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.

 

Combining Projects

As you know, there are some complexities involved in DSRIP! So in hopeful preparation for five more years, HHSC is beginning to implement some strategies aimed at administrative simplification. For example, three of our community mental health centers cover more than one region, which means they get updates and “to-do’s” not just from me but from up to three other anchors. They commonly have similar projects serving different counties across these multiple regions which means they have to do April and October reporting in duplicate (triplicate? quadruplicate?) for what may operationally be one project but in terms of DSRIP exists as three or four unique projects. HHSC has released guidance and a template for combining projects, and this opportunity is available to all providers if some criteria are met. Even if you meet the criteria, you DO NOT have to combine projects. This is OPTIONAL.

 Review your project list and determine:

  1. Do you have multiple projects in the SAME project option? If no, you are not eligible to combine projects.
  2. If you were to add two or more of these projects together (DY5 Cat 1 or 2 value only), do they add up to less than $5 million? If no, you are not eligible to combine projects.

 If yes to both questions above, your projects may be eligible for combining. But you should also consider:

  1. Do they have similar Cat 3 outcome measures and QPIs that can easily be merged/added?
  2. Are the projects similar in nature, are they managed by the same project manager, and/or target similar populations?   

If NO, these are not deal-breakers but you need to seriously consider whether or not combining projects would actually simplify things for you.

                 Based on my review, the following providers might consider combining:

  • UHS 2.10 and CMA 2.1 (project IDs)
  • SAMHD multiple projects within project options 2.6 and 2.7
  • UTHSCSA 1.7, 1.8, 1.23 (project IDs)
  • HCMHDD – multiple projects with project option 2.13
  • HCMHDD, Camino Real, BB Trails projects across regions

 For more information, view the companion document and template for combining projects.  The companion document outlines the criteria, requirements and timeline for requesting to combine projects.  Please note the deadline for template submissions to HHSC is February 1, 2016 at 5:00pm.

  Cat 3 Baselines

I thought HHSC was sending a summary file to ALL providers with current baseline/performance info, but it looks like HHSC sent confirmation of the recently reported baselines from October reporting to those specific providers. I received the aggregated file yesterday that shows HHSC needs to provide technical assistance to UTHSCSA (ID 3.101), Nix (3.102), Dimmit (3.1), and Camino Real (3.200). Two outcomes were changed from QISMIC to IOS methodology due to high performance (UTHSCSA 3.103 and 3.22).  The other baselines reported in October seem to be ok as submitted.

 With that said, just because HHSC doesn’t request TA and/or thinks your baselines are fine doesn’t mean they are. Many providers have experienced that sinking feeling when they realized their reported baselines were not conducted per specifications, or were calculated based on incomplete data sets or the wrong measurement period. How confident are YOU in your reported baselines?

 Please review ALL of your Cat 3 outcome baselines using the Cat 3 Summary Goal Calculator and ask yourself the following questions.

The “Goal Calculator” file enables providers to confirm current selection and reporting information and determine new goals and achievement levels if corrections are anticipated. All providers can review their Category 3 milestone structure, approved subsets, reported baseline, goals, measurement periods, and performance if reported.  The summary will also indicate if an outcome is eligible to make corrections during performance reporting, or if outcomes need to make corrections during an interim correction period.

 Have you reported baseline data? Is it consistent with what HHSC shows on record in the Goal Calculator file?

  1. Do you understand the reporting specifications for that measure and did you report consistently with those specifications?
  2. Did you use the correct measurement period for your baseline as approved by HHSC, and is the DY4 performance measurement period you reported (or plan to report) directly adjacent to the baseline measurement period?

 If you need to correct your baseline data, there are three ways to do this, but all three methods are NOT available to each project/outcome.

 a.       Correct baselines using the Interim baseline correction template. The template is for P4P outcomes that have already reported performance and are not under review by MSLC, as well as outcomes with a custom goal (maintenance, HHSC approved alternate achievement request, P4P changed to P4R due to small volume) that are not under review by MSLC. The interim correction template should be completed for each eligible outcome needing a correction and emailed to the waiver mailbox (txhealthcaretransformation@hhsc.state.tx.us) by Sunday, February 14th, 2016 in order to be reviewed and finalized prior to the April DY5 reporting period. If you are unsure if this option applies to you, open the template and select your project ID from the dropdown list. If the subsequent fields “open up” then you can take this route. If it doesn’t, see options b and c  below.

 b.      Correct baselines though Myers & Stauffer. If your cat 3 outcome measure is under review/validation by M&S, please work with your M&S contact to correct your baseline.

 c.       Correct baselines during April reporting. If this applies to you, use the Goal calculator to determine your DY4 and DY5 targets as they may change along with your new baseline.

 As a reminder, for most cat 3 measures: half of your DY4 Cat 3 incentive is tied to achievement of your target and ALL of your DY 5 Cat 3 incentive is tied to achievement. Partial achievement/payment is allowed.

 I hope this was helpful. Please contact me if you have any questions or would like to discuss your individual situations.

 Carol A. Huber, MBA

Director, RHP 6

University Health System

(210) 743-6378

(210) 269-6505 mobile