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Monthly Status Call June 2, 2017

Monthly Status Call June 2, 2017. Agenda. Learning Collaborative Activities Regional LC Summary & Feedback DSRIP in Action Waiver Updates. RHP 12 Learning Collaborative Event. to all who attended our March 24, event. 104 Participants 28 Provider Partners Represented.

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Monthly Status Call June 2, 2017

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  1. Monthly Status Call June 2, 2017

  2. Agenda Learning Collaborative Activities • Regional LC Summary & Feedback • DSRIP in Action Waiver Updates

  3. RHP 12 Learning Collaborative Event to all who attended our March 24, event. • 104 Participants • 28 Provider Partners Represented

  4. Learning Collaborative Event March 24, 2017

  5. Legislative Hot Topic Panel • Moderator: Tony Privett, Owner High Plains Research • John Frullo, The Honorable John Frullo State Representative District 84 • Jeff Dane,Executive Vice President & Chief Financial Officer University Medical Center • John Henderson,Chief Executive Officer Childress Regional Medical Center • Phil Ritter,Chief Operating Officer Meadows Mental Health Policy Institute for Texas

  6. Value-Based PurchasingAlternative Payment Models • Andy Vasquez and Kyle Trzasalski addressed the need and importance for VBP/APM. Examples were presented that are already implementedand in place. Question and Answer session followed with attendees. • Andy Vasquez- Deputy Associate Commissioner Health and Human Services • Kyle Trzaskalski Provider Network Specialist Provider Performance Superior Healthplan

  7. DY7-DY8 PFM Guest Speaker: Stephanie Fenter Director of Program Planning & RHP1 Anchor University of Texas Health Center of Tyler • Stephanie presented the DY7-DY8 PFM in detail so attendees will be versed with all information moving forward. • The PowerPoint presentation can be found on the RHP 12 website: www.texasrhp12.com

  8. DSRIP Project Evaluation Tool Guest speaker Bonnie McCamey Regional Manager of Waiver Analytics for RHP 10 John Peter Smith Health Network Handouts were given to each provider to evaluate their projects with instructions. Steps included: • Challenges & Objectives • Alignment Score: • Community Needs Addressed • Organizational Goals Impacted • Financial Score • Achievement Score • Triple Aim Score: • Quality and Experience of Care • Population Health Management • Reduction of Cost of Care • Our Key to Success • Metric Results: • QPI and Metric Name • Future Possibilities • Improvement Still Needed • Replication across the State

  9. Event Feedback Takeaway: Overall Event was a success

  10. feed·back/ˈfēdˌbak/information about reactions to a product, a person's performance of a task, etc., used as a basis for improvement. We appreciate your feedback so we can make improvements for future Learning Collaborative Events. • This is what we heard from you: • Great event! Excellent speakers. Thanks for providing a chance for the providers to ask questions. • Enjoyed learning about Value Based Purchasing and Alternative Payment Models. • Really enjoyed the panel discussion. • Have the event end earlier and not on Friday. • The room was freezing cold!

  11. Posters Posters rocked and we THANK YOU for participating! 13 individual posters 7 providers participated

  12. 1st Place Plains Memorial Hospital “A Holistic Approach to Patient Care Navigation”

  13. 2nd Place StarCare Specialty “Psychiatric Crisis Center”

  14. DSRIP in Action On February 24, 2017 Swisher Memorial Healthcare Memorial Healthcare hosted a DSRIP in Action event for our region. Hosts for the event were Ryan Barnard, CEO, Swisher Memorial Healthcare and Elizabeth Adams ,BSN, RN, Director of Quality & Foundation, Swisher Memorial Healthcare Strategic Initiatives. We had 13 attendees from 8 different regional provider locations join us for the event.

  15. DSRIP in Action(cont.) Project Highlights: • Primary Care Expansion- has increased access to healthcare in the primary care setting, decreased the utilization of the Emergency Department for non-urgent care and provided patients with the right care in the right setting while controlling costs. • Enhance Urgent Medical Advice-Swisher has been successful in implementing a Medical Advice Line by providing a FREE 24/7 Medical Advice line, decreasing the utilization of the Emergency Department for non-urgent care and providing our patients with the rifht care in the right setting while controlling costs.

  16. DSRIP in Action: June 16th- Lynn County Hospital District, Tahoka, TX July- TBA August 11th- StarCare, Lubbock, TX September 28th- RHP12 Regional Learning Collaborative Special Guest: Commissioner Charles Smith, HHSC October 11th & 16th- Lubbock Reporting Workshop October 12th & 13th- Amarillo Reporting Workshop

  17. Waiver Updates Bobbye Hrncirik

  18. Waiver DY6 Reporting & Payment Timeline: • June 9, 2017- HHSC completes their review of reporting submissions and notifies providers of the April DY6 initial reporting results. NMI requests • July 3, 2017 –IGT settlement date for April reporting DSRIP payments. • July 7, 2017- Due date for providers who received requests for additional information to submit their April DY6 NMI documentation. • July 31, 2017-April reporting DY4 and DY5 DSRIP payments processed for all providers and DY6 DSRIP payments processed. Note that there are separate transactions for each payment for each DY. • August 9, 2017 – HHSC completes their review and notifies providers who received requests for additional information of the April DY6 NMI reporting results.

  19. Compliance MonitoringCAT 1&2

  20. Key PFM Changes • RHP Plan Update Due Date • RHP Plan Update Submission changed from November 30, 2017, to January 31, 2018 • Category Funding Distribution • An additional payment of 20% of your total valuation will be given for the submission & approved RHP Plan Update. • Private Hospital Participation Incentive • Based on Feedback from private hospitals the incentive was not enough, the revision increases the incentive from 10% to 15% Pay for Reporting in Cat D

  21. Key PFM Changes • Cost and Savings • Allows providers to track costs and savings for just one activity of their choice rather than all activities. Activity must be from CAT A activities • EXEMPTION – Providers = or <1Million in valuation by DY • Carry Forward • Two Types of Carry Forward • Reporting Carry Forward • Achievement Carry Forward • Reporting Carry Forward Allowed • CAT B – MLIU PPP – April of following year (6 months) • CAT C – P4R – April of following year (6 months) • CAT C – P4P – Calendar Year Measurement Period - One immediately following the measurement period or the following reporting period (6 months) • Achievement Carry Forward • CAT C – P4P ONLY • Same as current carryforward but the measurement period will not be on a calendar year so DY7 = 2018 and DY8 = 2019 • Carryforward of achievement would be reported in 2020 & 2021 – YIKES, did I just say that? • Private Hospital Participation Incentive • Based on Feedback from private hospitals the incentive was not enough, the revision increases the incentive from 10% to 15% Pay for Reporting in Cat D

  22. Key PFM Changes • Remaining Unused Funds • Leadership decision on unused funds is to first allow RHPs that did not fully use their allocation to use it for DY7-8. – WE DO NOT HAVE ANY UNUSED FUNDS IN OUR REGION • New and existing Performing Providers would be eligible for the funds through a process determined by the RHP. • Patient Population by Provider (PPP) • PPP is meant to measure the volume a provider serves at large. HHSC does not want reduced MLIU served to increase CAT C achievement • No proxy population • Individuals • MSLC data fields • Unique Individual Definition • PPP Baseline Due 1/31/18 • Average of DY5 & DY6 Total PPP & MLIU PPP • Must Maintain numeric not ratio – HHSC will just monitor the ratio • Payment Levels –Allowable Variations • 100% maintenance = 100% valuation payment • 90-99% maintenance = 90% valuation payment • 75-89% maintenance = 75% valuation payment • 50-74% maintenance = 50% valuation payment • Less than 50% = ZERO valuation payment

  23. Waiver Negotiations Update

  24. Measure Bundle Protocol • HHSC is targeting mid-June for release of the Measure Bundle Protocol. This will be the opportunity for providers and other stakeholders to give feedback on the measures. • The menu of proposed Measure Bundles for hospitals and physician practices and measure for CMHCs and LHDs will be defined in the Measure Bundle Protocol. • This protocol will also include draft Category D measures and Category A – Core Activities. • Following the release of the Measure Bundle Protocol, HHSC will open a survey for stakeholder feedback.

  25. Clinical Champions Workgroup • HHSC had conference call with LHDs and CMHCs to continue discussions on measures for those provider types.

  26. Congratulations! • April reporting period ended April 30, 2017. • “Thank you” to everyone for your hard work & continued efforts on transforming the delivery system of healthcare!!

  27. Thank you!

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