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Region 15 Regional Healthcare Partnership 12 th Public Meeting

Region 15 Regional Healthcare Partnership 12 th Public Meeting. Friday, April 19, 2013 University Medical Center of El Paso Anchor Hospital. 1. Confirmation of Participants. Roll Call. 2. Recap From Anchor Call 4/12/13. The last Texas Region RHP Plan was sent to CMS on 4/12/13

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Region 15 Regional Healthcare Partnership 12 th Public Meeting

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  1. Region 15Regional Healthcare Partnership12th Public Meeting Friday, April 19, 2013 University Medical Center of El Paso Anchor Hospital 1

  2. Confirmation of Participants • Roll Call 2

  3. Recap From Anchor Call 4/12/13 The last Texas Region RHP Plan was sent to CMS on 4/12/13 All RHP Plans from Texas are uploaded to HHSC website Upon Submission to CMS 1st CMS Response Received on 4/12/13 for Region 17 Region 15 CMS Response Received 4/18/13 30 days to modify and resubmit projects

  4. PFM Protocol Amendment(changes to sections IV and VII) • Revised April 4, 2013 • Initial approval of most projects will occur by the end of May for DY2 and DY3 • CMS will do a phased approval process • Final years of the Waiver projects will be settled by September, 2013 • DY4 and DY5 • This is due to the heavy scrutiny placed on patient volumes / quantifiable patient impact and valuations • HHSC will schedule webinar within the next few weeks to clarify changes to the Protocol

  5. Semi-Annual Reports and Mid-Point Assessment • DSRIP providers will be required to submit semi-annual reports to HHSC on the progress of projects • HHSC will contract with an independent entity to monitor the progress of DSRIP projects and make recommendations to facilitate the success of the projects • Based on this assessment, CMS and HHSC may require prospective changes for DY4 and DY5

  6. CMS Review PeriodApril 18, 2013 first CMS response to Region15 • Modifications to flagged projects will need to be performed in collaboration with HHSC in the next 30 days • CMS has 15 day review period for these • Need to understand how HHSC will work directly with us on the projects • Project replacements can also be provided during this timeframe • Other project options may not be used for project replacements • Must be directly from the DSRIP Menu

  7. CMS Response to Region 15 Plan • Initially Approved Projects • Region 15 = • These projects are approved to submit metrics for DY2 and DY3: • UMC • SPHN • HCA • EPCH • Texas Tech • EHN • Health Dept.

  8. CMS Response to Region 15 PlanSection IV PFM Protocol • Priority Technical Corrections • Expected Patient Benefit / Quantifiable Patient Impact Milestones • HCA (1) • Health Dept – (1) already corrected • Overlap in Cat3 Outcome and Cat1 or Cat2 Improvement Target • Project components not included • One process and one improvement milestone • Standalone and non-standalone rules

  9. CMS Response to Region 15 Plan • Valuation Issues – 4 options • Replace project • Justify the original value with more data • Accept the Reduced value • Change Category 3 outcome choice • If we do not receive full valuation approval by Sept., 2013, we will still have an opportunity through March, 2014 subject to project modifications

  10. CMS Response to Region 15 Plan • Projects Not Approved • These fall in the category of • Not servicing the underfunded population • Supply sensitive • Resource Intensive • Dialysis Services, Catheterization Labs, or CT Scanning • Off menu projects • Projects that will be approved after modifications are made: • UMC • SPHN • HCA • EPCH • Texas Tech • EHN • Health Dept.

  11. DSRIP and UC Payment Timelines 2013 and 2014 • DY1 UC – • IGT due 5/13/2013 • Payment date 6/7/13 • DY1 DSRIP – Region 15 = 2nd Round • IGT due 4/29/13 • Payment date 5/17/13 • DY2 UC • 7/20/2013 • 1/16/2014 • 3/28/2014 • DY2 DSRIP • 9/30/2013 • 11/12/2013 • 1/24/2014 • DY2 Admin • 2/10/2014 • IGT for the above payments must be submitted to HHSC 20-30 days prior • HHSC is proposing to retain ½% of all DSRIP payments for monitoring purposes

  12. UC DY1 Payment TimelineUC Commitment Form due to HHSC - 4/19/13

  13. Learning CollaborativePrimary Care Expansion in Region 15 CMS will schedule webinar to share their expectations of learning collaboratives Project Presentations: Share updates, successes and challenges • Providence and Sierra East – Expansion of Urgent Care Centers • University Medical Center – VNA/Salvation Army, VNA/Rescue Mission, UMC Neighborhood Health Clinics: extended hours and weekends, improving reporting capacity, expand/enhance medical homes, patient satisfaction, chronic care model • Health Department – Expansion of Oral Health Services • Texas Tech – Expansion of Pediatric Primary Care, Development of a Primary Care Medical Home • Other Community HealthCare Providers

  14. Roundtable 14

  15. Contact Information • Waiver Website & Email Address: • http://www.hhsc.state.tx.us/1115-waiver.shtml • TXHealthcareTransformation@hhsc.state.tx.us • UMC Website: • http://www.umcelpaso.org • Region 15 - RHP • Paso del Norte Blue Ribbon Committee Needs Assessment: • http://www.elpasotexas.gov/health/_documents/BRCGapBook.pdf 15

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