1. Region 15 Regional Healthcare Partnership 4th Public Meeting
Wednesday, July 25, 2012
University Medical Center of El Paso
Anchor Hospital

2. Confirmation of New Participants

3. Medicaid Waiver Timelines

4. Medicaid Waiver Timelines
Program Funding & Mechanics (PFM) and the RHP/DSRIP protocol
HHSC is reviewing more than 900 public comments and in negotiation with CMS
Final Approval - ??
UC Protocol Approval
Hospital and Physician UC Protocols Approved
The tool should be available on July 30th
Individual pre-populated tool will be created for each Hospital
30 days from posting to due date
Still finalizing the Ambulance and Dental tools

5. RHP Planning Summit Pre-Summit Webinar – tentatively August 3rd:
Changes in PFM Protocol
Clarifications re Public Comments
Overview of the DSRIP Planning Status
RHP Planning Summit – August 7,8, 2012 Austin, TX
Final protocol for submission of RHPs will be rolled out to Anchors
Instructions on electronic template submission rules
Webinar to view the Summit, watch presentations and hear discussions:

6. Medicaid Waiver Timelines
September 1, 2012 – Submit RHP to HHSC (4 year plans)
HHSC / CMS extended the deadline for submission of RHPs to October 31, 2012 for regions that require an extension.
RHP15 would like to submit the plan to HHSC on August 15th
Timelines of 1st year payments are dependent on when RHP is submitted to HHSC/CMS
September 1 - October 31, 2012 – HHSC Submit Final RHP to CMS
Dependent upon when Region submits to HHSC
HHSC is requesting submission the soonest possible date from regions
October 15, 2012 – RHPs make changes to their plan if required
December 15, CMS completes review
RHPs returned for revisions during the 30 day period
January 15th, Revised RHP Plans to CMS
February 1st, CMS Final Decision

7. RHP 15 DSRIP Projects See Handout
Categories I and II for all Performing Providers
Categories III and IV for Hospital Performing Providers
Hospitals must submit:
Category III Optional Project and Measurements
Category IV Reporting Data

8. New Draft DSRIP Menu Category I Project Areas
1. Expand Primary Care Capacity
2. Increase Training of Primary Care Workforce
3. Implement and Utilize Disease Management Registry Functionality
4. Enhance Interpretation Services and Culturally Competent Care
5. Collect Accurate Race, Ethnicity and Language (REAL) Data to Reduce Disparities
6. Enhance Urgent Medical Advice

9. New Draft DSRIP Menu Category I Project Areas (cont.)
7. Introduce Telemedicine
8. Enhance Coding and Documentation for Quality Data
9. Expand Specialty Care Capacity
10. Enhance Performance Improvement and Reporting Capacity
11. Expand Behavioral Health Services
12. Expand Dental Services
13. Expand or Enhance Emergency Medical Transportation Services

10. New Draft DSRIP Menu Category II Project Areas
Expand Medical Homes
Expand Chronic Care Management Models
Redesign Primary Care
Redesign to Improve Patient Experience
Redesign for Cost Containment
Establish/Expand a Patient Care Navigation Program

11. New Draft DSRIP Menu Category II Project Areas (cont.)
Apply Process Improvement Methodology to Improve Quality/Efficiency
Improve Patient Flow in the Emergency Department/Rapid Medical Evaluation
Use Palliative Care Programs
Conduct Medication Management
Implement/Expand Care Transitions Programs
Health Promotion and Disease Prevention

12. New Draft DSRIP Menu Category III Project Areas
Severe Sepsis Resuscitation and Management (Mandatory)
Choose Process Measure
Choose Improvement Measure
Potentially Preventable Admissions
Congestive heart failure admission rate
Diabetes, short-term complications, admission rate
Diabetes, uncontrolled diabetes, admission rate
Behavioral health potentially preventable admissions
Chronic obstructive pulmonary disease or asthma in adults admission
Hypertension admission rate
Diagnosis and management of asthma
Potentially Preventable Readmissions
All cause readmission rate
Congestive heart failure readmission rate
Diabetes readmission rate
Behavioral health readmission
COPD readmission
Stroke readmission

13. New Draft DSRIP Menu Category III Project Areas (cont.)
Potentially Preventable Complications
Perinatal Outcomes
Birth trauma rates
Elective pre 39-week delivery
Diabetes Composite Measure
Hemoglobin A1c (National Quality Forum (NQF) 0059)
Blood Pressure (NQF 0061)
Low-Density Lipoprotein Cholesterol (NQF 0064)
Retinal or dilated eye exam (NQF 0055)
Foot exam (NQF 0056)
Nephropathy screening (NQF 0062)

14. New Draft DSRIP Menu Category IV Project Areas
1. Potentially Preventable Admissions
Congestive heart failure admission rate
Diabetes, short-term complications, admission rate
Diabetes, uncontrolled diabetes, admission rate
Behavioral health potentially preventable admissions
Chronic obstructive pulmonary disease or asthma in adults admission
Hypertension admission rate
Diagnosis and Management of Asthma
2. 30-Day Readmissions
All-cause readmission rate
Congestive heart failure readmission rate
Diabetes readmission rate
Behavioral health readmission
COPD readmission
Stroke readmission
Pediatric asthma

15. New Draft DSRIP Menu Category IV Project Areas (cont.)
3. Provider Preventable Complications
4. Patient-centered Health Care
a. Patient satisfaction
b. Medication management
5. Emergency Department
a. Admit decision time to ED departure time for admitted patients
6. Diabetes Composite Measures
a. Hemoglobin A1c
b. Blood Pressure
c. Low-Density Lipoprotein Cholesterol
d. Retinal or dilated eye exam
e. Foot exam
f. Nephropathy screening

16. Roundtable

17. Contact Information
Waiver Website & Address:
UMC Website:
Region 15 - RHP
Paso del Norte Blue Ribbon Committee Needs Assessment: