Welcome to RHP 9 – Transforming Healthcare Now

Waiver Information

  • 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
  • 25 providers participating in Delivery System Reform Incentive Payment (DSRIP) projects
  • Needs assessment: Gaps in access, behavioral health, and overall care coordination.
  • 129 DSRIP projects
    • 46 Infrastructure Development projects (Category 1)
    • 83 Program Innovation and Redesign projects (Category 3)
    • 200 Plus Outcome Measures (Category 3)

Friday, December 9, 2016: 

HHSC and CMS will complete their review and approval of October reports or NMI regarding the data reported

Thursday, December 15, 2016: RHP9 Annual Report and Regional Learning Collaborative Plan for DY6a is due to HHSC
Sunday, January 1, 2017: Draft Protocols for continuing projects to finalize by Spring 2017
Tuesday, January 3, 2017: IGT due for October DY5 reporting DSRIP payments
Friday, January 13, 2017: October reporting DY5 DSRIP payments for transferring hospitals and top 14 IGT Entities
Monday, January 16, 2017: Due date for providers to submit responses to HHSC on NMI and incomplete semi-annual progress reports. 
Monday, January 30, 2017: DSRIP payment for October DY5 for remaining providers, April DY5 approved NMI, and DY4 CF. 
Tuesday, January 31, 2017: DSRIP payment for October DY5 for remaining providers and approved NMI from April DY5 for all providers
Wednesday, February 22 and Thursday, February 23, 2017: 

RHP 9 & 10 Collaborative Connections: Impacting Care Learning Collaborative.  Register at:  RHP 9 & 10 Learning Collaborative Event

Friday, February 24, 2017: HHSC and CMS will approve / deny NMI.  Metrics approved will be included in payment for the next DSRIP payment period (July 2017).  
June 2017: Regional Community Needs Assessment due.  

 

Making a Difference

Compliance Monitoring

There are a lot of questions and comments coming in about Compliance Monitoring results:

  • HHSC realizes that the timing would be better if providers received review results prior to reporting period and were aiming that way, however, MSLC did not have enough time to share the results prior to reporting period. Having this information now probably assisted some providers in decision making for DY5 reporting.
  • HHSC will make additional adjustments for the next rounds of review.
  • Category 1 and 2 Round 1:  HHSC has completed its review of MSLC findings for Round 1.
  • Category 1 and 2 Round 2:  HHSC is reviewing MSLC findings from Round 2.
  • The HHSC DSRIP team sent out communication to certain providers with CC to anchor informing them that additional work may need to take place to do additional validation of data for certain projects, and that this work should take place during the NMI period. The impacted projects had DY3 carryforward.
  • As HHSC continues to review, they may request additional information from providers.
  • HHSC anticipates that they will complete the initial review of Round 2 Category 1 and 2 by mid-November and determine what additional information is needed.
  • Category 3 Performance Review Round 1: HHSC is still reviewing results of Category 3 performance review and will have more details on any impacts to payment at a later date.

 DY6 Alternate Achievement Requests:  HHSC is currently reviewing responses from providers required to submit additional information and hopes to have final notice of approval the first week of November.  

DY6 Alternate Achievement Requests
HHSC is currently reviewing responses from providers required to submit additional information and hopes to have final notice of approval the first week of November
DSRIP rules
The second set of DSRIP rules has been published as adopted in the October 21 issue of the Texas Register, which is available here:http://www.sos.state.tx.us/texreg/index.shtml.
MSLC – Compliance Monitoring
  • Round 2 Cat 1 & Cat 2 and Round 1 Cat 3 Performance review will be finalized by September 30th.  MSLC will be submitting to HHSC first.
  • There are providers (unsure if RHP9) who either did not submit the required data or submitted it late.  HHSC will be sending a list of the providers/projects.  To finalize the review, providers will need to work with MSLC in October. 
  • Round 1 Cat 1 & 2 – still under review by HHSC 
Category 3

Cat 3 Interim Corrections

  • HHSC will send approval notices before the end of the month.

 

Category 3 Alternate Achievement Requests

  • HHSC feedback expected by the end of the month.
  • HHSC will not offer another opportunity to submit DY6 Alternate Achievement Requests for Category 3 outcomes.

 

Category 3 October DY5 Reporting:

  • Reporting Process: Similar to April DY5 reporting, all providers will submit a Category 3 template & certification for milestones related to reporting and achievement of Category 3 outcomes (milestones PM‐10, PM‐12, AM‐1.x, and AM‐2.x). Providers will not make any selections or updates in the online reporting system. All providers must submit a Category 3 Reporting Template, even if not reporting for payment. Providers will use the online reporting system to report on Population Focused Priority Measures (DY5 milestones AM‐3.x) and Stretch Activities (DY5 milestone PM‐11).
  • Reporting Eligibility: All outcomes that have a previously reported baseline are eligible to report all PYs that end by 09/30/2016 and have not been previously reported to HHSC. Outcomes with an open MSLC Category 3 Performance Review will need to complete review before October DY5 performance can be reported.
  • Correction Eligibility: As most P4P outcomes have reported Performance Year 1, most outcomes will not be able to automatically make corrections to previously reported baselines or performance in the October DY5 reporting template.
    • The following outcomes will be able to make corrections:
      • P4R outcomes, excluding those that were switched to P4R due to low volume.
      • P4P outcomes that have not yet reported PY1, excluding those with a baseline review conducted by MSLC, and excluding those with a custom goal (maintenance, HHSC approved alternate achievement request for DY4/DY5).
  • HHSC will update the Category 3 Summaries with October DY5 reporting eligibility as well as eligibility to correct previously reported baseline/performance through the reporting template.
  • MSLC Category 3 Performance Reviews: On September 30th, HHSC will receive an update on MSLC reviews of Category 3 performance. HHSC will update the Category 3 data used for October DY5 reporting to reflect any changes to baseline or performance as reported by MSLC. Most outcomes included in this round of Category 3 performance should have a completed review by September 30th. MSLC Category 3 performance reviews that are not completed by September 30th will

    continue into October, and will not be eligible to report performance in October DY5 until review is complete. MSLC estimates that they can complete any outstanding Category 3 performance reviews by the end of October if providers do not request additional extensions.

  • Attached is an updated Category 3 Summary