Summary of Regional Performance Data

RHP 6 is excited to release a new report:

Assessing Progress and Opportunities to Improve Health and Transform Care in RHP 6: Summary of available regional performance measures related to the Medicaid 1115 Waiver

This report presents data currently available by region so we can assess the waiver’s impact beyond the project level. These measures have been produced by HHSC (and/or its contracted External Quality Review Organization) using Medicaid Claims data.

Further, HHSC has identified many of these measures as candidates for a proposed Performance Bonus Pool (PBP) if the waiver is extended beyond September 30, 2016. Additional measures being considered for the PBP can be found on HHSC’s website (http://www.hhsc.state.tx.us/1115-docs/012616/Performance-Bonus-Pool.pdf) but are not included here because regional-level subsets are not yet available.

While we await further guidance from HHSC on waiver extension, this subset of measures can help us evaluate progress, reassess priorities, and promote additional collaboration across our region. Providers and stakeholders are encouraged to review these data and reflect on areas of strength and opportunity for further improvements. These measures will also be integral to our regional dialogue as we prepare for the development of the RHP 6 PBP plan and continue to transition our focus from individual project outcomes to regional transformation. Please communicate your ideas, questions, and concerns to Carol Huber at Carol.Huber@uhs-sa.com.


Cat 3 Data and Other opportunities

Dear RHP 6 Performing Providers,

 April reporting is quickly approaching. Remember that if you plan to report achievement of a milestone in April, it must be completed by March 31, 2016. Roughly 30 projects will be reporting Cat 3 measures again. Unlike DY4 where you earned half your incentive for reporting, in most cases the entire Cat 3 incentive for DY5 is tied to achievement (partial payment and carry forward are still available).  Our Cat 3 results for DY4 are shown below. Congrats to all who fully achieved their goals. Did you hit your target? Are you making progress toward your DY 5 target? Last Sept/Oct we held Cat 3 Learning Collaborative webinars on selected domains so participants could share challenges, lessons learned, and ask questions. If you are interested in participating in another round of these, please let me know of which domain(s) you are interested and I will schedule them.

  Continue reading


Recommendations on Combining Projects and Cat 3 Baseline Corrections

Dear RHP 6 Performing Providers,

 Friendly reminder we have an ACES webinar today at noon. We will continue our work on sustainability action plans and focus on program evaluation. Please register if you have not already done so.

 I also wanted to offer some commentary/guidance on what to do with the information coming from HHSC regarding combining projects and revising cat 3 baselines. Please read below and as always, call me to discuss your individual situations. I’m happy to help you navigate these waters! My apologies in advance for the length and density of this email.

  Continue reading


Readmissions Learning Collaborative – February 8

RHP 6 Performing Providers:

 

  • As a reminder, for those of you with NMI (Needs more Info) requests from HHSC for your October reporting, these are due January 15. All responses should be posted to the online tool. Follow HHSC’s instructions regarding filenames and how to denote new progress updates as your NMI response. Do not delete previous notes from your October submission. Contact me with any questions.
  • Many of you are receiving notifications from Myers and Stauffer regarding compliance audits for Cats 1 and 2. These have been coming through pretty steadily yesterday and today from Scott Smith and Alejandro Acosta. Be sure your IT systems are not blocking emails with extensions “MSLC.com”

 NEW!

Continue reading


Statewide Learning Collaborative Summit – August 27-28, 2015

HHSC is hosting the 2015 Statewide Learning Collaborative Summit August 27-28, 2015. The event will take place at the AT&T Executive Education and Conference Center in Austin, Texas. Due to limited capacity, in-person attendance is restricted to DSRIP performing providers and invited guests.

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.

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

Agenda

RHP 6 will be well represented at this event. Bren Manaugh (Center for Health Care Services) will be a panelist during the panel session on “Alignment with Managed Care” on August 28th. Carol Huber will be a panelist during the “DSRIP Progress” session on August 27th and “Conducting Meaningful and Effective Program Evaluation” session on August 28th.

The following RHP 6 providers were invited to present posters:

Provider Project
The Center For Health Care Services In-house women’s wellness program
University of Texas Health Science Center at San Antonio Implement innovative evidence-based strategies to increase appropriate use of technology
University of Texas Health Science Center at San Antonio Increase, expand and enhance dental services
University of Texas Health Science Center at San Antonio Implement remote patient monitoring programs for diagnosis and /or management of care
San Antonio Metropolitan Health District Breastfeeding promotion program for childhood obesity prevention
San Antonio Metropolitan Health District Miles of Smiles (MOS)
Methodist Hospital Introduce, expand or enhance Telemedicine/Telehealth
The Center For Health Care Services Integrated primary care for substance abuse and HIV population

The following RHP 6 providers were recognized as “mentors” and invited to share best practices during break out sessions on August 27th:

Improving Primary Care Infrastructure 
Community health worker program to address health and social needs in a vulnerable population University of Texas Health Science Center at San Antonio
Primary Care – New Physician Recruitment & Community Health Worker Program Uvalde Memorial Hospital
Crisis Interventions for Behavioral Health Consumers 
Trauma informed care Hill Country Mental Health and Developmental Disabilities Centers
Increasing Access to Comprehensive Behavioral Health Services
Transitional care upon hospital discharge University of Texas Health Science Center at San Antonio
Disease Prevention and Health Promotion
Longitudinal diabetes and other chronic disease registries to improve patient outcomes University of Texas Health Science Center at San Antonio
Miles of Smiles (MOS) San Antonio Metropolitan Health District


HHSC Webinar: Change Requests for 3-Year Projects

Topic:              Change Requests for 3-Year Projects

Date:               Thursday, July 2, 2015

Time:               10AM – 11:30AM, Central Daylight Time

To join the online meeting:

1) Go to Join WebEx meeting
2) Click on Attend Meeting

3) Enter Meeting Number: 734 441 728

4) Call 866-430-8535

 

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 technical difficulties accessing the webinar or should you have any questions, please email waiver staff at: TXHealthcareTransformation@hhsc.state.tx.us. For updated materials and to sign up for email alerts please refer to the waiver website: http://www.hhsc.state.tx.us/1115-waiver.shtml.


IGT files from HHSC

HHSC released the following files today for performing providers and IGT entities related to April DY4 reporting:

April DY4 Reporting Affiliation Summary_for web

April DY4 Reporting IGT Summary_forweb

April DY4 Reporting Project Summary Before IGT Submitted_forweb

Please make note of these important transaction dates:

July 7,   2015 Last Date for   Public Entities to enter TexNet and submit Trace Numbers
July 8,   2015 TexNet Sweeps   (Settlement Date of funds)
July 21,   2015 Payment issue   date for Top 20 Entities for DY4 payments
July 31,   2015 Payment issue   date for remaining DSRIP Providers

**Please note that this is the final opportunity to IGT for DY2 DSRIP payments**

For additional instructions, providers should refer to the email from HHSC.


HHSC April Reporting Webinars

HHSC will be holding two webinars to assist with April reporting:

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

2) Click on Attend Meeting

3) Enter Meeting Number: 733 793 836

4) Call 866-430-8535

Presentation Slides: April DY4 DSRIP Reporting

Presentation Slides: April DY4 QPI

Excel File: Projects with QPI Issues

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

2) Click on Attend Meeting

3) Enter Meeting Number: 730 881 279

4) Call 866-430-8535

Presentation Slides: April DY4 Cat 3&4

Excel File: Category 3 Baseline TA Status Update_040715

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.


Message from HHSC

The following message from sent by HHSC on Thursday, March 12, 2015:

Transformation Waiver Stakeholders –

We want to provide you an update on HHSC’s recent visit to Baltimore to discuss with CMS the renewal/extension of the 1115 Transformation Waiver and how to move forward to address the concerns CMS raised in the September 2014 UC deferral letter regarding IGT financing for private hospitals.

Chris Traylor, Kay Ghahremani and Monica Leo met with key CMS staff on Monday, including Vikki Wachino (Acting Director, Center for Medicaid and CHIP Services, acting in Cindy Mann’s former role), Tim Hill (Finance), Kristin Fan (Finance), Eliot Fishman (Director, Children and Adults Health Programs Group, which oversees 1115 waivers), and Brenda Blunt (HHSC’s waiver project officer).

HHSC sent CMS four documents in advance of the meeting – agendas for each of the topics and a draft of the Transition Plan for the Pools that HHSC is required to submit to CMS later this month along with an attachment to the transition plan.

Agenda for Meeting with CMS re: Waiver Transition

STC 48 Transition Plan Draft 20150302

STC 48 Transition Plan Attachment A

Agenda for Private Hospital Funding Meeting

 

 Waiver Extension/Renewal and the Pool Transition Plan due March 31st

There were no big surprises in the meeting. The comments from CMS regarding waiver renewal/extension were similar to messages they’ve conveyed both in Texas and nationally recently. As we assumed, Texas will need to make a strong case to CMS to continue the DSRIP and UC pools beyond the original 5-year waiver term. We’re committed to working with you to make that case, and HHSC emphasized for CMS the key points in the first attached agenda. Some highlights from the meeting:

  •  HHSC: DSRIP and the RHP structure have enabled locally driven, provider-level innovation, which is so important to improving how care is delivered.
  • CMS acknowledged that the Texas DSRIP program took long to get up and running, so we will want to continue to strongly make this point as part of our argument to extend DSRIP.
  • CMS: DSRIP is hard to administer in Texas (and other states) and CMS is uncertain about what return it’s getting for its large investment.
  • CMS wants further alignment of Texas Medicaid quality efforts and to further value based payment within Medicaid managed care.
  • Of different states’ DSRIP programs, CMS thinks the New York model is well designed. (HHSC already is looking into the NY model, and what elements from it may be applicable to TX.)
  • CMS wants a sustainability plan for DSRIP and UC; it is hesitant about ongoing supplemental payments and would rather see increases in Medicaid payment rates. (CMS noted that another way to reduce Texas’ UC burden would be insurance coverage expansion.)
  • CMS Financial staff acknowledged they understood the importance of these funds to help support Texas’ safety net providers.

HHSC plans to submit the attached transition plan to CMS by the deadline of March 31, 2015. Many of you provided input on an earlier draft that was incorporated into this version. If you see anything in this final draft that you think is factually incorrect, please let us know as soon as possible.

 

Private Hospital IGT Financing

Regarding the UC deferral issue, CMS Financial staff provided HHSC a binder in response to the letter HHSC sent CMS in December. The attached 17 PDF documents are the entire contents of the binder by tab. HHSC is sharing the full binder with all of you because we know this issue has potential statewide implications and will need your assistance to continue to make our case to CMS regarding waiver financing. As you can see from the contents of the binder, CMS has reviewed this issue in detail; however, it’s unclear at this point to what extent their General Counsel has been involved in the response.  We’ll follow up with them to ask whether their Legal team has reviewed. HHSC plans to review this issue internally and will work closely with impacted stakeholders before responding back to CMS on the points they made in the binder.

Table of Contents  Tab1  Tab2  Tab3  Tab4  Tab5  Tab6  Tab7  Tab8  Tab9  Tab10  Tab11  Tab12  Tab13  Tab14  Tab15

CMS Findings

 

Thanks,

 Lisa Kirsch

Chief Deputy Medicaid/CHIP Director for Policy and the Transformation Waiver

Texas Health and Human Services Commission

512-707-6096


Results of October DY3 Reporting

Of the 847 milestones eligible for reporting in DY3, 729 (86%) were achieved. Many of the 43 (5%) milestones designated in October as needing more information, will also likely be achieved. Providers opted to carry-forward the remaining 75 (9%) milestones into DY4.

Of the remaining 34 DY 2 milestones carried forward into DY3, all have been approved with the exception of four which require additional information to be provided to HHSC by January 16, 2015, for final disposition.

  For additional details on accomplishments, please read the DY 3 Annual Report.


Statewide Learning Collaborative

To view the presentations from the Statewide Learning Collaborative, held Sept. 9-10 in Austin, click here.

Due to the size of the files and other technical issues, HHSC has been delayed in posting these to their site. The link above takes you to Region 12′s Dropbox account.


Release: 2014 Community Health Improvement Plan

On July 23, 2014, the Health Collaborative released its 2014 Community Health Improvement Plan. RHP6 DSRIP providers were invited to attend to identify opportunities for collaborative partnerships and shared aims.

This Community Health Improvement Plan is the result of a formal community health improvement assessment and planning effort that reflects over 24 months of collaborative work with agency partners and community stakeholders, to establish a shared vision, conduct a comprehensive community health assessment, and develop  an assets-based planning document. We are thankful for the support and valuable input of stakeholders and partners from across multiple sectors that took part in the community workgroups.


Results of April 2014 Milestone Reporting

In April 2014, providers participating in our Regional Healthcare Partnership (RHP 6) reported achievement related to transformation projects underway through the Medicaid 1115 Waiver. RHP 6 is pleased to announce the following results which have been approved to-date by the Texas Health and Human Services Commission.

  • For Demonstration Year 2*, providers in RHP 6 achieved a total of 384 milestones (93%) and earned $214 million in incentives**.
  • For Demonstration Year 3, providers in RHP 6 achieved a total of 249 milestones (50%) and earned $93 million in incentives**.

 Congratulations to these providers, their collaborating stakeholders, and patients/clients who are all benefitting from the great work being accomplished in our region!

 

Notes:

*We are currently in month 9 of Demonstration Year (DY) 3. Providers have up to one year following each DY to complete milestones.

**The federally-funded Delivery System Reform Incentive Payment (DSRIP) incentives are shown in gross dollars. A state/local match equivalent to 40% is required to draw down the entire incentive amount.