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Region 15 Regional Healthcare Partnership 11 th Public Meeting

Region 15 Regional Healthcare Partnership 11 th Public Meeting. Wednesday, March 27, 2013 University Medical Center of El Paso Anchor Hospital. 1. Confirmation of Participants. Roll Call. 2. Recap From Anchor Call 3/22/13. 10 Texas Region RHP Plans Sent to CMS

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Region 15 Regional Healthcare Partnership 11 th Public Meeting

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  1. Region 15Regional Healthcare Partnership11th Public Meeting Wednesday, March 27, 2013 University Medical Center of El Paso Anchor Hospital 1

  2. Confirmation of Participants • Roll Call 2

  3. Recap From Anchor Call 3/22/13 10 Texas Region RHP Plans Sent to CMS • Region 15 was largest hospital district submitted -- 3/2/13 • 4th overall approval for submission to CMS out of 20 Texas Regions All RHP Plans from Texas are uploaded to HHSC website Upon Submission to CMS

  4. CMS Stated Areas of Concern with Projects • ‘Other Projects’ • ‘Other Category 3 Outcomes’ • Duplication of Federal Funds • Collaborations • Valuation

  5. Project-specific guidance from CMS • Projects CMS has indicated would not be approved • Project Option: 1.11.3 Client Health Information Access Portal - This “Other” project proposed by an MHMR center will likely not be approved as it is focused on providing clients access to tablet computers to gain access to health information. • Projects that would need Clarification / Enhancement • Project Option 2.5 – Redesigning for Cost Containment • For projects in the 2.5 project area, CMS requires the specific approach to cost containment and how this approach is expected to improve care for the Medicaid and indigent populations. Many of these projects could be interpreted to mean increased billing, rather than a specific focus on how medical care is improved.

  6. Project-specific guidance from CMS • Project Option: 1.9.2 – Expand Access to Specialty Care • CMS has indicated that projects in the “Access to Specialty Care Projects” that are: • high-intensity procedures must have a significant focus on the Medicaid/indigent population for the specific services that are included in the proposed project. • The need for the access must be clear and focused on Medicaid and indigent. CMS likely will request that metrics with quantifiable Medicaid/indigent impact be added for these projects if they are to move forward. • If there is an access issue in the Medicaid program for certain specialty care services in the region, the project focus should include the enrollment of the specialty physicians in the Medicaid program so that access can be measured specific to Medicaid. • Project Option 2.8.1–Apply Process Improvement Methodology • There are some projects that in this option that are focused on Emergency Departments. CMS would prefer projects focused on earlier access to primary care. • However, given the range of providers and needs, they would consider a focus on the ED if a specific evidence-based model is proposed. • In addition, a more robust Category 3 outcome than Patient Satisfaction would be required.

  7. CMS Review Period • 3/2/13 HHSC Submitted Region 15’s Plan to CMS • 45 Day Review Period by CMS • At the end of 45 days, CMS will respond regarding approved projects and projects that need revisions or replacements to complete our Plan • April 15, 2013 expect first CMS response to Region 15 • If projects are not completely approved, modifications will need to be performed in collaboration with HHSC in the next 30 days • Project replacements can also be provided during this timeframe

  8. DSRIP and UC Payment Timelines 2013 and 2014 • DY1 UC – 5/7/2013 • DY1 DSRIP – Region 15 = $22,037,042 • IGT due 3/25/13 • Payment date 4/30/13 • DY2 UC • 7/20/2013 • 1/16/2014 • 3/28/2014 • DY2 DSRIP • 9/30/2013 • 11/12/2013 • 1/24/2014 • DY2 Admin • 2/10/2014 • IGT for the above payments must be submitted to HHSC 20-30 days prior • HHSC is proposing to retain ½% of all DSRIP payments for monitoring purposes

  9. Learning CollaborativeBehavior Health in Region 15 Overview – Emergence Health Network Project Presentations: • Emergence Health Network • University Medical Center • Texas Tech • Las Palmas Del Sol • Other Community HealthCare Providers

  10. Roundtable 10

  11. Contact Information • Waiver Website & Email Address: • http://www.hhsc.state.tx.us/1115-waiver.shtml • TXHealthcareTransformation@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 11

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