1. Audio and Video
Everyone is muted by default so we won’t be disrupted by late-comers. But, when you want to talk just click the microphone icon in the bottom bar to mute or unmute yourself. Be sure that your phone or computer, depending which option you chose is also unmuted. You can also choose to have your camera on or off.
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2. Checking and Changing Audio Settings
Select the small arrow next to the microphone and click Audio Options to change your settings. If you called in by phone before clicking the link please open your Audio Options and press # Participant ID #

3. Chat Feature
The Chat Feature is located in the ribbon at the bottom of your screen.

4. Value Based Contracting Office Hours
CPC+ Office Hours
October 16, 2018
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5. Agenda CPC+ Topics: Review CPC+ Timeline – Cindy Mattingley
eCQM Reporting & Evaluation – Kim Brown
RMHP Attribution Reports – Patrick Gordon
Review of Total Cost Relativity – Patrick Gordon
Overview of VBCRC – Cindy Mattingley
RMHP Support – Cindy Mattingley
Q&A
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6. RMHP CPC+ Timeline
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7. RMHP Performance Based Incentive Eligibility
“Year 1” shall mean January 1, 2017 through December 31, 2017.
“Year 2” shall mean January 1, 2018 through December 31, 2018.
“Year 3” shall mean January 1, 2019 through December 31, 2019.
“Year 4” shall mean January 1, 2020 through December 31, 2020.
“Year 5” shall mean January 1, 2021 through December 31, 2021.

8. Performance Based Incentive Good Standing (Monthly)
Timing of RMHP Payment
Base Medical
Performance Based Incentive
Enhancement
(Monthly)
Good Standing (Monthly)
Quality/Cost
(Annually)
Reminder of how your payment is coming through to you on the enhancement and the performance payment. The year 1 performance based incentive payment is being calculated. Patrick do you have any updates on a time line of when practice will get that?
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9. eCQM Reporting & Evaluation

10. eCQM and Quarterly Assessment Timeline
The 3rd Friday of the month following the quarter
(April, July, October and January)
RMHP CPC+ Quarter 3 Reviews to be completed
Quarterly eCQMs due to RMHP
eCQMs due this Friday. Quarterly feedback reports allowing meaningful comparison. Opportunity to trouble shoot reporting issues before the annual reporting requirement.
Payment Period #3
Quarter 3 Performance Period
Influences
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13. Data in the CPC+ Attribution Reports

14. Cost Data Total Cost of Care (TCOC) Emergency Hospital
Inpatient Hospital
Outpatient Hospital
Pharmacy
Physician Services – Primary Care
Physician Services – Specialist Care
All Else

15. CPC+ TRACK 1 RMHP ATTRIBUTION REPORT
Practice Summary Tab

16. CPC+ TRACK 1 RMHP ATTRIBUTION REPORT
Patient Summary Tab

17. CPC+ TRACK 2 RMHP ATTRIBUTION REPORT
Practice Summary Tab

18. CPC+ TRACK 2 RMHP ATTRIBUTION REPORT
Patient Summary Tab

19. Utilization Chart
This section of the report will show your practices breakdown in three buckets; as a raw count for your practice on patients that have been to the ED, had an IP Admit or have had an IP Readmit. You will then get a per member count for your practice on patients that have been to the ED, had an IP Admit or have had an IP Readmit. You will then see a per 1000 members count for your practice on patients that have been to the ED, had an IP Admit or have had an IP Readmit.
You will then be given the same breakdown of data for other CPC+ Track 1 or Track 2 practices that RMHP contracts with for CPC+.
This allows you to compare your practice with other practices participating at the same level and gauge where you stand.
You will also receive an average HCC score risk score for you practice as well as other CPC+ practices.
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20. Trend Data Average Risk Score Average ER Visits Average IP Visits
Average IP Readmits
Average Total Cost
Average PMPM Cost
This data is provided to practices in a run chart format and looks at your data over a 12 month period. There are three lines for each run chart.
One is the ‘You’ line which is your practices raw data, not normalized
All line which = all other practices in CPC+ that are participating in the same Track.
You Norm = A normalized line using your risk score (HCC score).
There are run charts for the following:
• Average Risk Score and Average Total Cost
• ER Visits, Inpatient Visits & IP Readmissions
• Average of your PMPM Cost
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21. Total Cost Relativity

22. TRACK 1 – Incentive Eligibility
To remain eligible for earning the incentive payment, practices must:
 Develop, embed, utilize and document processes for Empanelment, Risk Stratification and Care Management of High Risk Patients.
Care management and care coordination processes are utilized for monitoring high risk patients and utilization of services such as Hospitalizations and ED use.
Effective in 2019, and moving forward, practices will be evaluated using the Total Cost Relativity calculation for determining incentive payment.
*Refer to your practices monthly CPC+ attribution report from RMHP for your current TCR*

23. TRACK 2 – Incentive Eligibility
To remain eligible for earning the incentive payment, practices must:
 Develop, embed, utilize and document processes for Empanelment, Risk Stratification and Care Management of High Risk Patients.
Care management and care coordination processes are utilized for monitoring high risk patients and utilization of services such as Hospitalizations and ED use.
Annually, practices will be evaluated using the Total Cost Relativity calculation for determining incentive payment.
*Refer to your practices monthly CPC+ attribution report from RMHP for your current TCR*

24. TCR Outcomes – “Year 1” (CY 2017)
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25. TCR Outcomes – “Year 1” (CY 2017)
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26. Overview of the Value Based Contracting Review Committee (VBCRC)

27. Value Based Contracting Review Committee (VBCRC)
RMHP utilizes the Value Based Contracting Review Committee for a decision making and review process to review Practice performance, make recommendations, and make payment eligibility decisions based on Practice performance in RMHP value based contracting relationships of CPC+, RAE, and Prime
The 4th week of the month following the quarter
(April, July, October and January)
The VBCRC will review the previous quarters performance
The second month following the quarter
(May, August, November and February)
Letters will be mailed to practices regarding their status
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28. RMHP CPC+ Support

29. We are still here for you
CPC+ monthly 30 minute virtual meeting with the QIA & CI to touch base on RMHP CPC+ contractual requirements
Value Based Contracting Office Hours
RMHP CPC+ Newsletter
Free Consultative Services

30. Questions?

31. Contacts Lori Stephenson Dale Renzi Patrick Gordon
Director – Clinical Program Development and Evaluation
Dale Renzi
Director - Provider Network Management
Patrick Gordon
Vice President