Monthly Status Update Call September 2014

RHP 12 Learning Collaborative

DSRIP Road Trip New Cohort Topics Project Highlight Waiver Updates Statewide Learning Collaborative Feedback

Agenda

DSRIP Road Trip

How’s your project(s) doing? On-site PDCA Cycle Motivational Interview Training Waiver 101 Ideas for other topics to address

Access to care Preventive Services Medical Home Readmissions Unnecessary ED Utilization Infectious Disease Management Post-Acute Care

Survey will be sent out to gage interest

New Cohort Topic Suggestions

DY3-Provided Education/Evidenced-based practices

DY4-Focus on Category 3 Measures Top 5 Measures Selected for Cat 3 include:

◦ ED Related (30)◦ Diabetes Care Related (22)◦ HTN (Blood Pressure) Related (7)◦ Satisfaction Survey Related (13)◦ BH-Quality of Life Type Surveys (13)

Would also involve reporting metrics monthly

New Idea for DY Cohorts

Need Volunteers! Feature 1-2 projects per month Tell us about your project Share a patient story Share successes Share challenges

Project(s) Spotlight

Waiver UpdatesBobbye Hrncirik

HHSC continues to reach out to providers that have notified them of baseline data concerns that will not have 6 months of baseline data by the end of DY3 (09/30/14) or anticipates a baseline rate of “0”. The following RHP 12 providers have requested baseline assistance from HHSC:

HHSC is nearing the completion of updating the Category 3 Appendixes and they are expected to be finished this week.

Determination of baseline period and DY4 and DY5 achievement periods:◦ Baseline period will be officially submitted during DY3 October Reporting and

should include 6-12 consecutive months of data beginning not before 09/01/12 and ending not later than 09/30/14

◦ DY4 measurement period with be the first 12 months immediately following the baseline period

◦ DY5 measurement period will be the second 12 months immediately following the baseline period

Category 3

HHSC has estimated that they will provide comments/preliminary determinations to the anchors in late October or early November

Providers will be asked to respond to HHSC comments on Change Requests in mid-November

HHSC will be prioritizing plan modifications over technical changes so that they can provide plan mod feedback as soon as possible

Plan Mod and Tech Change Request

HHSC continues to work with Cooper Consulting on the development of an automated web based system for DSRIP reporting

HHSC is determining the extent of the use for the system in regards to DY3 October Reporting◦ Website stress and load testing is being conducted on the

automated system this week. If stress and load testing does not pass, the webinar will focus on the spreadsheet system used in the past instead of the automated web based system.

DSRIP Automated Reporting System

Due on or before October 31, 2014 Do not submit achievement of a metric unless achieved on or before

September 30, 2014 HHSC focuses on Dates. Please include a date on all documentation 100% achievement beyond a shadow of a doubt

We are expecting the same qualitative questions as before: Project Overview: Accomplishments? Project Overview: Challenges? Project Overview: Lessons Learned? Patient Impact for Medicaid/Low-Income Uninsured (MLIU) Population? Progress on Core Components? Continuous Quality Improvement Activities?

Your responses to the qualitative questions should relate to the project from 10/01/13 through 09/30/14 but even more specifically from 04/01/14 through 09/30/14

DY 3 October Reporting

Wednesday, October 1 from 10:30 a.m. to 12 Noon: Quantifiable Patient Impact (QPI)

Thursday, October 2 from 2 to 3:30 p.m.: Category 3 baselines

Monday, October 6 from 10:30 a.m. to 12 Noon: Method of reporting –HHSC plans to have the log-in information in advance of the webinar along with user instructions. If the stress and load testing does not pass, the webinar will focus on the spreadsheet system we have used in the past.

QPI, Cat 3 and Method of Reporting Webinars

Objective: Review the degree to which the project being implemented is related to the approved plan and is measureable. Identify risk issues associated with variances from the approved plan

Approximately 700 projects statewide were selected for a detailed desk review based on one of the following:◦ Project options requested to be reviewed by CMS (1.10,

2.4, 2.5, and 2.8)◦ Projects flagged (high dollar value, risk, etc.) by HHSC

during approval, plan modification, or reporting reviews◦ Projects selected via random sampling (approximately

400)

Mid-Point Assessment

34 projects within RHP 12 were selected for a detailed desk review

Mid-point assessment will consist of:◦ Detailed desk reviews of DY2 October and DY3

April reporting for each of the 34 projects◦ On-site reviews of project status for limited

number of projects from the initial 700◦ Plan modification reviews

Mid-Point Assessment

The following providers had at least one project selected: Childress Regional Medical Center City of Amarillo Cogdell Memorial Hospital Collingsworth General Hospital Coon Memorial Hospital Covenant Medical Center Golden Plains Community Hospital Helen Farabee Center Hereford Regional Medical Center Lynn County Hospital District Medical Arts Hospital Memorial Hospital Moore County Memorial Hospital Gaines County Ochiltree General Hospital Pampa Regional Medical Center Parmer County Community Hospital StarCare Specialty Health System Sunrise Canyon Hospital Texas Tech Amarillo Texas Tech Lubbock University Medical Center

Providers selected for Mid-Point Assessment

Representative Coleman recently met with CMS representatives to request that Texas be allowed to access $345 million in unspent DY2 DSRIP funds

CMS was receptive and some of the ideas discussed were related to Behavioral Health and care for veterans

HHSC will be working on a proposal for how to use these funds in a way that is transformative, builds on existing DSRIP projects, and is not overly administratively burdensome for providers, anchors and the State.

HHSC has welcomed our thoughts on this and will share the proposal with us in advance of submitting the amendment request to CMS

HHSC plans to develop the framework for comment and they also want to get a sense of who may be interested in participating (and has IGT to do so)

Unspent DY2 DSRIP Funds

The current 5-year Waiver is set to expire on September 30, 2016

HHSC must submit a transition plan to the Centers for Medicare & Medicaid Services (CMS) by March 31, 2015. Transition plan includes:

Experience with the DSRIP projects Actual UC trends in the State Investment in value based purchasing or other reform options

For the March 2015 transition plan, HHSC plans to convey the continued need for both UC and DSRIP funds in Texas

Waiver Renewal/Extension

Highlights from the Summit included: Patient Stories DSRIP has created what may be the highest level of provider

collaboration Texas has seen in regards to healthcare Peer networking between providers CMS emphasis is on continuum of care, care transitions,

measures, and patient outcomes CMS is looking for sustainable changes CMS is looking to Texas to make a case for how the money

allocated to Texas is making a difference and what needs to happen next (renewal/extension)

Childress cancer collaboration video was played (result of 1115 Waiver collaboration). Here is the link: https://www.dropbox.com/s/ku5fv7yot6233iw/Texas%20RHP12%20Video.mp4?dl=0

Statewide Learning Collaborative Highlights

As part of the Summit, we are distributing a survey to all attendees to better understand successes and challenges with the DSRIP program as we plan for waiver extension/renewal. In case you did not fill out a paper copy of the survey at the Summit on September 9th and 10th, it is available to be completed online. Please click on the provided link to answer the questions and click "Done" when complete: https://www.surveymonkey.com/s/dsripslcsummit

The survey link will remain live until October 6th. Learning Collaborative participation for Metric Achievement Recorded sessions coming soon

Statewide Learning Collaborative Follow-Up

Questions/Discussion

Thank you!