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1115 Waiver

The 1115 Waiver fundamentally shifted how healthcare providers collaborate and develop healthcare infrastructure. Still, the rules and guidance frequently change. Below are resources from HHSC and CMS. For additional information, visit HHSC's 1115 Waiver website.  Performing Providers may find additional information on HHSC's DSRIP Online Reporting Tool's Bulletin Board.

 Category C Baseline Reporting

Category C Summary Workbook

The Category C reporting summary is below. The Cat C Summary includes Category C measures in all regions.

Summer DY7 Early Baseline Reporting

The first opportunity to report Category C baselines is the Summer 2018 Early Baseline Reporting Period. For providers opting to report baseline during Summer DY7, Templates are due to HHSC via email on Monday, August 6th at noon (deadline has been extended)

 

- The Category C Reporting Companion was updated 07/06/18 to correct some minor errors. Corrections are highlighted in yellow. 

- The Category C Baseline Reporting Template was updated 07/20/2018 to correct an issue with data validation for measures using sampling, and includes prior updates to the the baseline measurement period for grandfathered LHD measures and to correct an issue with baselines measurement periods ending after 6/30/2018 showing as eligible to report during Summer DY7 baseline reporting.

- The Category C Modification Request Form was updated 07/11/2018 to correct an insignificant template error that was prevented a section from showing "Complete." Prior versions of the template can still be completed and submitted. 

 April DY7 Reporting

​General Reporting Materials

Below please find the April DY7 Reporting Companion Document and April DY7 DSRIP Online Reporting System User Guide. Please note that DY6 carryforward metrics (QPI and Cat 3) do not require a coversheet because they utilize a standard template. HHSC has also posted a list of DY6 carryforward metrics in order to assist Anchors and other entities in tracking what needs to be completed during the April DY7 reporting period, since the DY2-6 projects do not appear on the Anchor and IGT entity home pages when DY7 is selected.

Category 3 Reporting

The link below is to the April DY7 Category 3 Reporting Template. The template must be submitted by all providers with a Category 3 DY6 carryforward milestone for semi-annual reporting. Please refer to the general April DY7 Reporting Companion Document for additional guidance on Category 3 reporting.

QuantifiablePatient Impact (QPI) Reporting

The links below are to the April DY7 QPI Reporting Template and the April DY7 QPI Reporting Companion document.Please refer to the companion document for guidance on how to complete and submit the April DY7 QPI Reporting Template for milestones M-1 and M-2. Please note that an April DY7 QPI Reporting Template should only be completed and submitted during the April DY7 reporting period if the provider is reporting metric achievement. 

HHSC has updated the April DY7 QPI reporting template on 4/20/2018 to account for a formatting issue some providers encountered with the MLIU check boxes on the Project Data Entry tab. Providers who did not experience this problem with the first version of the QPI reporting template do not need to redo the template

IGT Entity Feedback (Optional)

For April DY6, the IGT Info tab is no longer available on the DY6 carryforward project reporting page. IGT entities should use the IGT Entity Feedback Form to communicate their concerns around the accuracy of metric reporting. Examples of issues toi nclude are: reported progress that was not actually achieved, changes in project scope that were not reported by the provider, and risks to the project that were not reported by the provider. IGT entities should NOT use this form to identify technical errors entered in the reporting system. IGT entities should submit completed forms to the waiver mailbox at TXHealthcareTransformation@HHSC.state.tx.uswith "April DY7 IGT Entity Feedback" in the subject line by May 18, 2018.

Estimated IGT for DY7 Round 1

IGT Entities should review the yellow highlighted columns for DY7 Round 2 estimated DSRIP payments and DY7 Monitoring IGT due. The estimated payments are based on the assumption that all carryforward milestones reported as achieved in DY7 Round 1 will be approved by HHSC. These estimates are provided to inform any needed IGT changes in entities or proportion. Changes are due to HHSC by June 1, 2018, 5:00pm using the IGT Change Form located on the DSRIP website: https://hhs.texas.gov/sites/default/files//documents/laws-regulations/policies-rules/Waivers/medicaid-1115-waiver/1115-medicaid-waiver-tools-guidelines-regional-healthcare-partnership-participants/igt-entity-change-form-dy7.xlsx. The FMAP for July 2018 payments is 56.88.
 
Please note that the remaining 20 percent of DY6 Anchor payments are included with fake project IDs of “000000000.0.X”,where X is the Anchor’s corresponding RHP. DY7 RHP Plan Update submission payments will be included with DY7 Round 1 payments; however, the amounts are not included in this file as HHSC is still reviewing submissions. However, if you have a DY7 IGT change since the RHP Plan Update submission, please complete the IGT Change Form. DY7 Monitoring amounts will also be updated based on RHP Plan Update submissions in the final payment files sent from Rate Analysis.
 
Do NOT use these estimates to submit IGT. Rate Analysis will notify IGT Entities and Anchors of the actual IGT due the week of June 18, 2018.

 Waiver Renewal

RHP Plan Update

The RHP Plan Update provider templates are below - a standard template for current DSRIP providers and a new provider template for regions that received additional funding. The templates and Companion Document will also be posted on the HHSC website. Please review the Companion Document and attend the webinar on Thursday, February 8th at 10:00am before sending questions to the waiver mailbox. HHSC will send out the call-in information for the webinar as soon as it's available. 
Note that the templates are large and require enabling of macros, editing, content, and as a trusted document to function correctly. Due to the automation included in the template, each entry will take one to a few seconds to process before allowing additional entries.

Approved DSRIP Protocols

We look forward to working with providers as DSRIP continues to transform healthcare in Texas.

Risk-Adjusting Resources for Category C 30-Day Readjusted Readmission Measures:

A2-384: Risk Adjusted CHF 30-Day Readmission Rate
B1-141: Risk Adjusted All-Cause 30-Day Readmission for Targeted Conditions: heart failure hospitalization, coronary artery bypass graft (CABG) surgery, CHF, Diabetes, AMI, Stroke, COPD, Behavioral Health, Substance Use
B1-217: Risk Adjusted All-Cause 30-Day Readmission
H2-216: Risk Adjusted Behavioral Health/ Substance Abuse 30-Day Readmission Rate
M1-216: Risk Adjusted Behavioral Health/ Substance Abuse 30-Day Readmission Rate

MSLC Guidance for DY 7-8

Category B System Definition Data Support Guide: assists providers in determining what data should be retained to support system definition and the PPP reporting. 
Category C Data Support Guide: assists providers in determining data support and retention requirements
UPDATED 4/16/18: added a technical note to the "Instructions and Guidance" tab; Added a technical note to the risk-adjusted measure descriptions for A2-384, B1-141, B1-217, H2-216, and M1-216. 
Guidance for Texas DSRIP Risk-Adjusted Measures: updated document for DY 7-8 
Risk Adjusting Template: an optional tool for providers to use for risk adjusting. Instructions for use of the risk adjusting template are available in the first two tabs of the template. Please direct any TA questions regarding the risk adjusting template to MSLC. 

E2-A01 OB Hemorrhage Collaborative Activity

Below are documents that provide additional details for the collaborative activity that is a required component if a hospital or physician practices selects Measure Bundle E2 Maternal Safety. Measure E2-A01 refers to the Texas Department of State Health Services (DSHS) sponsored implementation of the AIM Safety Bundle for Obstetric Hemorrhage. Draft milestone requirements are included as well as additional information from DSHS on the collaborative. 

Category B Frequently Asked Questions (FAQ)

The Category B Frequently Asked Questions (FAQ) document provides HHSC responses to both specific and broad questions we are receiving on Category B system definition and patient population by provider (PPP) reporting. Questions and responses are organized by subject. The FAQ has been updated as of April 20, 2018.

Waiver Renewal Planning Documents

Below are docuements related to the draft Measure Bundle Proptocol, and a draft Value Based Purchasing Roadmap.

 Category 3

Category 3 reporting summaries are below. The Cat 3 RHP Summary includes all Category 3 outcomes in a given region. The Cat 3 Summary includes outcome specific summaries and the Category 3 goal calculator. These summaries contain the most recent reporting information submitted to HHSC as of 3/23/18. Providers should review the data and check for accuracy.
 
There will not be interim corrections period prior to April DY7 or October DY7 reporting. Instead, providers will need to make any needed corrections in the April DY7 or October DY7 Category 3 reporting template. 
 
Providers who need to make corrections should email the Waiver mailbox during the reporting period with the RHP number and  project ID, the outcome measure, the years requiring correction, and a detailed explanation of why the correction is needed (i.e., why the information reported previously is inaccurate and how the correction information is calculated). Once this information is reviewed, HHSC will provide instructions on how to make corrections. Please contact HHSC as early as possible in the reporting period, so that we have time to review your information and respond before the reporting period closes. For April DY7 reporting, please contact HHSC by April 20 at the latest.
 
Note: The workbooks were updated on 4/5 to correct an issue with the dropdowns and to include information from MSLC reviews closed in March. 

 October DY6 Reporting

DSRIP October DY6 Reporting Webinar

Below please find the slides to the October DY6 Reporting Webinar. The recording of the October DY6 Reporting webinar can be found here: https://player.vimeo.com/video/236974051.

General Reporting Materials
Below please find the October DY6 Reporting Companion Document, October DY6 DSRIP Online Reporting System User Guide, Learning Collaborative Reporting Template (an optional template used to report on DY5 carryforward Learning Collaborative metrics), and the DSRIP Reporting Coversheet (required for Category 1 & 2 DY5 carryforward non-QPI metrics.

Quantifiable Patient Impact (QPI)

The links below are to the October DY6 QPI Reporting Template and the October DY6 QPI Reporting Companion document. Please refer to the companion document for guidance on how to complete and submit the October DY6 QPI Reporting Template for milestones M-1 and M-2.  Please note that ALL Category 1 & 2 projects must complete and submit an October DY6 QPI Reporting Template as part of semi-annual reporting (SAR) requirements for their DY6 QPI milestones.

Hurricane Harvey DY6 QPI Carryforward QPI Reporting Template

Providers from FEMA designated disaster areas with eligible DY6 metrics that were approved for DY6 carryforward during the October DY6 reporting period may submit the Hurricane Harvey DY6 QPI CF QPI Reporting Template during the October DY6 NMI reporting period. Please note that the Hurricane Harvey DY6 QPI CF QPI Reporting Template must be submitted by January 16, 2018 in order to be considered for the March 2018 off-cycle payment for impacted providers.

Category 3 NMI Reporting Template
Attached below is the DY6 R2 Category 3 Reporting Template for the NMI period. The Cat 3 NMI template allows reporting only for outcomes that received an NMI determination. Providers responding to an NMI for a Category 3 outcome upload one template to the first NMI milestone, and indicate where the template is uploaded in the online reporting system milestone progress update. Providers will make selections in the online reporting system in accordance with the achievement levels indicated in the NMI reporting template. 

Note: The NMI Reporting Template was updated on 12/14/17 to unlock some projects for NMI reporting that were previously locked. If you already submitted the previous version of the template, and you have confirmed that all of the projects for which you received an NMI were unlocked, there is no reason to submit the revised template.

Category 3 Stretch Activity Coversheet

Below please find the Category 3 October DY6  Stretch Activity 3 (SA3) Coversheet (updated 10/5/17 to include RHPs 17-20).

DY6 Sustainability Template

The links below are to the DY6 Sustainability Template and its companion document. Please refer to the companion document for guidance on how to complete and submit the DY6 Sustainability Template for milestone M-4.

Category 4

Below please find the October DY6 Category 4 Reporting Template.

 1115 Medicaid Waiver Forms

The RHP Contact Change Form below should be completed and submitted when providing HHSC with updated contact information or requests for access to the DSRIP Online Reporting System. Please make your form selections based on what the contact will need access to. For example, if the individual belongs to an organization that is an Anchor, Provider, and IGT Entity, but the individual will only need Provider access to the reporting system and HHSC d-list, then they should select "Performing Provider" on the form. Completed forms should be sent to the waiver mailbox at TXHealthcareTransformation@hhsc.state.tx.us.
 

RHP-Contact-Change-Form.pdf (06/22/2017)

 

The link below is to the DY6 IGT Entity Change Form. IGT Entity changes must be submitted by the due date of the semi-annual reporting of DSRIP milestone achievement to be considered for payments in that period (i.e. April 30 or October 31). Completed workbooks and RHP Plan Section VI. RHP Participation Certifications should be submitted to the waiver mailboxat TXHealthcareTransformation@hhsc.state.tx.us. 

NOTE: Materials for new affiliations must be submitted according to the instructions listed on the "Instructions and Checklist" tab in the workbook.
 

IGT Entity Change Form (DY6).xlsx (11/17/2017)

 DSRIP Reporting Summaries

The links below are to the project payment summaries. Please note that these are the official payment files and may not match the amounts displayed in the DSRIP Online Reporting System.

The links below are to the provider and project reporting summaries which contain information from the October DY2 through April DY6 reporting periods. The Provider Summaries provide a high-level narrative overview of the status of all of a provider's DSRIP projects. The Project Summaries provide project-level status information related to a specific project's accomplishments, challenges, lessons learned, etc.

 MSLC

​Myers and Stauffer works exclusively for government health programs. Their experience covers the breadth of healthcare provider types, and there is never a conflict of interest. They serve state and federal Medicaid and Medicare clients on issues concerning Audit, Rate Setting, Consulting and Program Integrity for a multitude of provider categories.

Myers and Stauffer LC Presentation on Texas DSRIP Compliance Monitoring

On May 7th, 2018, Myers and Stauffer LC (MSLC) presented on Texas DSRIP Compliance Monitoring at the Learning Collaborative for RHPs 8 and 17. Performing providers from these two regions had an opportunity to ask questions after the presentation. Recording of the presentation and the follow up questions are located at RHP 8 and 17 website https://1115waiver.tamhsc.edu/compliance-monitoring.html.
 
To make sure all providers have the opportunity to ask questions on the information presented by MSLC, HHSC is setting up a process for the submission of questions from all RHPs.
 
Timeline for follow-up questions for Myers and Stauffer LC - presentation on Texas DSRIP Compliance Monitoring:

June 1 - June 13 - providers and anchors can view the presentation and submit follow up questions to Anchors 

June 14 - deadline for Anchors to submit unduplicated questions from their Region.

June 15 - early July - MSLC creates FAQ document with responses to the questions from RHPs. Early July - HHSC posts FAQ with MSLC responses.

 Content Editor