9/15/17 Anchor Update

Good morning Region 2,

HHSC did not release Anchor notes last week; however, they did send the following email. Please note the highlighted sections.

Also, a reminder that the application for the additional DY 7&8 funds available to Region 2 is due by September 30th. Completed applications are to be sent to Andrew Herndon (atherndo@utmb.edu). The application information can be found at https://www.utmb.edu/1115/ under the September 13th section in the Important Dates.

Susan Seidensticker, BSIE, MSHAI, CPHQ, CSSBB, PMP
Director, Waiver Quality Operations
University of Texas Medical Branch (UTMB)
Shearn Moody, 9th Floor
From: HHSC Texas Healthcare Transformation and Quality Improvement Program [mailto:TXHealthcareTransformation@hhsc.state.tx.us]
Sent: Friday, September 15, 2017 3:03 PM
Subject: 9/15/17 Anchor Update

Good afternoon, Anchors –

We have several updates for you this week:

October DY6 Reporting
• HHSC is tentatively scheduling a webinar for guidance on October DY6 reporting for October 4, 2017 from 10:00 am – 12:00 pm. We will get more information out to you with specifics as soon as possible, but please save the date.
• HHSC sent out the Active Users Update file for October DY6 reporting to Anchors on Tuesday, September 9th. Anchors should submit an updated regional October DY6 Active Users file to HHSC by Wednesday, September 27th, so that HHSC can make user updates in the reporting system before the start of the October DY6 reporting period. After this deadline, providers should submit the RHP Contact Change Form (https://hhs.texas.gov/sites/default/files/documents/laws-regulations/policies-rules/1115-docs/RHP/Plans/Contact-Change.pdf) to request changes to contact information and reporting system access.
• HHSC is planning to post October DY6 reporting templates on the DSRIP Online Reporting System Bulletin Board only , instead of also posting them on the waiver website. Because we can update the online reporting system quickly, but can’t make changes to the waiver website as quickly, we don’t want multiple versions of templates accessible to providers at the same time. Providers should make sure they get the appropriate staff access to the reporting system for reporting materials. We will also add a note on the waiver website to contact the waiver mailbox for assistance if needed, and we will continue to post the companion documents and webinar presentation on the website.
• QPI data files have been updated with the most recent MSLC findings for QPI metrics that were validated as achieved. These updates include pre-DSRIP baseline changes or any date adjustments within the allowable time frames. Providers will see this updated data in the October DY6 QPI templates and as applicable, in the online reporting system.

Hurricane Response
• This week, HHSC discussed with CMS several potential changes to DSRIP DY6 reporting in light of the issues caused in many of the regions by Hurricane Harvey.
• HHSC and CMS are still determining the best way to identify providers impacted by the hurricane, and how and to whom to apply these reporting exceptions. HHSC will be reaching out to anchors of regions with counties included in the disaster declaration to help us identify impacted providers and/or projects.
• The potential reporting exceptions discussed, subject to CMS approval, are:
o Waiving the requirement for UC-only hospitals impacted by the hurricane to attend a regional learning collaborative in DY6.
o Allowing an alternate measurement period for Category 3 outcome measures for Performance Years 3 and 4, as applicable for impacted providers. This might include an 11 month measurement period instead of 12 months, or a gap in the data to account for hurricane recovery time.
o Extending the “Needs More Information” (NMI) reporting period for impacted providers/projects following the October DY6 reporting period. HHSC has proposed to extend this due date for impacted providers/projects for up to 6 weeks (ending in late February rather than mid-January) to allow providers additional time to submit additional information and still allow HHSC time to review the additional information before the April DY7 reporting period. Any NMI-approved milestones/metrics would be paid in July 2018.
o Provisionally approving and paying DY6 metrics with low risk of recoupment for impacted providers/projects that are not able to submit complete information during the October DY6 reporting period. Metrics eligible for provisional approval would be Category 1-2 milestones M-3 (Project Summary and Core Components) and M-4 (Sustainability Planning), and Category 4 reporting domains. Provisionally approved metrics would be eligible for payment with other approved metrics in January 2018. Impacted providers who receive provisional approvals for these metrics would be required to submit complete information during the extended NMI reporting period. Provisional payments would be recouped if complete information is ultimately not submitted and/or the provider does not respond to requests for additional information. HHSC is determining how providers would request provisional approval and accounting for providers that may not have IGT available to fund provisional payments.
• CMS will let HHSC know in the next several days whether they will approve these requests for DY6 reporting exceptions for impacted providers.
• Possible exceptions or changes to the proposed DY7-8 requirements are still being discussed internally at HHSC and any determinations will be made after the extent of potential issues in the regions is known, and would be subject to CMS approval.

Category 3
• The Category 3 team is updating the summary workbooks. The updated data will be posted on the DSRIP Online Reporting System Bulletin Board by COB today. Providers need to verify the summary workbooks’ accuracy and submit any errors to the waiver mailbox by COB on Friday, September 22nd.

Compliance Monitoring
• HHSC will send out remaining communication to providers for Category 1 and 2 Round 2 early next week.
• HHSC is requesting additional information for some projects from Category 1 and 2 Round 3 review where providers either Did Not Achieve the goals or results were Not Validated per MSLC. Please provide additional information to MSLC as requested.
• HHSC is still reviewing some of the Category 3 results from the Performance Review Round 2.

Renewal: Category B System FAQ
• The System FAQ will be posted to the waiver website and online reporting system Bulletin Board early next week as a reference for anchors and providers.

Value-Based Payment and Quality Improvement Advisory Committee
• The Value-Based Payment and Quality Improvement Advisory Committee will hold its next meeting on Friday, September 22nd at 10am. The meeting will take place in the Brown-Heatly Public Hearing Room. The agenda can be found at the following link, and supporting material will also be posted closer to the meeting date: https://hhs.texas.gov/about-hhs/communications-events/meetings-events/2017/09/22/value-based-payment-quality-improvement-advisory-committee.

Please let us know if you have any questions. Thanks,

Amanda Broden
Healthcare Transformation Waiver Operations
amanda.broden@hhsc.state.tx.us | 512-462-6388

RHP2 – 1115 Waiver Public Meeting

Dear RHP2 Performing Providers and Stakeholders:

To be compliant with HHSC’s instructions that were made part of the DRAFT Program Funding and Mechanics Protocol (05/17/2017), RHP2 will conduct two public meetings related to the Texas Healthcare Transformation and Quality Improvement Program (1115 Medicaid Waiver). Additional funding opportunities for both current and prospective Delivery System Reform Incentive Payment (DSRIP) providers within the region will be discussed, including specific allocation requirements set by the State. The regional allocation of additional DSRIP funds for RHP2 is valued at $2,308,000 (all funds) per Demonstration Year (DY), and is expected to align with DY7 and DY8 subject to CMS’ approval of HHSC’s additional 21-month request. RHP2 includes: Angelina, Brazoria, Galveston, Hardin, Jasper, Jefferson, Liberty, Nacogdoches, Newton, Orange, Polk, Sabine, San Augustine, San Jacinto, Shelby and Tyler counties.

Please feel free to share this notice with others who may have an interest in attending these public meetings to learn more information about the allocation process. Meeting details follow:

Wednesday, September 13, 2017
10:00 a.m.
Call-In: 877.226.9790
Access Code: 3020674

Log-In: https://www.webmeeting.att.com
Meeting Number: 8772269790
Code: 3020674

In-Person Meeting:
Monday, September 25, 2017
10:00 a.m.
Island Community Center
4700 Broadway
OLLI Suite B101, Dolphin Room
Galveston, Texas 77551
Please note this location is a change from the previously announced Beaumont location.

Should you have additional questions regarding the meeting, please contact Bobbie Guyton at 409.766.4045 or bjguyton@utmb.edu.

CANCELLED- RHP2 – 1115 Waiver Public Meeting, Friday, August 25, 2017

Good morning RHP 2 Performing Providers & Stakeholders:

Due to the upcoming inclement weather expected to hit the Galveston area, the 1115 Waiver Public Meeting scheduled on Friday, August 25th at 2:00 pm will be postponed until further notice. I will send notification as soon as we have a rescheduled date identified.

Our second public meeting is still set in Beaumont on September 25th, 855 Jim Gilligan Way at 10:00 am. Thanks.

Craig S. Kovacevich, MA
Associate Vice President,
Waiver Operations &
Community Health Plans
UTMB Health
281.806.0347 (Cell)
409.766.4047 (Office)

DY 6 DSRIP IGT Notification for July 2017 Payment Government Entities 2

Please carefully review this message in its entirety making note of the information provided which pertains to the DY6 Delivery System Reform Incentive Payments (DSRIP). Government entities that owe monitoring will need to submit two separate transactions for monitoring and DSRIP projects. Failure to do so may result in a delayed payment for the providers.

Attached are the following files: DSRIP Notification- DY6 Round 1 April 2017 Affiliation Summary and DY6 Round 1 April 2017 IGT Summary workbooks. These workbooks include DY6 DSRIP payments for DY6 Reporting (April), DY5 Carryforward Reporting, DY4 Carryforward Reporting, and DSRIP Monitoring.

The DY6 Round 1 April 2017 Affiliation Summary workbook has separate tabs for each Regional Healthcare Partnership (RHP) and contains the Intergovernmental Transfer (IGT) needed, by affiliation, for DY 6 DSRIP payments for DY 6 Reporting (April), DY 5 Carryforward Reporting, and DY4 Carryforward Reporting.

The DY6 Round 1 April 2017 IGT Summary workbook has separate tabs for each RHP and contains the total IGT needed by IGT Entity Name for the DY 6 DSRIP payments for DY 6 Reporting (April), DY5 Carryforward Reporting, DY4 Carryforward Reporting, and DSRIP Monitoring.

Providers can determine their estimated payment amount by dividing Column N of the DY6 Round 1 April 2017 Affiliation Summary by the state share of the current FMAP. The current FMAP is 56.18%/43.82%.

The Transformation Waiver Team had earlier emailed the Anchors information to share with providers regarding how much will be paid by project. Health and Human Services Commission (HHSC) Rate Analysis is unable to answer questions regarding this information. Please send any questions regarding this information to TXHealthcareTransformation@hhsc.state.tx.us

HHSC requires separate TexNet transactions for DSRIP Monitoring IGTs and DSRIP Reporting IGTs. The DSRIP Monitoring IGT should be placed in the Audit Cost bucket and the DSRIP Reporting IGT should be placed in the DSRIP bucket. If the full DSRIP Monitoring IGT is not submitted in the Audit Cost bucket, HHSC will reallocate IGTs for DSRIP Reporting for DSRIP Monitoring payments. Note that failure to submit two separate transactions or failure to IGT the full DSRIP Monitoring requirement may result in a delayed payment as additional manual steps will need to be performed.

IGT Entities may choose to IGT less than the required amount for DSRIP Reporting payments; however, all affiliated providers and projects will be paid proportionately. IGT may not be directed towards specific providers, projects or metrics. This will be the final opportunity to submit IGT for DY4.

A screen shot/.pdf of the confirmation/trace sheet or email of the confirmation number if the TexNet is submitted over the phone is required and must be emailed to Rate_Analysis_DSRIP_Payments@hhsc.state.tx.us. We are requesting that all government entities enter their IGT transactions into TexNet no later than July 2nd with a Settlement Date of July 3rd. No IGT’s submitted after July 3rd will be accepted.

Information regarding TexNet Connect can be found at https://comptroller.texas.gov/programs/systems/docs/96-1193.pdf

Thank you,

HHSC Hospital Rate Analysis
Texas Health and Human Services Commission
P.O. Box 149030, Mail Code H-400
Brown-Heatly Building
4900 N. Lamar Blvd.
Austin, TX 78714-9030

DSRIP Draft Measure Bundle Protocol for Cats B & C

HHSC is releasing the draft Measure Bundle Protocol in 2 parts. This Protocol is for DYs 7-8 beginning October 1, 2017, contingent on CMS approval. Thank you for your continued work as we take this next step.

Please see the attached draft of Part 1 of the Measure Bundle Protocol, which includes the Category B System Definition and Category C Measure Bundles for Hospitals and Physician Practices; Measures for Community Mental Health Centers; and Measures for Local Health Departments.

HHSC plans to release the full Measure Bundle Protocol draft next week, which will also include Category A Core Activities and Category D Statewide Reporting Measure Bundles for all DSRIP performing provider types.

HHSC is planning a webinar on June 21 to focus on changes in the Program Funding and Mechanics (PFM) protocol resulting from stakeholder feedback and the Measure Bundle Protocol; the webinar will primarily focus on Category C and understanding point values of the measure bundles. We will send out additional information separately on the webinar.

HHSC will also release a survey next week for feedback on the Measure Bundle Protocol (all sections) and request feedback by July 7th.

We know this is a lot of information and believe staging the Protocol will provide a chance to review key areas closely and give us some additional time on other sections while still adhering to timelines.

For Local Health Departments, please note there are some changes to the last list of measures that you reviewed. Some measures have been deleted that do not have measure stewards. Utilizing the survey, please let us know if you had planned to use these measures or have any other concerns.

For Community Mental Health Centers or Local Health Departments, if there are measures in the Hospital/Physician Practice Measure Bundles that CMHCs are able to report on and would like to have added to the list for CMHCs or LHDs, please let us know in the survey.

Prior to the webinar next week we will send out a measure summary document with a preview of measure specifications for more information on measure details.

Please note that there will be changes needed to the PFM to be consistent with this draft Measure Bundle Protocol. HHSC will not be issuing a new draft of the PFM until discussions are further along with CMS. The changes that would be needed are as follows, so you are aware. You can also let us know via the survey if you have any concerns about these potential changes.
• Each hospital or physician practice with a valuation of over $2 million per DY must select at least one Measure Bundle with a required 3 point clinical measure or add an optional 3 point clinical measure to a Measure Bundle with no required 3 point clinical measures.
• Only hospitals with a valuation equal to or less than $2 million per DY may select the rural Measure Bundles as identified in the Measure Bundle Protocol.
• A hospital or physician practice may only select optional measures for which they have at least the minimum denominator size as specified in the Measure Bundle Protocol.
• A hospital or physician practice may only select a bundle for which they have significant volume for at least half of the required measures in the bundle.
• For required measures with less than the minimum denominator size or a denominator of 0, the valuation for the measures and milestones within the Measure Bundle are valued differently as specified in the Measure Bundle Protocol.

Please share this with your providers. We will also get it up on the waiver website as soon as possible. Let us know if you have any questions. Thanks,

Amanda Broden
Healthcare Transformation Waiver Operations
amanda.broden@hhsc.state.tx.us | 512-462-6388

May 02

CANCELLED-RHP 2 Meeting-Friday, May 19, 2017

Dear RHP 2 Providers & Stakeholders: The regional meeting scheduled on Friday, May 19, 2017, from 10:00 am-3:30 pm (CST) is cancelled.  A rescheduled date will be announced pending new information from HHSC.  Thanks.  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 Representing: …

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Permanent link to this article: https://blogs.utmb.edu/1115/2017/05/02/cancelled-rhp-2-meeting-friday-may-19-2017/

Apr 12

RHP2: April 2017 DSRIP Reporting Webinar Slides

RHP2, Attached are the webinar slides from Tuesday, April 11th for your reference. Also be reminded that since reporting closes on Sunday April 30th at midnight the Anchor Office will not be open for normal business hours. Our cell numbers are available to you for emergencies but the Anchor Office can only guarantee responses and …

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Permanent link to this article: https://blogs.utmb.edu/1115/2017/04/12/rhp2-april-2017-dsrip-reporting-webinar-slides/

Mar 28

03/24/17 Anchor Update

Good afternoon Region 2, Please see the Anchor notes that HHSC issued on Friday below.  Additionally, HHSC has updated the Category 3 summary documents following DY5R2 NMI Reporting, MSLC Updates, and approved DY6 R1 Interim Corrections submitted by the February deadline. Please review the linked documents carefully and contact HHSC if you identify any errors …

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Permanent link to this article: https://blogs.utmb.edu/1115/2017/03/28/032417-anchor-update/

Mar 22

DSRIP 03/17/17 Anchor Update

HHSC issued a brief Anchor Update. Related to April reporting, Your Anchor team has volunteered to test the new QPI reporting template. As a reminder, is you have any changes to your organizational contact information and/or users for the online reporting tool, the deadline to make the changes via the regional submission is next Monday …

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Permanent link to this article: https://blogs.utmb.edu/1115/2017/03/22/dsrip-031717-anchor-update/

Mar 17

DSRIP Quality Measure Bundle Advisory Teams

As you all know, there is still much to be decided on the structure of the proposed Category C Measure Bundles for DY 7&8.  HHSC is starting from a pared down version of the existing Category 3 list, as well as considering new measures.  The evaluation process will include the use of Bundle Advisory Teams …

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Permanent link to this article: https://blogs.utmb.edu/1115/2017/03/17/dsrip-quality-measure-bundle-advisory-teams/

Mar 14

DSRIP 3/10/17 Anchor Update

Good morning Region 2, HHSC has provided the attached FAQ in preparation for DY6 April reporting, which will help you determine what deliverables for your organization are eligible to be reported for achievement next month.  For organizations currently reporting on Category 4, be on the lookout for the PPE reports to come from the State …

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Permanent link to this article: https://blogs.utmb.edu/1115/2017/03/14/dsrip-31017-anchor-update/

Feb 16

Reminder: Registration Open for The 2017 Care Transitions Summit, Hosted by UTMB on Friday, March 24, 2017

This summit has been designed to offer an opportunity for providers at all levels, including those working outside of DSRIP, to come together and discuss strategies to strengthen the quality of care provided to patients. We expect participation from a wide variety of regional constituents, including administrative and clinical leaders and front-line staff from hospitals, …

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Permanent link to this article: https://blogs.utmb.edu/1115/2017/02/16/reminder-registration-open-for-the-2017-care-transitions-summit-hosted-by-utmb-on-friday-march-24-2017/

Feb 15

Region 2 DSRIP DY7/8 PFM Discussion

The RHP 2 Anchor team hosted a discussion and Q&A session regarding the HHSC Program Funding Mechanics (PFM) proposal for DY7 and 8 on February 14th, which served as a follow-up for the HHSC webinar conducted on February 9th.  Attached is are the minutes and the PFM.   Susan Seidensticker, BSIE, MSHAI, CPHQ, CSSBB, PMP …

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Permanent link to this article: https://blogs.utmb.edu/1115/2017/02/15/region-2-dsrip-dy78-pfm-discussion/

Feb 15

DSRIP DY7/8 PFM Discussion – Region 2

RHP 2, Please find today’s DSRIP DY 7/8 PFM Discussion Webinar slides attached as well as the PFM document the feedback must address. The HHSC PFM feedback survey link is https://www.surveymonkey.com/r/MMBZ6P7 and can be found on the HHSC Medicaid 1115 Waiver website at https://hhs.texas.gov/laws-regulations/policies-rules/waivers/medicaid-1115-waiver as well as all other applicable documents and updates that are …

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Permanent link to this article: https://blogs.utmb.edu/1115/2017/02/15/dsrip-dy78-pfm-discussion-region-2/

Feb 09

DSRIP DY7-8 PFM Webinar-Thursday, February 9, 2017

Webinar HHSC will be holding a webinar to discuss the requirements in the draft DSRIP Program Funding and Mechanics (PFM) Protocol for DYs 7-8.  The draft PFM has been posted on the waiver website (https://hhs.texas.gov/sites/hhs/files//documents/laws-regulations/policies-rules/1115-waiver/DRAFT-PFM-Protocol-DY7-8_20170131.pdf). Topic:                    DSRIP DY7 and DY8 Webinar                         Date:                     Thursday, February 9, 2017 Time:                     2:30-4:00PM, Central Standard Time Speakers:            Ardas Khalsa, Noelle …

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Permanent link to this article: https://blogs.utmb.edu/1115/2017/02/09/dsrip-dy7-8-pfm-webinar-thursday-february-9-2017/

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