1. Region 15 Regional Healthcare Partnership Fifth Public Meeting
Wednesday, August 22, 2012
University Medical Center of El Paso
Anchor Hospital

2. Confirmation of New Participants
El Paso County
UBH
Salvation Army
El Paso Child Guidance Center

3. New Template and Evaluation Form
Revised RHP 15 Project Template
Multiple changes to reflect the latest revisions by HHSC
Added section for narrative to be included for each project valuation
HHSC would prefer to see fairly flat valuations across the 4 years
Maximum project value over the four year period is the greater of 10% of entity’s Pass 1 allocation or $10,000,000
DSRIP Proposal Evaluation Form
For use by IGT Entities to evaluate outside entity project proposals

4. Summit Recap – UC Tool & RHP Plan Template Tool
UC Protocol Approval
Hospital and Physician UC Protocols Approved
The tool has been uploaded
30 days from posting to due date
Completion of this tool will provide UC Reimbursement
UC -- DY1 Payment = late November / December 2012
UC – DY2 Payment = Early 2013
Issues with macros in the tool
HHSC will publish a UC Tool Training webcast online ASAP
An electronic RHP Plan Template Tool will be released after the protocols are approved by CMS (8/31/12).
Webinar training will be provided for this tool

5. Anchor Call Recap - DSRIP Menu Changes
ICD-10 Coding and ED Door to Doc Times, both removed from the Menu (Cat 1 and 2)
Patient Experience moved to Category 3 (Outcome Measure)
Residency Programs – Yes
No longer a 3 project requirement in Category 3
Waiver Projects surrounding Jail system – patients or services must be for a Medicaid eligible patient
They would like to see a listing of our projects that we considered but excluded from the Plan, i.e. No List

6. Anchor Call Recap - DSRIP Menu Changes
Significant Changes in the entire format of the Menu!
Involving Metrics and Outcomes Reporting for Categories 1, 2 & 3
All Category 1& 2 projects MUST have an associated Category 3 Outcome
New Definition – Outcomes Definition = “measures that assess the results of care experienced by patients, including patients’ clinical events, patients’ recovery and health status, patients’ experiences in the health system, and efficiency/cost”
Category 1&2 contain many “outcomes measures” that will be moved to Category 3.
Other Improvement measures that do not meet the outcomes definition will remain in Cat 1&2.
A list of Category 3 Outcomes is under development.

7. Anchor Call Recap – Category 3 Payments
Possible Options:
Cat 3 DY 2 & 3 Payments will be for preparing to report outcomes for DY 4 & 5, i.e. establishing baselines and preparing data systems
Or, no funding in Cat 3 for DY 2 & 3
Cat 3 DY 4 & 5 payments will be for meeting outcome targets
Can either set an estimated outcome goal in plan, or list TBD
Criteria to meet the targets has not been developed yet
HHSC is proposing that Cat 3 be a combination of pay for performance and pay for reporting
Partial payments for Outcomes may be considered

8. Medicaid Waiver Timeliness
Final Approval on PFM Protocol and Menu – August 31, 2012
Draft that was just sent to CMS is on our website
Two weeks after approval – IGT Entities and Private Hospitals submit their final Chapter of Projects to Anchor
Estimate September 14, 2012
October 31, 2012 – Submit RHP to HHSC (4 year plans)
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

9. New Draft DSRIP Menu Category I Project Areas
Expand Primary Care Capacity
Increase Training of Primary Care Workforce
Implement and Utilize Disease Management Registry Functionality
Enhance Interpretation Services and Culturally Competent Care
Collect Accurate Race, Ethnicity and Language (REAL) Data to Reduce Disparities
Enhance Urgent Medical Advice
Introduce Telemedicine
Expand Specialty Care Capacity
Enhance Performance Improvement and Reporting Capacity
Expand Behavioral Health Services
Expand Dental Services
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 for Cost Containment
Establish/Expand a Patient Care Navigation Program
Apply Process Improvement Methodology to Improve Quality/Efficiency
Use Palliative Care Programs
Conduct Medication Management
Implement/Expand Care Transitions Programs
Health Promotion and Disease Prevention
Behavioral Health

11. New Draft DSRIP Menu Category III Project Areas
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

12. 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).
Patient Experience

13. New Draft DSRIP Menu Category IV Project Areas
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
30-Day Readmissions
All-cause readmission rate
Congestive heart failure readmission rate
Diabetes readmission rate
Behavioral health readmission
COPD readmission
Stroke readmission
Pediatric asthma

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

15. Roundtable

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