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.

Pending: Anchor submits RHP 9 plan to HHSC 
Tuesday May 22-23, 2018:  2018 RHP 9, 10 & 18 Collaborative Connections - Impacting CareRegistration at https://2018collaborativeconnectionsimpactingcare.eventbrite.com
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

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.
Compliance Monitoring
  • MSLC is continuing its work with Category 1 and 2 and Category 3 Performance Reviews with the expected completion date of May 2018.
  • MSLC guidance for DY7-8 for the Category B - System Definition Data Support Guide and Category C Data support guide and Guidance for Risk Adjusted Measures has been posted on Bulletin Board under Waiver Renewal.
Waiver Extension

Category A

Anchors previously asked HHSC if this is a reasonable approach to understanding a Driver Diagram:

  • Core Activity/Primary driver: What is the change/intervention that is needed to impact the measure/bundle?
  • Secondary driver: Where are the opportunities for this change to happen?
  • Change idea: How will you create optimal change (in the secondary driver)?
  • This approach seem to be in line with other information available on driver’s diagram. For example:
    • Core Activity/Primary Driver - intervention/goals/ that will “drive” the achievement of the main goals.
    • Lower level drivers or secondary drivers - the process of breaking down an intervention/core activity/goal into more specific areas, lower level goals.
    • Change idea -range of actions that will be undertaken to make an impact and achieve the goals. Assumption is made that actions from change ideas will ultimately assist in reaching goals for primary and secondary drivers and impacting the main goal.
  • Attached is an example of driver diagrams from RHP 6. This is still a work in process and the information may change, but the examples may be helpful.
Category B
  • HHSC is planning to include additional updates to Category B FAQ next week.