1. RHP 12 Learning Collaborative

2.  2016 Learning Collaborative Activities ◦ Monthly Status Calls & Project Highlights ◦ DSRIP In Action ◦ Regional LC Events ◦ Focused Cohorts - WIP  Waiver Updates

3.  DSRIP in Action are Learning Collaborative events hosted at the facility of a provider in our region.  DSRIP in Action at a glance: ◦ Hosting provider DSRIP project presentation ◦ Question & Answer sessions ◦ Participants share updates on DSRIP projects ◦ Open forum discussion ◦ Networking opportunities ◦ Tour of regional provider’s facility

4.  Monthly Status Calls :  Monthly calls will be conducted to touch base and update you on information that we feel is important to you. These calls give us a chance to see how everyone is doing and see what successes and challenges each of you may be experiencing. We encourage you to ask any questions and make suggestions during these calls!  We will not have status calls during our reporting months of April and October.  We will also share what we learned at our visit during our “Project Highlight” for the month!

5.  Anchor will travel and visit your facility.  We will discuss your successes and challenges you may be faced with at that time.  Visits can include a tour of your facility.  We will take pictures so we can “highlight” you and your facility on our next monthly status call.  We encourage any patient stories you may have as we would like to add to what we learned while visiting.  This is a great way for our team to see what you are all about. We want you to shine!

6.  We are planning 3 DSRIP in Action events in 2016.  Tentative schedule & locations are: ◦ Feb: Amarillo, TX ◦ May: Dimmitt, TX (confirmed) ◦ August: Big Spring, TX

7.  2016 Regional Learning Collaborative Events March 16, 2016 We are planning Peer to Peer and Interactive discussions, presentations and a we are moving forward with our networking luncheon. September 28, 2016 TBD

8. Put your thinking caps on and please consider doing a poster for our upcoming LC event in March! Our last posters are “outstanding” and we look forward to your new posters! We have been visiting with other RHP’s to see what other avenues are available such as video’s… let us know if you have any ideas!

9.  Potential Format: ◦ Write an AIM Statement ◦ Set one goal to report ◦ Participate in facilitated face-to-face meeting. ◦ Participate in follow-up conference calls each month ◦ Report progress, challenges, barriers, and lessons learned during conference calls. ◦ Participants will present final achievements during the Learning Collaborative in September 2016.

10. Bobbye Hrncirik

11.  Total metrics: 622metrics eligible to report in DY4  October DY 4 ◦ Approved in October DY4 Reporting: 289 metrics ◦ Approved to Carry forward: 131 metrics ◦ NMI: 24 metrics ◦ Partial Achievement and CF Approved: 24 metrics  April DY 4 ◦ Partial Achievement and CF Approved in April DY4 Reporting: 2 metrics ◦ Approved in April DY4 Reporting: 152 metrics

16.  Deadline for NMI/Incomplete information is Friday, January 15, 2016.  DSRIP Payments ◦ January 15, 2016 for transferring hospitals ◦ January 29, 2016 payments processed for all providers  NOTE: There are separate transactions for each payment for each DY.

17.  A reminder that the DY5 Monitoring IGT will be calculated based on IGT commitments as of January 1, 2016. HHSC may request up to $5M for DY5 Monitoring IGT. If IGT Entities have changes in funding DSRIP projects, please submit an IGT Entity Change Form prior to January 1, 2016. The form is located on the waiver website at http://www.hhsc.state.tx.us/1115-docs/DY3- Templates/April2014/IGT-Entity-Change-Form.xlsx.http://www.hhsc.state.tx.us/1115-docs/DY3- Templates/April2014/IGT-Entity-Change-Form.xlsx  HHSC is reviewing actual MSLC costs compared to the $4M collected for DY3 Monitoring IGT. HHSC estimates that IGT refunds for unused DY3 Monitoring IGT will be processed in early 2016. HHSC does not expect to process DY4 Monitoring IGT refunds.

18.  Providers are required to work with Myers & Stauffer (MSLC) to complete the review process, including responding to follow up questions related to Corrective Action Plans. We appreciate your assistance to remind providers that DSRIP payments are Medicaid payments, and as such, may be subject to state and federal audits  Working through baseline issues now with MSLC will be helpful to complete before MSLC begins performance review, and MSLC can assist providers for preparation for the next stage of review  CAT 1&2 Validation-MSLC has notified providers of the metrics that were selected for review and has starting reaching out to providers to request additional data and sample documentation

19.  In early 2016, HHSC will distribute a revised Population Focused Priority measure (PFPM) baseline reporting template and provide guidance on submitting a DY3 or DY4 baseline for the selected alternate achievement outcome. All providers with an alternate achievement outcome will be asked to submit a baseline for their selected measure, regardless if a baseline was previously submitted. This is to prepare for possible reporting in DY5. All providers who were approved by HHSC to select an alternate outcome measure (PFPM or P4P Cat 3 outcome measure) as a result of being transitioned to maintenance mode for high performance should inform HHSC of their selected alternate outcome measure as soon as possible.

20.  In early 2016, HHSC will distribute a revised Population Focused Priority measure (PFPM) baseline reporting template and provide guidance on submitting a DY3 or DY4 baseline for the selected alternate achievement outcome.  All providers with an alternate achievement outcome will be asked to submit a baseline for their selected measure, regardless if a baseline was previously submitted. This is to prepare for possible reporting in DY5.  If you were transitioned to high performance mode for a CAT 3 you need to inform HHSC of your selected alternate achievement outcome measure as soon as possible.

21.  Providers have expressed concerns related to the compendium specifications for the following outcomes: IT-1.10 HbA1c poor control, IT-1.11 BP control, IT-1.21 Adult Body Mass Index (BMI) Assessment, IT-1.7 Controlling high blood pressure, and IT-12.4 Pneumonia vaccination status for older adults.  The concern centers around the denominator requirement for a clinic visit in the 12 months prior to the measurement period.  As a result, HHSC has determined that providers may waive the requirement for an encounter in 12 months prior to the baseline measurement period for these outcomes.  Myers and Stauffer reached out to providers with impacted outcomes to confirm their decision to waive the requirement.

22.  The waiver team is focusing on additional details for the proposed transition year (DY6) and will update the survey for feedback in early 2016.  HHSC has a page on their site for Waiver Renewal.Waiver Renewal

23.  Request DY5 Level of DSRIP Funding $3.1Billion  Continue the majority of the current active Category 1 and 2 projects (some may be required to take a logical next step to further transformation in DY6 and many will do so in DY7 -- for example, a chronic care management project may add additional chronic conditions or a project to expand primary care may take a next step to certify as a medical home.)  Establish a new performance bonus pool (pay for performance) in place of the current Category 4 pay for reporting (in the extension request, this was discussed as use for unearned funds rather than changing Category 4)  Lay the groundwork for further quality alignment between DSRIP and Medicaid managed care, including development of a value based payment roadmap in DY6.  Combining projects