every month starting in June.

2016 Statewide Learning Collaborative

  • We are working on the agenda for the 2016 SLC, and we’d like your help.  Attached is a form for you to use to nominate outstanding projects to potentially highlight in peer-to-peer and/or outcome discussions during the SLC.  The categories of the projects we are looking for are described in the form.
  • We would appreciate the forms back by June 10th, but if you need additional time please let us know.

We will keep you updated on any feedback we get from CMS on our proposals for DY6 and other waiver extension discussions. Please let us know if you have any questions.  HHSC will be closed on Monday (5/30) for Memorial Day. We hope you have a fun and safe holiday weekend.

 

Healthcare Transformation Waiver Operations
Medicaid/CHIP
Texas Health and Human Services Commission

 

Permanent link to this article: https://blogs.utmb.edu/1115/2016/05/27/52716-anchor-update/

May 26

RHP 2 Meeting Agenda-Friday, July 8, 2016

Dear RHP 2 Providers & Stakeholders:

We will hold a regional meeting on Friday, July 8, 2016, from 9:30 am-2:15 pm (CST) in the Research Building 6 on UTMB’s main campus located at 301 University Boulevard, Galveston, Texas, 1st floor Research Building 6, 1.206.  Please note, the Administrative garage is now closed to public parking.  Public parking is available in the garage labeled Hospital Garage, located off 6th and Harborside Drive.  Below is the link for the UTMB campus map.  For viewing the link, it is recommended that you use Google Chrome or Mozilla Firefox.

During this meeting, we will be discussing several different topics related to the DY6 transition year and the opportunities for renewal/extension of the 1115 Waiver.  We are pleased to have Ardas Khalsa, the Deputy Medicaid CHIP Director, Healthcare Transformation Waiver, joining us for this meeting.  Ardas is a key player in Texas’ negotiations with CMS for DSRIP and UC.

For catering purposes, please RSVP your attendance to Bobbie Guyton at bjguyton@utmb.edu by COB on Wednesday, June 29th.  The agenda is attached.  Thanks.

http://www.utmb.edu/map

 

Craig S. Kovacevich, MA
Associate Vice President,
Waiver Operations &
Community Health Plans
UTMB Health
409.766.4047 (Office)
cskovace@utmb.edu

Representing:
1115 Medicaid Waiver – RHP 2
UTMB HealthCare Systems
UTMB Community Health Plans

Permanent link to this article: https://blogs.utmb.edu/1115/2016/05/26/rhp-2-meeting-agenda-friday-july-8-2016/

May 13

5/13/16 Anchor Notes

Good afternoon Region 2,

HHSC has released the latest set of Anchor notes, as well as the slide deck from the Executive Waiver Committee meeting held earlier this week.  We’d like to call your attention to a few items of interest in the Anchor notes:

 

  • April DY5 Reporting:
    • HHSC still expects to have DY5 R1 reporting results back to providers on June 8th, with IGT settlement on July 1st.  Expected payment processing date is July 29th (unless it’s for transferring hospitals and the top 14 IGT entities – then it’s July 15th).
    • For any NMIs received, the response will be due back by July 6th, with HHSC expecting to have results back to providers on August 5th.

 

  • As per the Compliance Monitoring section on page 2:
    • If your organization has a Category 1 or 2 metric under review and it is determined that recoupment may need to occur, HHSC plans to start making those notifications in June. There will be an opportunity for Providers to respond prior to any recoupment occurring.
    • MSLC plans to start the next cycle of Category 1 and 2 reviews in May (this month); they will be looking at DY3 carry forward and DY4 metrics.  TBD as to when the next set of Category 3 reviews will begin, but it is expected to be soon.

 

  • Waiver Renewal notes begin on page 2:
    • Note the explanation on the 15-month extension and its impact on the 12-month DY6.  This clarifies the valuations available for projects.
    • There will not be a requirement to report to the Medicaid ID level for DY6.
    • Metric structure for DY6 will be the same as in prior years.
      • Category 3 will not be moving to P4R.  HHSC is still working to finalize the PY3 (DY6) targets for Category 3.  For those projects with a Stretch Activity in DY5, our office has a question in to the HHSC mailbox regarding whether or not there will be an additional deliverable required for DY6 as well.  A question was posed to HHSC during the call about a potential Category 3 reselection window but we were told that the potential for that is still on the table with CMS and should be part of the ongoing discussions.
      • Category 4 will remain the same, so the discussion around the regional Performance Bonus Pool (PBP) is being delayed for now.  HHSC reserves the right to request that work begins on the PBP in DY6.
    • HHSC will be developing a Category 1/2 sustainability template for the metric that will be reportable in DY6 R2 (October 2017), but the template has not yet been developed.  If your organization has ideas on some of the elements that you think would be helpful in a sustainability assessment, we’ve tasked Andrew Herndon (atherndo@utmb.edu) in our office to develop our suggestions on the matter; his current deadline to have something for review with the Anchor team is June 13th.
    • Projects approved by HHSC earlier this year for combination are almost certain to be good to proceed by CMS.

 

  • DY6 Rules Packet(s) information begins on page 3:
    • Packet #1 expected to go into effect June 1st.  Please note the revisions related to the project withdrawal window (as noted in the last set of Anchor notes) and Medicaid ID reporting.
    • Packet #2 expected to see revisions as HHSC continues negotiations with CMS in the coming months.

 

  • Statewide Learning Collaborative (SLC)
    • You should have received the email Thursday with the registration and hotel information.  The conference hotels may run out of the block room rate quickly, so if your organization plans to attend we strongly encourage you to make your reservations soon.
    • While it’s not in the notes, we asked HHSC during the call if members of the Clinical Champions committee were being allocated SLC spots individually.  As of now, that is not the case.

 

 

Susan Seidensticker, BSIE, MSHAI, CPHQ, CSSBB, PMP
Director, Waiver Quality Operations
University of Texas Medical Branch (UTMB)
409-766-4041
smseiden@utmb.edu

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

From: HHSC Texas Healthcare Transformation and Quality Improvement Program
Sent: Friday, May 13, 2016 3:39 PM
Subject: 5/13/16 Anchor Notes

Anchors,

Thank you for joining us on today’s call.  Attached are the notes.  Updated IGT amounts for DY5 Round 1 will be communicated to anchors on June 17th, and this has been added to the April DY5 Reporting Timeline in the notes.  I’m also attaching the slides from yesterday’s Executive Waiver Committee as requested.

Please let us know if you have any questions.  Have a great weekend!  Thanks,

 

Healthcare Transformation Waiver Operations
Medicaid/CHIP
Texas Health and Human Services Commission

 

Permanent link to this article: https://blogs.utmb.edu/1115/2016/05/13/51316-anchor-notes/

May 12

2016 Statewide Learning Collaborative Summit Registration Information

Good morning RHP 2,

HHSC has released the following information regarding the Statewide Learning Collaborative, which will be held in Austin on August 30 & 31. The details below include information on the conference hotel(s).  As in prior years, space is expected to be limited.  Each performing provider is guaranteed at least one spot; for those with 10 or more active projects (Spindletop & Gulf Coast Center) you are guaranteed two.

The Anchor Office intends to host a regional gathering (date, time and location TBD) while we are in Austin.  To help facilitate the planning, we request that:

  • Providers please let Bobbie Guyton (bjguyton@utmb.edu) know who is registered to attend as soon as the registration process is completed
  • Providers please let Bobbie know if no one from your organization will be able to attend
  • Providers please let either Bobbie or myself (smseiden@utmb.edu) know if your organization would like an additional spot if they become available

 

Susan Seidensticker, BSIE, MSHAI, CPHQ, CSSBB, PMP
Director, Waiver Quality Operations
University of Texas Medical Branch (UTMB)
409-766-4041
smseiden@utmb.edu
***************************************************************************

Dear Anchors,

Please see below the registration information for the Statewide Learning Collaborative Summit, August 30-31, 2016. As we have in the past, we felt it would be best if the invitation goes out to providers through you, since you likely know who at each entity should be responsible for coordinating their attendee(s). As specified below, 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 provider slots are separate from the 2 slots allotted to each Anchoring Entity (in your role as anchor). We will send an email to our provider d-list to let them know that their organizations will be getting registration information from the anchors.

For providers with projects in multiple regions, we propose to use the same RHP assignments as in previous years for the purposes of coordinating SLC registration:

 

RHP Provider Name
RHP 2 Burke Center
RHP 2 Spindletop Center
RHP 3 The University of Texas Health Science Center – Houston
RHP 4 Driscoll Children’s Hospital
RHP 4 Gulf Bend Center
RHP 6 Camino Real Community Services
RHP 6 Hill Country Community MHMR Center (dba Hill Country MHDD Centers)
RHP 6 University of Texas Health Science Center at San Antonio
RHP 8 Bluebonnet Trails Community Mental Health and Mental Retardation Center
RHP 8 Central Counties Services
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 11 Center for Life Resources
RHP 14 Permian Basin Community Centers
RHP 14 West Texas Centers
RHP 17 Tri-County Services
RHP 18 Texoma Community Center
RHP 19 Helen Farabee Center
RHP 20 Border Region Behavioral Health Center

Please let us know if you have any questions. Thanks so much for your assistance!

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

To:  Texas Regional Healthcare Partnership Representatives

RE:  Registration Information – Texas 1115 Healthcare Transformation Waiver Statewide Learning Collaborative (SLC) Summit/ August 30-31, 2016

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 Tuesday, August 30th and Wednesday, August 31st at the AT&T Executive Education and Conference Center.   The deadline to register is Monday, August 8th.  Seats are limited, and therefore registration is required.   Background information, as well as registration instructions, are included below.

What is the Purpose of the SLC Summit?   The primary goal of the Summit for 2016 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 the performance bonus pool and sustainability of projects.  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 and hear discussions.  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://2016slcsummit.eventbrite.com by Monday, August 8th. The registration passcode is HHSC2016.  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 $176.00 per night are available until Monday, August 8, 2016.  A limited number of Government room rates are also available at $135.00 per night.
    • For standard group room rate reservations, please CLICK HERE to complete your reservation.
    • For government room rate reservations, please visit CLICK HERE to complete your reservation.
    • Hotel information and directions can be found at the following website: http://www.meetattexas.com.
  • A second block of rooms has also been reserved at the nearby Hampton Inn & Suites Austin @ The University/Capitol. Rates are the same as above, but only available until Saturday, July 23, 2016.
  • 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

Thank you.

 

Permanent link to this article: https://blogs.utmb.edu/1115/2016/05/12/2016-statewide-learning-collaborative-summit-registration-information/

May 05

Governor Abbott Announces New HHSC Leadership

Good morning RHP 2,

I am sharing a press release related to leadership changes at HHSC.  Please see the attached. We continue to be optimistic about the Texas Waiver on the heels of the formal extension agreement announcement and the appointment of new leadership who will continue to work with CMS on behalf of the state.

Thank you.

 

Craig S. Kovacevich, MA
Associate Vice President,
Waiver Operations &
Community Health Plans
UTMB Health
409.766.4047 (Office)
cskovace@utmb.edu

Representing:
1115 Medicaid Waiver – RHP 2
UTMB HealthCare Systems
UTMB Community Health Plans

Permanent link to this article: https://blogs.utmb.edu/1115/2016/05/05/governor-abbott-announces-new-hhsc-leadership/

May 04

DSRIP – April DY5 Reporting ends tonight

Good morning Region 2,

As a reminder, the HHSC online reporting tool will lock at after 11:59:59 tonight, May 4th, 2016.  As the Anchor office reviews the regional status to date, it appears that most of you have completed your reporting for this cycle.  If you did not hit the optional “submit” button, you still have the opportunity to edit your submission today if needed; if you did hit “submit”, no further edits are allowed.  HHSC has stated that as long as the information is in the system when it locks, it is considered to be submitted.

If you’re still working on your reporting effort, please make sure to:

  • Complete the Overall Provider Summary for your organization.
  • Make sure you Category 3 template is completed and uploaded.
    • Even if you’re not submitting any Category 3 for payment, the template must be completed.
    • File is to be uploaded to the first Category 3 outcome associated with the first Category 1 or 2 project in the online reporting tool.
    • HHSC has directed that you use the following naming convention: RHP02_TPI######_Cat3_AprDY5
    • The scan of the signed certification page should be attached with the Category 3 excel template.  HHSC has not given clear guidance on if the signed version is required if you are not reporting anything for payment, but we encourage you to err on the side of caution and have this uploaded.
  • Complete and upload a coversheet for each Category 1 or 2 project submitting one or more metrics for achievement.
  • For any Category 1 or 2 QPI metric submitting for achievement, upload a completed QPI template.
  • Review all supporting documentation being submitted to ensure that no protected health information (PHI) is uploaded into the online reporting tool.
  • If your organization has associated Category 4 metrics, you must complete and upload the Category 4 template – even if you’re not submitting for achievement.

The Anchor team is available today to provide assistance if needed.

 

Susan Seidensticker, BSIE, MSHAI, CPHQ, CSSBB, PMP
Director, Waiver Quality Operations
University of Texas Medical Branch (UTMB)
409-766-4041
smseiden@utmb.edu

Permanent link to this article: https://blogs.utmb.edu/1115/2016/05/04/dsrip-april-dy5-reporting-ends-tonight/

May 02

15-month 1115 Waiver Extension Approved

Hello Region 2,

I am pleased to share with you the email sent to the Anchors this morning from HHSC.  CMS has officially approved a 15-month extension of the 1115 Waiver for Texas, which is a key stepping stone to a longer continuation of the program.  This confirms the expectation of DY6 (“transition year”) and the beginning of DY7, which is expected to be the starting point for Waiver 2.0.  As noted below, negotiations are ongoing regarding that longer extension.  Please see the attached approval letter and the Special Terms and Conditions (STCs).

The successes of DSRIP to date and the input that everyone has provided on where this is going has been extremely important in getting to this point.  The Region 2 Anchor Office wishes to thank each and every one of you for your hard work, and we look forward to even further success as the 1115 Waiver moves forward.

Thanks.

Craig S. Kovacevich, MA
Associate Vice President,
Waiver Operations &
Community Health Plans
UTMB Health
409.766.4047 (Office)
cskovace@utmb.edu

Representing:
1115 Medicaid Waiver – RHP 2
UTMB HealthCare Systems
UTMB Community Health Plans

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

Dear Anchors –

HHSC has received confirmation from CMS that a 15-month waiver extension has been approved. A longer term extension will continue to be negotiated. Please see below the press release going out this morning.  We will share the relevant documents and additional information with you very soon, but wanted to get this initial information out to you now.

The Health and Human Services Commission and the Centers for Medicare and Medicaid Services have agreed to extend a state and federal partnership that finds innovative ways to deliver healthcare.

The 1115 Waiver, which funds Uncompensated Care and the Delivery System Reform Incentive Payment Program (DSRIP), was extended 15 months under an agreement between the health agency and CMS. The agreement will take the program through December 2017 and will maintain its current funding.  Over the next 15 months, HHSC and CMS, which oversees the Medicaid program, will continue negotiating a longer term extension.

DSRIP consists of local programs working to improve health care delivery costs and outcomes. There are 1,451 DSRIP projects across 20 regions in the state. In each region a coalition of governments, hospitals and other providers are charged with coming up with novel solutions to containing health care costs while preserving access and quality. Most projects focus on increasing primary and preventative care, which not only improves outcomes, but saves money by reducing the need for expensive emergency room visits. The waiver program also helps hospitals with uncompensated care costs.

The Uncompensated Care program and Delivery System Reform Incentive Payment programs are funded through a combination of federal and local money. Both Uncompensated Care and DSRIP contribute $3.1 billion a year, each.

 

Healthcare Transformation Waiver Operations
Medicaid/CHIP
Texas Health and Human Services Commission

Permanent link to this article: https://blogs.utmb.edu/1115/2016/05/02/15-month-1115-waiver-extension-approved/

May 02

4/29/16 Anchor call notes

Good morning Region 2,

Attached please find the latest Anchor Notes received from HHSC.  The Anchor Office would like to make sure you note the following:

  • HHSC confirmed that the next round of Compliance Monitoring will begin in May (Categories 1, 2 and 3) and should be drawn from metrics reported for DY4.
  • The Anchor Notes lists the responses to several comments/requests made to Myers & Stauffer LC (MSLC).  Please note on page 2 that MSLC is telling HHSC that providers can expect a response after requests for additional information within 2 weeks.
  • HHSC updated the information on Transition Year Rule Packet #1 (effective June 1st, 2016). They intend to revise the language around continuing projects in the transition year that then decide not to continue; near the bottom of page 3 please see the new information regarding a withdrawal period between the second payment period for DY7 and the first reporting period for DY8 (likely July-September 2018).

Additionally, please note the references to the draft Transition Year Rules Packet #2, which will be discussed at the Hospital Payment Advisory Committee (HPAC) meeting  on May 5th and at the Medical Care Advisory Committee (MCAC) meeting on May 12th.  This draft rule packet #2 contains requirements for the DSRIP program transition year (to be effective September 30, 2016), while rule packet #1 (which has previously been made available to providers) is for actions in preparation for the extension of the DSRIP program (to be effective June 1, 2016).  As this is a draft, it is expected that changes will be made to this rule packet prior to its proposal in the Texas Register for public comment (tentatively scheduled for July 8). Feedback from CMS regarding the waiver extension may also result in changes needing to be made.  The main difference between the draft proposed rules in rule packet #2 and the draft Program Funding and Mechanics (PFM) protocol language posted to the waiver website for stakeholder comment in January 2016 is that HHSC has added more detail to the rules related to uses of leftover funds and anchor requirements (see Sections 354.1673 and 354.1675 of the attached).

 

Craig S. Kovacevich, MA
Associate Vice President,
Waiver Operations &
Community Health Plans
UTMB Health
409.766.4047 (Office)
cskovace@utmb.edu

Representing:
1115 Medicaid Waiver – RHP 2
UTMB HealthCare Systems
UTMB Community Health Plans

Permanent link to this article: https://blogs.utmb.edu/1115/2016/05/02/42916-anchor-call-notes/