Welcome to RHP 9 – Transforming Healthcare Now

Waiver Information

 

  • Medicaid 1115 Waiver renewed October 1, 2017 – September 30, 2022. Click here to review  the updated RHP 9 Plan for demonstration years DY7-8.
  • Five-year demonstration waiver that began on September 1, 2011
  • Aligns with the Triple Aim of the Centers for Medicare and Medicaid Services (CMS): Improve the experience of care, Improve the health of populations, and Reduce the per capita costs of healthcare without compromising quality.
  • Creation of Regional Healthcare Partnerships (RHP) that support coordinated, efficient delivery of quality care, and a plan for system transformation that is driven by the needs of the community.
  • Provides incentive payments for quality improvement and healthcare delivery system reform

Quick Facts on RHP 9:

  • 3 Counties: Dallas, Denton, & Kaufman
  • 2,530 square miles
  • Population of 3.1 million
  • 40% are low income
  • 23 providers participating in Delivery System Reform Incentive Payment (DSRIP) projects
  • Needs assessment: Gaps in access, behavioral health, and overall care coordination.

May to June, 2018: 

HHSC reviews and may request additional information

Saturday, June 30, 2018: HHSC approves RHP plans
July 2018: Providers receive 20% of DY7 valuation 

 

Making a Difference

Waiver Extension DY7-8

Category A:   For DY7, the items providers will need to report on includes the following:

  • Identifying the tool the provider plans to use for the analysis (HHSC will be recommending tools to use)
  • Identifying challenges associated with completing the analysis and identifying how the provider plans to overcome these challenges
  • Indicating if the provider has identified data sources to be used in the analysis
  • Identifying the Core Activity that will be used for the analysis, including an explanation as to why this Core Activity was selected
  • Stating any additional information that describes progress made for the analysis.
  • HHSC is working on guidance related to cost and savings and plans to share it this summer (estimated in July).
Category C
 
Early Baseline Reporting
The baseline measurement period for Cat. C measures end 12/31/17 unless an exception for a delayed baseline is approved.
HHSC will be accepting early reporting of baselines in July-August 2018.
HHSC encourages providers to report baselines early if possible to allow HHSC to identify any need for technical assistance as soon as possible after the RHP Plan Updates are approved.
Payment for baseline reporting will occur as usual following the October 2018 reporting period.
Providers could report some baselines early and others during the regular October reporting period.
Tentative Early Baseline Reporting Timeline:
July 2 – Cat. C Baseline Template published by HHSC
Week of July 10 – Cat. C. Baseline Reporting Webinar
August 3 – Cat. C Baseline Early Reporting Templates due to HHSC
August 31 – Notice of technical assistance needed sent to providers

October 2018 Baseline Reporting
For providers using a standard baseline measurement period (ending 12/31/17) who do not report baselines early and a delayed baseline that ends by 03/31/18, providers will report during the regular October 2018 reporting period, which includes the NMI period (However, please don’t delay reporting until the NMI period unless absolutely necessary as it results in significantly more work for HHSC staff and does not allow a reasonable amount of time for technical assistance.). Providers are strongly encouraged to report baselines as early as possible to identify any technical assistance needs and allow time for resolution.
The DSRIP rules do not allow standard CY17 baseline reporting to be carried forward to the April 2019 reporting period.
§354.1713 (h)(1). Carry forward of reporting. If a performer does not report a measure’s baseline reporting milestone or performance year reporting milestone during the first reporting period after the end of the milestone’s measurement period, the performer may request to carry forward reporting of the milestone to the next reporting period.

Delayed Baseline Measurement Period:  For a delayed baseline measurement period that ends after 03/31/2018 and on or before 09/30/2018, providers could report in the October 2018 period or carryforward reporting to the April 2019 reporting period.

Providers will not be eligible to report performance for a given measure until HHSC has reviewed a baseline and approved for performance reporting. A provider with a standard baseline that reports baseline for the first time during the October DY7 NMI period may not be eligible to report Performance Year 1 (CY2018) in April DY8, as HHSC may not have sufficient time to review baseline prior to April DY8.

Category D:  HHSC will be responding this week on questions related to Category D reporting regarding the data and period for reporting patient satisfaction results.
Compliance Monitoring
  • MSLC should be finishing up the majority of their Category 1 and 2 as well as Category 3 Performance Round 3 reviews by the end of May. HHSC may be contacting providers whose reporting is not validated or the metric goal is not met in cases when additional information is needed.
  • MSLC presentation at RHP 8 and 17 Learning Collaborative should be posted soon and providers will be able to submit their questions in writing. Anchors will consolidate a list of questions from each region. Will let you know when the recording is available.
April DY7 Reporting
  • Reporting materials for April DY7 have been posted to the DSRIP Online Reporting System bulletin board.
  • Provider templates will not be posted to the waiver website, but the IGT Entity Feedback Form, DSRIP User Guide and companion documents have been posted. Providers will be reporting on DY6 carryforward milestones and metrics.
  • If a provider has no DY6 carryforward to report, they will not have to report any information to HHSC during the April reporting period.
  • Please note that Anchors and IGT entities must select Demo Year (DY) 6 on their homepages in order to access links to their providers’ DY2-6 projects in the reporting system.
  • HHSC has uploaded a list of DY6 carryforward metrics to the bulletin board under April DY7 Reporting -> General Reporting Materials to help Anchors track who should be reporting during the April DY7 reporting period.
  • When navigating the online reporting system to find projects, providers should search directly for the Category 3 project ID (or select the Category 3 project ID from the Project Summaries tab or Reporting Status tab on the Provider Details page), rather than by their Category 1 or 2 ID, because the Cat 1 or 2 project may be closed if there are no DY6 carryforward metrics. Be sure to select the DY2-6 dropdown option when searching for a project.
  • Providers will need to complete the Project Summary tab in the online reporting system for active DY6 carryforward metrics. The provider may discuss any continuing related Category 1 or 2 project activities and/or their ongoing Category 3 activities.
  • Please note that while there are tabs in the Category 3 template for projects without a carryforward milestone, the template does not require a project update for those milestones. The template will show complete without the progress update if the project was not carried forward.
  • See below for April DY7 Reporting and Payment Timeline. 
  • April 20, 2018 - Final date to submit questions regarding Category 3 April reporting and inform HHSC of any issues with DY6 data in the Category 3 reporting template or online reporting system.
  • April 25, 2018 – Final date to submit Category 1 & 2 QPI questions regarding April reporting and inform HHSC of any issues with DY6 data in the reporting system.
  • April 30, 2018, 11:59pm – Due date for providers’ submission of April DY7 DSRIP reporting using the DSRIP Online Reporting System and upload of applicable QPI and Category 3. Late submissions will not be accepted.
  • May 1, 2018 – HHSC will begin review of the April reports and supporting documentation.
  • May 17, 2018 – HHSC will post the estimated IGT due for April reporting based on milestones and metrics reported as achieved. Final IGT due will be based on HHSC review and approval.
  • May 18, 2018, 5:00pm – Due date for IGT Entities to approve and comment on their affiliated providers’ April reported progress on metrics using the "IGT Entity Feedback Form” that is posted on the Bulletin Board.
  • June 1, 2018, 5:00pm – Due date for submission of any IGT changes in entities or proportion of IGT among entities submitted to HHSC (TXHealthcareTransformation@hhsc.state.tx.us) using the IGT Entity Change Form that is posted under 1115 Medicaid Waiver Forms on the Bulletin Board.
  • June 8, 2018 – HHSC and CMS will complete their review and approval of April DY7 reports or request additional information (referred to as NMI) regarding the data reported.
  • July 2, 2018 – IGT settlement date for April reporting, RHP Plan Update submissions, and remaining 20 percent of DY6 Anchor DSRIP payments.
  • July 8, 2018, 11:59pm – Due date for providers to submit responses to HHSC requests for additional information (NMI requests) on April reported Category 1-3 milestone/metric achievement and Semi-Annual Reporting requirements. Please include "NMI" in the file name when uploading documentation in response to NMI requests.
Category 3
  • Because there was no interim correction period prior to April reporting, providers will need to make any corrections in the Category 3 reporting template. Providers who need to make corrections should email the Waiver mailbox during the April reporting period with the RHP and project ID, the outcome measure, the years requiring correction, and a detailed explanation of why the correction is needed (i.e., why the information reported previously is inaccurate and how the corrected information is calculated). Once this information is reviewed, HHSC will provide instructions on how to make a correction in the reporting template. Please contact HHSC as early as possible in the reporting period, no later than April 20th, so that we have time to review your information and respond before the reporting period closes.
  • Please note that HHSC updated the summary workbooks on the online reporting system’s bulletin board on April 5 to address an issue with the dropdowns and to include information from MSLC reviews closed in March.