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Region 15 Regional Healthcare Partnership 38th Public Meeting

Join the 38th public meeting of the Region 15 Healthcare Partnership on July 29, 2016, at the University Medical Center of El Paso. Confirmation of participants will be done through roll call. The meeting will discuss the 2016 statewide learning collaborative summit to be held on August 30-31, 2016, and the waiver extension from 10/1/2016 to 9/30/2017.

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Region 15 Regional Healthcare Partnership 38th Public Meeting

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  1. Region 15Regional Healthcare Partnership38th Public Meeting Friday, July 29, 2016 University Medical Center of El Paso Anchor Hospital

  2. Confirmation of Participants Roll Call

  3. 2016 Statewide Learning collaborative summit August 30, 31 2016 • Same rules as last year for attendance. • Confirm attendance by Performing Provider • Draft Agenda

  4. WAIVER EXTENSIONdy6A – 10/1/2016 – 9/30/2017 • On May 2, 2016, HHSC received approval of this 15-month extension from CMS. • The 15-month extension maintains current funding levels for both the Uncompensated Care (UC) pool and DSRIP. • During the extension period, HHSC and CMS will work on a longer term agreement. • 6A = 12 month project performance period • 6B = Additional 3 months for HHSC negotiations with CMS

  5. DSRIP Project Metrics DY6 Category 1 & 2 Main Project Metrics – QPI • Quantifiable Patient Impact - 25% Value • Same Patient Number Goals as DY5 • Pay For Performance • Carry Forward will be in effect to meet the goal if needed • MLIU QPI – Medicaid Low Income Low Insured – 25% Value • Pay for Reporting • We agreed to goals on the DY6 Participation Template • No requirement to meet the exact number listed though

  6. DSRIP Project Metrics DY6 • Category 1 & 2 Main Project Metrics – Qualitative Reporting • Core Component Reporting – 25% Value (HHSC will develop a template for reporting) • 1 -Project Overview: Accomplishments • 2 - Project Overview: Challenges • 3 - Project Overview: Lessons Learned • 4 - Progress on Core Components • 5 - Continuous Quality Improvement Activities • 6 - Provider’s participation in Learning Collaboratives

  7. DSRIP Project Metrics DY6 • Category 1 & 2 Main Project Metrics – Qualitative Reporting • Sustainability Planning – 25% Value (HHSC will develop a template for reporting) • Providers will be required to submit qualitative descriptions of sustainability planning efforts. • Planning efforts could include: • Project-level evaluation • Integration with managed care • Health Information Exchange (HIE) • Other community partnerships

  8. DSRIP Project Metrics DY6 Category 3 Quality Project Metrics • Same improvement goals as DY5 - Pay For Performance • Same value as DY5 • Carry forward and partial payment is in effect Category 4 Quality Project Metrics • Hospital Reporting Requirement • Same as DY5 – Pay for Reporting

  9. April ReportingDY5 April DY5 Reporting Timeline: • July 15, 2016– Payment Processed for UMC • July 29, 2016 – Payments Processed for all remaining Providers • August 5, 2016 – HHSC will complete NMI Reporting Review and distribute reporting results.

  10. DY6 – Waiver Extension Year • Waiver Renewal Planning Timeline: • July 22, 2016 - Anchors submitted the completed DY6 DSRIP Participation Templates to HHSC. • August 26, 2016 - HHSC will begin providing approval of requested MLIU reporting exceptions, required QPI/MLIU changes, and submitted next steps or request additional information. • September 9, 2016 - Anchors submit responses to HHSC requests for additional information, and Category 3 stretch activity selections and alternate achievement requests (templates for Category 3 stretch activity selections and alternate achievement requests will be distributed in early August). • September 30, 2016 - HHSC will approve or deny the additional information submitted in response to HHSC comments. • October 1, 2016 - Approved DY6 projects are effective.

  11. Anchor entity requirements IN DY6 • Submit a Learning Collaborative Plan at the beginning of DY6 – The Learning Collaborative must include a focus on DSRIP integration into Medicaid managed care, value-based purchasing, alternative payment models, or sustainability strategies for low-income uninsured. • Prepare for an Extension Stakeholder Engagement Forum to promote collaboration in the next phase of the waiver. • In June 2017, submit an updated Community Needs Assessment.

  12. Contact Information • Waiver Website & Email Address: • http://www.hhsc.state.tx.us/1115-waiver.shtml • TXHealthcare Transformation@hhsc.state.tx.us • UMC Website: • http://www.umcelpaso.org • Region 15 - RHP • Paso del Norte Blue Ribbon Committee Needs Assessment: • http://www.elpasotexas.gov/health/_documents/BRCGapBook.pdf

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