Welcome to RHP 9 – Transforming Healthcare Now

Waiver Information

 

  • Medicaid 1115 Waiver renewed October 1, 2017 – September 30, 2022. information can be found at the Texas Health & Human Services Waiver Renewal. 
  • Click here to review the updated RHP 9 Plan for demonstration years DY7-8.
  • 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.

Upcoming Event

 

RHP 9, 10, & 18 are pleased to announce the

                           5th Annual

2019 Collaborative Connections - Impacting Care

                      A Learning Collaborative Summit
            Tuesday, May 14, 2019:  8:30 a.m. - 4:00 p.m.
      Wednesday, May 15, 2019:  8:30 a.m. - 4:00 p.m.

Click here to Register 

Tuesday, May 14 - Wednesday May 15, 2019: RHP 9, 10, & 18 Learning Collaborative Summit.  Register at  2019 Learning Collaborative
2019 Statewide Learning Collaborative: September 4 and 5 in Austin 
September 2019: 86th Texas Legislative Session Recap

 

 

 

 

 

Making a Difference

April DY8 Reporting
  • A link to the recording of the April DY8 reporting webinar has been posted to the Bulletin Board and can be found here: https://register.gotowebinar.com/recording/2896637393023421697
  • Please complete and submit an RHP Contact Change Form if additional contacts need access to the reporting system for the April DY8 reporting period. The RHP Contact Change Form can be found on the Bulletin Board or on the Waiver Website under 1115 Medicaid Waiver Tools and Guidelines. RHP Contact Change Forms should be sent to the Wavier mailbox at TXHealthcareTransformation@hhsc.state.tx.us.
  • As mentioned in the April DY8 Reporting Webinar, the Percentage of Goal Achieved field on the Carryforward Cat B tab is not working as expected once the MLIU PPP Numeric Achievement value has been saved. This issue has been reported to HHSC IT and should be resolved soon.
  • Category C Template “Public Notes”: There are errors in the “Public Notes” field of the April DY8 reporting template for the following Category C measures. Since HHSC will not be able to correct the error within the reporting template at this time, providers who selected these measures received an email notice from HHSC earlier this week to please ignore the “Public Note” associated with these measures.

 

 

Measure ID

Measure Name

“Public Note”

Error Notice

H3-287

Documentation of Current Medications in the Medical Record

The denominators reported for H3-287 and H3-288 should be the same since the measures share the same denominator definition.

There are slight differences in denominator inclusion encounter codes between H3-287 and H3-288, so the denominators reported for H3-287 and H3-288 should not be assumed to be the same.

H3-288

Pain Assessment and Follow-up

The denominators reported for H3-287 and H3-288 should be the same since the measures share the same denominator definition.

H3-401

Opioid Therapy Follow-up Evaluation

The denominators reported for H3-401 and H3-403 should be the same since the measures share the same denominator definition.

Since H3-401 specifications include:

“NOTE: Include only patients that have 6 weeks opioid use through September 30 of the performance period. This will allow the follow-up evaluation of at least 90 days after opioid therapy within the reporting year,“

 

there is a difference in denominator measurement periods between H3-401 and H3-403, so the denominators reported for H3-401 and H3-403 should not be assumed to be the same.

H3-403

Evaluation or Interview for Risk of Opioid Misuse

The denominators reported for H3-401 and H3-403 should be the same since the measures share the same denominator definition.

H1-255

Follow-up Care for Children Prescribed ADHD Medication (ADD)

This measure is reported as two rates. The denominators for Rate 1 and Rate 2 should be the same.

There are differences in denominator specification between Rate 1 and Rate 2 for H1-255, so the denominators for Rate 1 and Rate 2 should not be assumed to be the same.

M1-255

Follow-up Care for Children Prescribed ADHD Medication (ADD)

This measure is reported as two rates. The denominators for Rate 1 and Rate 2 should be the same.

There are differences in denominator specification between Rate 1 and Rate 2 for M1-255, so the denominators for Rate 1 and Rate 2 should not be assumed to be the same.

D5-T07

Innovative Measure: Diabetes Outpatient Care Management (Care Coordination)

This measure is reported as two rates. The denominators for Rate 1 and Rate 2 should be the same.

There are differences in denominator specification between Rate 1 and Rate 2 for D5-T07, so the denominators for Rate 1 and Rate 2 should not be assumed to be the same.


Category A

Costs & Savings: HHSC will be developing a FAQ document and/or a webinar.  

Category C
  • Measure D3-335: It has been brought to HHSC's attention that the listed denominator exclusion for D3-335: Pediatric Pressure Injuries should have been a numerator exclusion. Specifically, if an individual has a pressure injury upon admission to the hospital, the PI should be excluded from the numerator but the individual's number of days at the hospital would not be excluded from the denominator.
  • HHSC understands that baselines have been reported for this measure, and will not be changing the published measure specifications for DY7-8. Providers do not have to revise their reporting methodology at this time. For DSRIP reporting purposes, providers may choose to report D3-335 using either the measure steward (SPS) specifications or the published HHSC specifications. Impacted providers were notified of this issue on 4/11/19.
Category D
  • PPE Reports: Providers have asked HHSC to clarify the situations in which providers would receive PPE reports with no meaningful data versus situations when providers did not receive any EQRO report. Based on the ICHP methodology:
    • For PPR/PPA/PPV, low volume provider is defined as <40 at-risk admissions/ED visits OR <5 actual PPR chain/PPA/PPV OR <5 expected PPR chain/PPA/PPV.  If a hospital receives no PPR/PPA/PPV report, it means this hospital has no at-risk admission for PPR/PPA (or no at-risk ED visits for PPV).
    • For PPC, low volume provider is defined as <40 at-risk admission OR <5 PPC admission.  If a hospital receives no PPC report, it means this hospital has <30 inpatient admissions.
  • Category D template: providers requested information on size limitations for the qualitative response in the Category D template. The template does not limit how many characters can be entered in the response to qualitative questions, the maximum is only limited by Excel’s capabilities, which is almost 33 thousand characters.
April DY8 R1 Reporting Period
  • Wednesday, April 24, 2019 – Final date to submit questions regarding Category C April reporting and inform HHSC of any issues with DY7 data in the Category C Reporting Template or DSRIP Online Reporting System.
  • Friday, April 26, 2019 – Final date to submit Category A, Category B, and Category D questions regarding April reporting and inform HHSC of any issues with DY8 data in the DSRIP Online Reporting System.
  • Tuesday, April 30, 2019, 11:59 pm – Due date for providers’ submission of April DY8 DSRIP