1. Region 15 Regional Healthcare Partnership 40th Public Meeting
Wednesday, NOVEMBER 30, 2016
University Medical Center of El Paso
Anchor Hospital
Texas tech university health sciences center – Medical Education Bldg (MEB) – Rm 1110

2. Confirmation of Participants
University Medical Center of El Paso
Texas Tech University Health Sciences Center at El Paso
El Paso Children’s Hospital
Hospitals of Providence (Tenet)
Las Palmas – Del Sol Hospital (HCA)
El Paso Health Department
Emergence Health Network
El Paso Medical Society
Visitors
Roll Call

3. ANCHOR UPDATES Cathy Gibson Anchor RHP 15 Compliance Monitoring
Waiver Renewal
Community Health Needs Assessment
Timeline

4. ANCHOR UPDATES Myers & Stauffer Compliance Monitoring
MSLC will prepare a summary for Cat 1 and 2 reviews soon
Anchor will receive and distribute to providers
ANCHOR UPDATES

5. ANCHOR UPDATES Waiver Renewal DSRIP Specific negotiations
Negotiations underway with CMS
October 21st face to face meeting in DC
Key Areas for Waiver negotiations:
Size of Uncompensated Care (UC) Pool
Size and evolution of the DSRIP Pool
CMS Supports Managed Care Delivery Model for Texas
5-Year waiver period beginning Jan
DSRIP Specific negotiations
CMS Focus on “payment reform” for all current waivers that contain DSRIP
CMS guiding principles on DSRIP
Should be about incentives, start-up funds and capacity building
NOT on-going program operations
Integration of funding into Medicaid Manage Care
However, a portion of DSRIP could continue OUTSIDE of Managed Care for UNINSURED
HHSC trying to understand CMS’s definition of value based purchasing and timelines for this transition to occur
ANCHOR UPDATES

6. ANCHOR UPDATES Community Health Needs Assessment
Currently June (may move to a later date)
Paso Del Norte Foundation
DRAFT
ANCHOR UPDATES

7. TIMELINE November 1, 2016 January 3, 2017 November 18, 2016
HHSC Review of October submissions
November 18, 2016
HHSC estimates IGT (October reporting)
November 21, 2016
5:00pm IGT approve and comment on estimates
December 2, 2016
5:00pm – Submission of any IGT changes
December 9, 2016
HHSC/CMS complete review and approval of October reports and/or NMI
January 3, 2017
IGT settlement date
January 13, 2017
DY5 Oct DSRIP payments processed for hospitals
January 16, 2017
11:59 pm Responses due to HHSC for NMI requests.
January 31, 2017
DY5 Oct DSRIP payments processed for all other providers
February 24, 2017
HHSC/CMS approve or deny NMI requests

8. Project PRESENTATION

9. ANNUAL REPORT INPUT DSRIP Program Manager Oscar Perez
Go to your browser: OR Text: OSCARPEREZ394 to To join the session

10. DY6 MILESTONES DSRIP Program Manager Oscar Perez
Quantifiable Patient Impact (QPI)
Core Component Reporting
Sustainability Plan

11. Cat 1 and 2 Requirements (Milestones)
Standardized for ALL projects
Four (4) Total Milestones
2 Quantitative
2 Qualitative
1. Total QPI
Value is 25%
2. MLIU QPI
3. Core Component Report
4. Sustainability Plan

12. MLIU – Medicaid low income uninsured
To qualify as MLIU QPI
Enrolled in Medicaid
at the time of at least one encounter during the DY
Qualified as Low-Income or Uninsured
Below 200% of Federal Poverty Level (FPL) OR
at the time of at least on encounter during the DY
Uninsured
at the time of a separate encounter during the DY
If patient was on Medicaid and then became Low-Income or Uninsured during the DY
Counted as “Medicaid” for DSRIP purposes
Either
Individuals Served OR
Encounters Provided
Stipulated by the project

13. Milestone 1: Total QPI HHSC will determine the target
Same as DY5 (TOTAL QPI Goal)
May request variance from HHSC (TBD)**
Grouping must be same as DY5
No changes
Pre-DSRIP baselines remain the same
Carry Forward IS allowed

14. Milestone 2: MLIU QPI If project had MLIU goal in DY5
DY6 goal is same as DY5 goal
Pre-DSRIP baseline stays same
If project had no MLIU goal in DY5
DY6 is
Pre-DSRIP QPI x %MLIU (DY3 or earliest on record)
EXAMPLE
MLIU QPI MAY BE PFP OR PFR
Projects in Project Area 1.9.*
% MLIU Not Achieved in DY3, DY4, DY5
Identified by HHSC and notified

15. Milestone 3: Core Component Reporting
Based on Project Option
Each Core Component must be addressed
Usually 3 or more of these
ALL have a Continuous Quality Improvement (CQI) Element
EXAMPLE
2.9.1
A,B,C,D,E A
Identify frequent ED users and use navigators as part of a preventable ED reduction program. Train health care navigators in cultural competency. B
Deploy innovative health care personnel, such as case managers/workers, community health workers and other types of health professionals as patient navigators. C
Connect patients to primary and preventive care. D
Increase access to care management and/or chronic care management, including education in chronic disease self‐management. E
Conduct quality improvement for project using methods such as rapid cycle improvement. Activities may include, but are not limited to, identifying project impacts, identifying “lessons learned,” opportunities to scale all or part of the project to a broader patient population, and identifying key challenges associated with expansion of the project, including special considerations for safety‐net populations.

16. Milestone 4: Sustainability Plan
Project Level
“How does the institution plan to keep this project going when the DSRIP dollars are gone?”
Plan may Include
Systems for Exchange of Health Information
Integration into Managed Care
Collaboration with other community partners
Project Level Evaluation
Return On Investment
Quantifiable Outcomes

17. REGIONAL learning collaborative PLAN
DSRIP Program Manager
Oscar Perez
Go to your browser: OR Text: OSCARPEREZ394 to To join the session

18. REGIONAL learning collaborative PLAN
New Plan needed for DY6+
Annual Summit for the Region (minimum)
Established Workgroups
Diabetes
Behavioral Health
Re-Focus : Integration of DSRIP projects:
Medicaid Managed Care
Value Based Purchasing
Alternative Payment Models
Sustainable Strategies for Low Income Uninsured Patients
Stakeholder’s Forum
Regional Community Healthcare Needs Assessment
Paso Del Norte Foundation
Tentatively DUE June 2017

19. Key Aspects of collaboratives
Focus on Closing the gap of a known problem with known solutions
Use Standard Model for this work
Must be Fast Paced with timeline for goals
Must use Standard Measures
Working Membership
Sharing of ideas and data is required
“All Teach, All Learn” philosophy

20. Contact Information
NEW Waiver Website:
Waiver
TXHealthcare
UMC RHP15 Website:
Region 15 - RHP

21. Next Meeting: January 25, 2017 1:00pm