RHP9 Updates

• Please see my email from Thursday, 8/23 on the cost and savings guidance documents.  They are also available on the DSRIP Online Reporting System.
• Providers requesting the use of Alternative Tools will need to fill out and submit Attachment B by December 3, 2018.  (Attachments A & B are in the guidance document but will send when HHSC posts them separately). 

Early Baselines

• Early Baseline:  HHSC will send notification of baseline acceptance or additional information /TA needed the 1^st week of September. 
• Early baseline measures will be marked as either “Accepted”, “Flagged for TA”, or “Not Accepted”
• Accepted:  Approved for payment for the baseline reporting milestone in October DY7 and are approved to report performance year 1 (PY1 /CY2018) in April DY8.
• Flagged for TA:  Approved for payment for the baseline reporting milestone in October DY7 but require additional communication between the provider and HHSC to resolve the baseline TA flag before PY1 can be reported.
  • Common causes of "Flagged for TA" include insignificant denominator volume for the currently approved achievement payer type, unreasonably low baseline rate (typically for process measures with a positive directionality), and adherence to measure specifications.
  • Measures flagged for Technical Assistance will receive a written summary of identified issues in the baseline review results. HHSC is not asking for an immediate response to the technical assistance flags.
  • HSC will begin working with providers with one or more TA flags to resolve the flags during the month of September. HHSC will contact providers via email to initiate the technical assistance process, and will CC anchors with the TA initiation email. Depending on the identified issues, HHCS may request a response in writing or request a conference call.
  • Some of the changes that could result from TA include:
    • Changes to the milestone structure, baseline measurement period, approved approximate baseline, or baseline numerator of zero;
    • Requiring that a correction be submitted in October DY7 or prior to PY1 reporting.
  • The baseline review results will include a general summary of common TA flags, possible resolutions, and the TA process.
• Not Accepted:  Do not meet the minimum baseline reporting requirements (for example, not reporting the all-payer rate when required and there is clearly an all-payer volume), or the provider indicated that significant modification requests were pending. Measures that are marked as "Not Accepted" will not be approved for payment for baseline reporting in October DY7 based on the early baseline reporting submission. Measures marked as "Not Accepted" will be eligible to submit a baseline that meets the minimum reporting requirements in October DY7, and will be reviewed by HHSC and possibly approved for payment when they are resubmitted.

Measure Specs

• MSLC’s Data Support Guide and FAQ to be updated this week
• HHSC’s Cat C FAQ to be updated early September

• Early September Release

• PPE reports sent to providers
• Regional summaries posted on the HHSC website
• Data for Cat D reporting for Physician Practices, CMHC, and LHD (some data may be posted earlier if it becomes available)

• Request for feedback

• HHSC is requesting feedback on potential changes to the measurement period for hospital reporting on Patient Satisfaction. HHSC received many questions on the measurement period that will be used by providers for Patient Satisfaction reporting. Based on previous reporting, providers utilized several measurement periods: calendar year, periods from 9/1-8/31, 10/1-9/30, 7/1-6/30, and 4/1-3/31.
• HHSC is considering standardizing measurement periods of calendar year 2017 (1/1/2017-12/31/2017) for DY7 and calendar year 2018 (1/1/2018 - 12/31/2018) for DY8.
• Please email me your concerns by noon today (Monday, 8/27)  if this simplification will have a significant impact on your reporting. If HHSC is not informed about any negative impact on providers with having only one option for the measurement period, these periods (stated above) will be used in DY7 and 8.

• HHSC is reviewing possible recoupments due to decreased achievements or unverifiable results from MSLC’s Cat 3 Round 3 reviews. HHSC will be contacting providers in the coming weeks regarding these reviews.
• MSLC Category 1 and 2 and Category 3:  Reviews in process.
• HHSC is still in the process of contacting providers about the results of Round 4 Category 1 and 2 reviews in cases where MSLC determined that the goals were not achieved or validated. Communication to providers should be expected during next two weeks as well.

• HHSC reorganized the DSRIP Online Reporting System Bulletin Board and removed outdated files.  This resulted in some files showing as revised when they were re-uploaded.  However no revisions were made.  (Reminder – there will be revisions for MSLC next week and Cat C FAQ in early September – see above).
• Waiver Website:  Planning and reference documents (ex:  DSRIP protocols, payment summaries, etc.).
• Online Reporting System Bulletin Board:  Documents needed for reporting and monitoring