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)

2018: RHP 9 Rapid Cycle Improvement Cohort.   Event is being Rescheduled....TBD


Making a Difference

Waiver Renewal
  • Waiver Negotiations Update
    • Communications are still ongoing with CMS and updates will be provided as they are available, including timelines.
    • CMS is currently reviewing the proposed Program Funding and Mechanics Protocol (PFM), the Measure Bundle Protocol (MBP), and the draft Measure Specifications.
  • Category C
    • The first installment of an FAQ based on the questions and feedback submitted on the draft Measure Specifications document will be posted early this week on the online reporting system bulletin board.
    • Over 1,000 individual questions were submitted to HHSC.  Many cannot be answered without program approval by CMS.
    • Questions can continue to be submitted to the HHSC box but please do not resubmit questions. 
    • HHSC has received a number of comments regarding the administrative complexity of the measure specifications source for measure J1-222 Severe Sepsis and Septic Shock Management Bundle (NQF 0500) and will be evaluating alternative specifications sources.
  • Rules
    •  The DSRIP DY7-8 rules were published as adopted in the November 24, 2017, issue of the Texas Register with an effective date of December 1, 2017. HHSC is currently working to amend these rules to reflect the most recent versions of the DSRIP protocols as of December 22, 2017. HHSC anticipates that the amendments will be published as proposed in the Texas Register in January 2018, for an anticipated effective date of April 2018. HHSC also anticipates that the rules may need to be further amended once HHSC and CMS have finished negotiating the DSRIP protocols.
October DY6 Reporting
  • For QPI NMIs, please utilize the October DY6 QPI Reporting Template to address NMI questions.
  • Category 3
    • The Cat 3 Template for the Need More Information (NMI) response period has been posted on the DSRIP online reporting system’s Bulletin Board. The NMI template differs from the Cat 3 Template used for the primary reporting period. Providers must submit the NMI Template during the NMI period. They should not submit the primary reporting period template.
    • The NMI Reporting Template originally posted on the online reporting system’s bulletin board was updated on 12/14/17 to unlock some milestones for NMI reporting that were inadvertently locked. The update affects DY5 milestones that had not been fully achieved and had not yet reported PY3A that were marked Partially Approved. Since DY6 R2 is the last opportunity to earn funds associated with DY5 milestones, the signoff has been changed to Need More Information to allow providers to report for achievement. HHSC has updated the online reporting system to reflect these changes and is contacting affected providers to make them aware of the NMIs. If you are not contacted about a change and are using the originally posted version of the NMI template, there is no reason to submit the revised template. If you are contacted about changes, please be sure to submit the revised (version 2) NMI template.
    • If you didn’t receive an NMI, please do not rely on the NMI reporting template to confirm DY6 R2 reporting. HHSC is still making updates to the Category 3 database.  HHSC will post an updated Summary Workbook to the online reporting system as soon as this process is complete.
Compliance Monitoring
  • HHSC continues sending out notifications for Round 3, and the process will continue for several weeks, depending on the resolution or need for clarification for some projects.
  • MSLC sent out notifications for Category 1 and 2 Round 4 review. The reviews should be completed by May 2018.
  • MSLC has started sending out notifications for Category 3 Round 3 Performance Reviews and will have all notifications out by the end of next week (12/22/17). We anticipate that this round of reviews will be completed by May 2018 for most projects.
October DY6 Reporting
  • Deadlines to submit October reporting questions to the HHSC box are October 20th for Cat 3 and October 25th for Cat 1, 2, and 4 issues. 
  • The October DY6 webinar and reporting documents are posted on the Online Reporting System Bulletin Board. 
  • If providers access to the reporting system, please complete and submit an RHP Contact Change Form, which can be found here: https://hhs.texas.gov/sites/default/files/documents/laws-regulations/policies-rules/1115-docs/RHP/Plans/Contact-Change.pdf.
  • For QPI: MSLC validated changes that were incorporated into the data seeding of the October DY6 template only include date changes for applicable carryforward metrics or changes to the pre-DSRIP baseline. These are the only elements that impact current reporting. Do not expect to see changes in the reported achievement numbers in the template.
  • For the Sustainability Template, the initial template had some sizing quirks that have been addressed in an updated version. If you find that you cannot see checkboxes or drop-down menus, please download the most recent version of the Sustainability Planning Template from the Online Reporting System bulletin board. The old version has been removed from the website in order to maintain version control.
  • There is an issue with the Category 3 October DY6 reporting template that affects the calculation of DY6 achievement for some projects. HHSC will be issuing a corrected template very soon. If a provider has not already completed the Category 3 reporting template, please wait until next week to download the template just to give us time to make sure the issue is resolved. HHSC will also send an email to providers we have identified that will be affected by this issue. If they discover an error in a template that has already been completed they will work with the provider to correct it.
  • Just a heads-up: HHSC plans to have a Cat 3 Template for the NMI period that will be different than the Cat 3 Template for the primary reporting period. Providers must submit the Cat 3 NMI Template during the NMI period. Providers cannot submit general reporting period template during the NMI period.
Category C
  • Attached is a MPT Calculator Tool and user instructions.The tool allows providers to model an array of measure bundles/measure selections in order to meet MPT. 
  • Reminder to complete the Cat C measure specification surveys.  The links were sent on in my 10/2/17 email.  HHSC is particularly interested in feedback on measure settings, the draft instructions for determining payer-type, sampling methodology, and currently included DSRIP specific modifications to measures.