1. Welcome & Regional Update
RHP 12
Welcome & Regional Update
Jeff Dane
Hospital Administrator, Executive Vice President & Chief Financial Officer

2. Who’s here today 90+ Attendees 30 of our 36 RHP12 providers (83%)
Other RHP’s
RHP 14 – Midland/Odessa
Managed Care Organizations
Amerigroup
Superior
Other Stakeholders
Other Stakeholders include:
Tony Privett
UC ONLY Hospitals - Debra Miller from Crosbyton Clinic Hospital & Jace hospital

3. In your Folder Agenda Presenter Biographies
Summary of RHP12 Selected Outcome Measures
Evaluation Form
Personal Highlights Activity
Agenda – We will walk through in a minute
Summary of RHP12 Selected Outcome Measures is a table of all Region 12’s selected and approved Measure bundles. The second column indicates the providers who have selected the bundle. Some measures within the bundles are optional therefore some measures may not be selected by providers. The 3rd column represents CMHC’s & LHDs who have selected a single measure from their respective menus that aligns with the hospital and physician practice measure bundles.
Evaluation form – We value your feedback and want to provide the most valuable LC events for you so please take a time at the end of todays event to complete the evaluation form. Please leave the completed form in the center of your table.
Personal Highlights Activity – We borrowed this idea from our friends down in San Antonio, Region 6. It’s a fun note taking activity. We’ll go over the details after a quick overview of the agenda.

4. Agenda Overview
9:45-10:45 Going Beyond Fee-For-Service: Trends Driving Value Based Purchasing
Jamo Rubin, MD, Chief Executive Officer, TAVHealth
10:45-11:00 Networking Break
11:10–11:30 Value Based Purchasing Contract Models in Action
Yvette Hinojosa, Director of Business Services, UMC Physicians
11:30-11:45 Networking Break
11:45-12:45 Lunch: The Telemedicine Wellness, Intervention, Triage and Referral Project
Billy Philips, PhD, Executive Vice President, Rural and Community Health Texas Tech University Health Science Center
We will first hear from Dr. Jamo Rubin, Chief Executive Officer at TAVHealth. TAVhealth’s focus is on solving social determinants of Health and improving outcomes today. Dr. Jamo will share the impact of social determinants on health and how the trends are driving value based care.
Networking break
Following Dr. Rubin, Yvette Hinojosa, Director of Business Services at UMC Physicians will share their journey to Value Based Contracting including their strategies, hurdles, and their current state.
Another Networking break
We have a guest speaker today for our lunch hour. Dr. Billy Philips is the Executive Vice President & Director for Rural and Community Health at Texas Tech University’s Health Sciences Center. They have developed and are implementing a new telemedicine wellness, intervention, triage and referral program dubbed “The TWITR Project”. This project is school-based and will provide screenings, assessments and referral services to students who are judged to be immediate threats to do harm to themselves or others.

5. Agenda Overview Adjourn 12:45-1:00 Networking Break
1:00-1:45 Mental Health Hot Topics
Lee Johnson, Deputy Director, Texas Council of Community Centers
1:45-2:00 Networking Break
2:00-3:00 Health Information Exchange Discussion
Emily Hartmann, PHIX Network – Physicians, Patient & Private Health Information Exchange
Gijs Van Oort, PhD, HASA Health Information Organization
Adjourn
At 1 we will hear from Lee Johnson, Deputy Director at the Texas Council of Community Centers. Lee will share updates on hot topics in mental health.
We will end our day with an Health Information Exchange Discussion led by Emily Hartmann and Gijs Van Oort. Emily and Gijs are leaders in the HIE arena and will provide an overview on what is an HIE, the current status of HIEs in Texas and tips on how to choose the right network.

6. Please open your folders and look for this “What are You Taking Home From Today’s Event” form. It looks like this.
This is an activity designed to be a fun way to help you record your personal highlights from today’s event. We have 5 different areas for you to be thinking about as you hear our speakers today:
In the circle, please list a program or resource you hear about that you would like to share with colleagues.
On the post it note look for a lesson learned that you will remember from today’s event
On the hand list the names of someone you met who you might call on to discuss all things waiver or other ideas.
What did you like about today’s Event? Place this in your thumbs up icon.
And finally you have a lightbulb for ideas you want to think more about and research further.
At the end of the day please take a picture of your completed form and or text it to Bobbye.
Please take a photo and completed highlights form to or text

7. Regional Healthcare Partnership 12
RHP 12
47 Counties
45,538 Square Miles
36 Performing Providers
22 Rural Hospitals
6 Urban Hospitals
4 CMHCs
2 Health Science Centers
1 Local Health Dept.
1 Psychiatric Hospital

8. What’s new with DSRIP?

9. 2018 = Performance Period for DY7 Outcome Achievement
11/7/2018
Not new
DSRIP is Complicated and Constantly Changing
2017
DY 7 Begins
Oct
Renewal Approved
Dec
2018 = Performance Period for DY7 Outcome Achievement
2018
Protocols Approved
Jan
Plans Submitted
April
Plans Approved
June
DY 7 Ends
Sept
Baselines Due
Oct
Targets Finalized
Dec
On the transition of the header the idea is to read “DSRIP is compilated and Constantly changing”…..THIS IS NOT NEW!! This has been, is and will continue to be the case.
Let’s look at what’s happened in DSRIP over the last year.
During 2018 the following has occurred.
DY7 started 10/1
We received renewal of DY7-8 in December of 2017
2018 (Calendar year, not DY) = Performance Period for DY7 Outcome Achievement
On January 9th the FINAL PFM (Program Funding and Mechanics Protocols) and Measure bundle protocols were approved.
In April we submitted our RHP plans that had our bundle and measure selections
Plans weren’t approved until the end of June.
DY7 ends in September 30th
All measure baselines are due by October 31st.
Targets are supposed to be finalized in December, at the end of performance year 1. Sound familiar?
Revisions and clarifications to protocols and measure specs have been occurring and continue to occur.
And 55% of our DY7 value is tied to performance of outcome measures.
Revisions and clarifications to protocols and measure specifications
55% of DY7 value tied to performance on outcome measures 9

10. From Project Focus To System Focus
11/7/2018
Category 1&2
Patients served by projects
60% of value
Category B
MLIU Patients served in system
10% of value
From Project
Focus To
Category 3
Outcomes for patients served by each project
30% of value
Category C
Outcomes for all MLIU patients in system
55% and 75% of value
System Focus

11. 11/7/2018
DSRIP Measure Bundles
Shown by number of RHP 12 providers selecting the bundle or related measures
Rural Preventive Care 15
Rural Emergency Care 9
Primary Care Prevention 7
Diabetes Management 6
Behavioral Health 4
Heart Disease Management
Cancer Screening 3
Maternal Care & Safety
Pediatric Care & Safety
ED Diversion / Patient Nav. 2
Palliative Care
Hospital Safety 1

12. Better Alignment of RHP 12 Outcome Measures
11/7/2018
Better Alignment of RHP 12 Outcome Measures
63%
One or two providers
22%
Four+ providers
80%
of measures
One or more providers
pursuing improvement
15%
Three providers
80% of measures in the bundles our region selected has one or two providers pursuing improvement.
Of those 80%, 51% have on or two providers, 30% have 3 providers or more and 17.5% have four or more providers.
In DY2-5 we had more project & provider specific measures that did not align.

13. Perspectives on Selecting Outcome Measures

14. What’s Next – DY9,10 & Beyond
Program Funding & Mechanics (DY9-10)
No major changes to framework expected
Need to determine allocation of funding pool reductions
PFM due to CMS by 3/31/19
Measure Bundle Protocol (DY9-10)
Assess CY18 results in summer of 2019
Refresh bundles and measures
Protocol due to CMS by 7/31/19
Transition Plan
Milestones for VBP after DSRIP
Due to CMS by 10/1/19

15. DY7 October Reporting Starts in 2 weeks - October 1st – October 31st
HHSC Hosted October Reporting Webinar
Tentative – October 4th – Two Webinars
Morning – CAT A,B & D (Time TBD)
Afternoon – CAT C (Time TBD)
Reporting Work Sessions
Amarillo – October 11th, 8-5pm & October 12th 8-3pm, S. Coulter
Lubbock October 15th, 8-5pm & October 16th, 8-5pm
309 North Slide

16. Comments/Questions?