DSRIP Funds Flow Update New! 11.07.17 The NYS Dept. of Health announced on November 2 that recent reporting reflects a substantial increase in the amount of money flowing from DSRIP Performing Provider Systems (PPS) to network partners. As of June 30, 2017, PPS have distributed a total of $878 Million, or 85% of all dollars earned, to various categories of downstream partners. In particular, there have been notable increases from DSRIP Year 2, Quarter 2 to DSRIP Year 3, Quarter 1 in distributions to primary care providers, mental health and substance abuse partners, and community-based organizations.
DSRIP Y2Q4 Report and Scorecard Released The Independent Assessor (IA) has completed its review of the DSRIP year 2 fourth quarter reports, which cover all PPS activity through March 31, 2017. The review results, along with a breakdown of performance payments earned by each PPS, may be found in the Achievement Value (AV) scorecards – click here and then on the name of an individual PPS to view. The total earned by PPSs through DSRIP Year 2 was $2,529,408,899 out of a possible $2,640,661,329 (95.78%) for all funds.
DSRIP Year 2 Performance Results DSRIP Year 2 (DY2) closed on March 31, 2017 with positive statewide performance results. Through DY2, PPS have earned a total of $2.4 billion, which is 95% of all available funds. Notable progress towards the DSRIP program goal of achieving a 25% reduction in avoidable hospital use by DSRIP Year 5 was demonstrated through a 14.9% reduction in Potentially Preventable Readmissions and an 11.8% reduction in Potentially Preventable ER Visits. If the current reduction rates are maintained, New York will achieve the goal of a 25% reduction by DSRIP Year 5. Additionally, PPS have successfully met all requirements for 31 projects in total and have successfully implemented 95% of all DY2 project requirements.
DSRIP PPS Mid-Point Assessment Action Plans: Public Comments Accepted through March 31st PPS Network Leads recently submitted Mid-Point Assessment Action Plans to the Independent Assessor (IA) in response to the Mid-Point Assessment Recommendations approved earlier this year by the Project Approval and Oversight Panel (PAOP). These Action Plans are now available for review - click here, then click on the individual PPS link and scroll down to access them. The IA will be accepting public comments on the Action Plans through March 31stby firstname.lastname@example.org. The IA will review all comments submitted and provide feedback to PPS Leads on their Action Plans. PPS Leads will then have the opportunity to amend their Action Plans before submitting a final version for approval by the IA. A full timeline is below:
PPS Submit Mid-Point Assessment Action Plans to IA
March 10, 2017
Mid-Point Action Plans posted to DSRIP Website
March 20, 2017
Public Comment Period Opens
March 20, 2017
Public Comment Period Closes
March 31, 2017
IA provides feedback to PPS
April 7, 2017
PPS respond to IA feedback
April 19, 2017
IA finalizes approval of Mid-Point Assessment Action Plans
April 30, 2017
We strongly encourage you to review and comment on your PPS Network Action Plan(s) by March 31st. This public comment period is the only chance to submit formal feedback on PPS Action Plans will help ensure that PPS Leads respond to and incorporate the PAOP’s recommendations throughout DSRIP Year 3.
DSRIP PAOP to Meet with Performing Provider Systems OnWednesday, February 1 through Friday, February 3, the DSRIP Project Approval and Oversight Panel (PAOP) will meet with the DSRIP Performing Provider Systems (PPS) in Albany at the Empire State Plaza (rooms 2 – 4) to discuss the Independent Assessor’s Mid-Point Assessment findings. The meeting is open to the public, but there will be no public comment opportunity on these days. Pre-registration is not required. The meetings will be webcast live.
DSRIP Mid-Point Assessments: Public Comment Day The NYS Dept. of Health will hold a public comment day on the DSRIP Mid-Point Assessment process and findings on Tuesday, January 31 in the Swyer Theater at The Egg from 10:30 a.m. – 5:00 p.m. Pre-registration is not required. Anyone wishing to speak must sign up at the onsite registration desk by 3:00 p.m. Speakers will have up to 5 minutes for public comment.
DSRIP Year 2 Timeline Updated DSRIP Year 2 began on April 1, 2016 and the timeline has been updated to include a number of important event dates and deadlines. To view the timeline, click here.
Integrated Services Info Added to State’s DSRIP Website The DSRIP Integrated Services webinar hosted by the NYS Dept. of Health on January 26 is now available online. An updated version of the Integrated Services FAQ document and the Billing Matrix, previously distributed on March 18, 2016, are now available on the State’s DSRIP website as well. Click here and scroll down to the Integrated Services section to view. Please direct any questions to email@example.com or through your PPS' DSRIP Account Support contact.
DSRIP Project Approval and Oversight Panel and DOH to Host Public Comment Days on 1115 Waiver New! The Department of Health has announced that it will host two Public Comment Days on New York’s 1115 Waiver programs. During these meetings, members of the DSRIP Project Approval and Oversight Panel will join NYS Dept. of Health staff in listening to comments provided by members of the public and stakeholders. Feedback on all waiver programs is welcomed.
The downstate Public Comment Day will be held on May 4 at the NYU Kimmel Center, 60 Washington Square Park South in NYC from 9:30 a.m. – 2:30 p.m.
The upstate Public Comment Day will be held on June 10 at the Empire State Plaza, Meeting Room #6 in Albany from 10:30 a.m. – 3:30 p.m.
These meetings will be webcast live and will be open to the public. Pre-registration is not required. Individuals who wish to provide comment will be asked to register on site and limit their feedback to 5 minutes.Additional details and logistical information will be made available in the coming weeks.
Updated VBP Roadmap Open for Public Comment The annual update to the 2016 Value Based Payment (VBP) Roadmap has been posted to the NYS Dept. of Health’s DSRIP websitein draft form for public comment through April 18, 2016 at 3:00 p.m. Developed with the input of the Value Based Payment Workgroup and other stakeholders, the Roadmap has been updated based on broad stakeholder engagement from a number of workgroups and subcommittees. Public comments should be submitted to firstname.lastname@example.org by the aforementioned deadline.
DSRIP Compliance Guidance Released The New York State Office of the Medicaid Inspector General (OMIG) has posted revised DSRIP Compliance Guidance on its website that details the mandatory compliance programs that must be in place for PPS leads. It replaces the DSRIP Compliance Guidance 2015-01 that was released on April 6, 2015, and sets out some special considerations that PPS leads should work into their compliance programs. Click here to access it.
NYSDOH Posts COPA / ACO Applications and FAQs The New York State Department of Health (NYSDOH) has posted the applications for the Certificate of Public Advantage (COPA) and the Accountable Care Organization (ACO) Certificate of Authority to its website, permitting applicants to request a COPA pursuant to Article 29-F of the Public Health Law (PHL) and proposed regulations 10 NYCRR Subpart 83-1 and/or a Certificate of Authority for an Accountable Care Organization (ACO) pursuant to Article 29-E of the PHL and proposed regulations 10 NYCRR Part 1003. Both sets of proposed regulations are available here.
In addition, NYSDOH has developed FAQ documents to assist DSRIP Performing Provider Systems in completing either of these applications in conjunction with their Project Plan applications, due on December 22. To access the COPA FAQ, click here. To access the ACO FAQ, click here. Please note that both the applications and the FAQs are subject to revision as the proposed regulations are finalized and as additional questions arise.
As mentioned in the FAQs, PPS Lead Applicants submitting COPA and ACO applications in conjunction with DSRIP Project Plan applications should expect to be notified of the Department’s determination by April 1, 2015. COPA and ACO applications submitted after the December 22nd DSRIP application deadline will be reviewed expeditiously, but notification may be sent after April 1, 2015.
NYS Medicaid Director Says “FQHCs Need to Be Included and Engaged” in DSRIP In a recent post on the MRT Innovation eXchange (MIX) online forum, NYS Medicaid Director Jason Helgerson notes that FQHCs are vital service providers that bring a lot to the table when it comes to achieving DSRIP goals and strongly recommends that PPS leads include them at the governance and project planning levels and in their capital applications. To access his comments, along with feedback and ideas submitted by other providers and stakeholders, sign up for a MIX account and log in. Your use of this idea bank as a means of both gathering inspiration and sharing ideas during this unprecedented time of health system transformation is encouraged!
Regulatory Flexibility Guidance Released The NYS Department of Health, the Office of Mental Health, the Office of Alcoholism and Substance Abuse Services, and the Office for People With Developmental Disabilities have issued guidance to PPSs interested in seeking regulatory waivers in connection with the DSRIP and Capital Restructuring Financing programs. To access this guidance document, click here. To access a list of potential regulation waivers that FQHCs may want to include in their PPS network applications (developed by CHCANYS and Brown & Weinraub PLLC), click here.
Brown & Weinraub has developed an updated list of regulatory requirements from which PPS networks should consider requesting regulatory and mandate relief in order to more effectively and efficiently implement the integration of health and behavioral health services. Although not exhaustive, this document, prepared by Brown & Weinraub, PLLC, provides concrete examples of regulatory and policy relief that may be requested. Additionally, this checklist includes a number of helpful tips for compiling requests for regulatory relief.
NYSDOH Releases DSRIP Provider Network Tool The New York State Department of Health has released an electronic DSRIP Provider Network Tool which will serve as the means by which PPS entities will update and/or replace their lists of partner organizations for the remainder of the DSRIP planning process. Partner organizations include those that bill Medicaid providers as well as other non-Medicaid billing providers.
This tool is housed within New York’s Medicaid Analytics Performance Portal (MAPP) and accessible here. Providers are required to update their partner organization list via this tool by September 29thso that the state can begin the process of running initial attribution. Updates may be made until November 24th, at which point the tool will be closed so that the State may run final attribution.
The Department of Health will soon be e-mailing PPS lead contacts with information on a Network Tool attestation. A senior level official within the Lead PPS entity must attest that each partner included in its Network Tool partner list has formally consented to be part of the PPS. This requirement will apply to both initial and final attribution.
For additional information on how to navigate MAPP and use the Network Tool, please click here. All issues regarding access to the DSRIP Network Tool should be directed to the MAPP Help Desk at MAPP-CustomerCareCenter@cma.com or 518-649-4335.
Timely network reporting is critical to ensuring accurate DSRIP attribution and valuation. It is imperative that your PPS is dedicating all necessary resources to this activity. For further clarity on how the PPS partner networks and the DSRIP attribution methodology are connected, please click here.
Proposed COPA Regulations Revised and Posted for Public Comment The Department of Health has posted a revised version of the proposed regulations for DSRIP applicants to obtain a Certificate of Public Advantage (COPA), pursuant to Public Health Law Article 29-F. Article 29-F sets forth the State’s policy of encouraging appropriate collaborative arrangements among health care providers who might otherwise be competitors, if the benefits of such arrangements outweigh any disadvantages likely to result from a reduction of competition.
The revised proposal is open for public comment until September 26, 2014. Click here to access it.
DSRIP Project Design Grant Awards Announced On August 6, 2014, the New York State Department of Health (NYSDOH) announced over $21.5 million in DSRIP Design Grant awards to emerging Performing Provider Systems (PPS). The funds are intended to assist with the development of comprehensive DSRIP project plans. For more information, including a list of awardees and allocated amounts, detailed comments on each design grant application, and copies of the award letters PPSs received, click here.
Upcoming Meetings & Webinars
NYS Department of Health DSRIP Web Page This page includes a wealth of important information, including official CMS documents, program funding and mechanics protocol, final Safety Net definition, timeline/deliverables schedule, data, a glossary, and more.
Request DSRIP-Related Data Support from CHCANYS CHCANYS offers data TA services to FQHCs who are participating in DSRIP proposals, including reviews of data provided to FQHCs by PPS partners, ‘office hours’ for consultation/questions, etc.
Additional Support Services
DSRIP Support from Vendors and Consultants As part of its DSRIP support efforts, CHCANYS recently requested information from a number of vendors and consultants who have experience with FQHCs about what type of DSRIP support they could provide. These areas of support include:
Strategy support and guidance;
Integrated delivery system design and implementation;
Subject matter expertise (e.g., care management, integrated care, care transitions);
PPS relationship development;
Community needs assessments;
Technology assessments and guidance (e.g., HIT, HIE, care management software/applications);
Writing, including application writing.
Note that the Section 6 of the DSRIP design grant application requires a potential PPS to provide details about vendors who will assist in DSRIP planning efforts. Optimally, PPSs should include vendors who have experience with FQHCs.
If you are interested in finding out more about the information that the aforementioned vendors and consultants have provided, please contact Suzanne Rossel, Senior Director of Health Center Support, at email@example.com or 212-710-3813.
Community Needs Assessment Guidance All PPSs are required to conduct a Community Needs Assessment and use the information as the basis for selecting DSRIP projects and to measure baseline metrics for each project domain. Per the State’s guidance, the Community Needs Assessment should be a comprehensive evaluation of the demographics and health needs of the population to be served as well as the health care resources (including FQHCs) and community-based service resources currently available in the service area.
Regulatory Relief Tool In collaboration with Brown and Weinraub, PLLC and Health Management Associates, CHCANYS has developed a list of potential regulation waivers that FQHCs may want to include in their PPS network applications. Although not exhaustive, this tool provides concrete examples of regulatory and policy relief that may be requested.
Click here to view Regulatory Flexibility Guidance released by the State.
Performing Provider System Development Lifecycle: An Illustrative Example An important resource, this Department of Health webinar outlines a step-by-step process for a hypothetical safety net provider going through the DSRIP planning phase, resulting in a DSRIP Project Plan. The process includes identifying PPS partners, development of a governance structure, use of the community needs assessment to identify projects to be included in the DSRIP project plan, and the valuation process applied to the project plan. All emerging PPSs are strongly encouraged review this webinar as they develop their applications. Questions may be directed to firstname.lastname@example.org.
DSRIP Letters of Intent The Department of Health received 88 letters of intent from providers wishing to participate in the DSRIP program and has categorized these submissions as either "emerging" or "non-emerging" based on how likely they are to meet program requirements.
DSRIP Design Grant Information The State has made available funding to emerging Performing Provider Systems to develop comprehensive DSRIP Project Plans. Applications for these planning funds were due on Thursday, June 26, 2014 and the NYS Department of Health announced awards on August 6, 2014.
Eligible Hospital Safety-Net List The DSRIP Eligible Hospital Safety-Net List has been updated to include all public hospitals, not just those mentioned in the Public Hospital Transformation Fund, as DSRIP eligible entities.
How To Guides
DSRIP Governance “How To” Guide and Webinar Released Developing a successful PPS with multiple partners requires an effective governance structure and process to assure PPS stewardship, oversight and representation. To assist, KPMG has developed a governance “How To” document and an associated webinar which provide an overview of key considerations when developing governance and three sample models intended to prompt thinking on the best approach for PPSs.
Whiteboard: DSRIP Project Plan Scale and Speed on Implementation For each project in the application, PPSs must indicate what the scale of implementation will be, as well as the speed at which full implementation will be achieved. PPSs will be awarded more or fewer points as scale and speed increase or decrease. This video aims to provide some clarity on how PPS should look to balance these variables when developing their project plans.
Webinar Series: DSRIP and Population Health To thrive in the new value-based environment of DSRIP, PPSs must become high performing organizations, working together across the community, to provide a seamless continuum of coordinated, patient or "person-centered" services that are population health focused. To be successful, PPSs will need access to complete, longitudinal information on what happens to patients over time and across organizational boundaries. The two-part “DSRIP Population Health Management" webinar series, originally presented in November and now available online, is designed to help PPSs ensure that they have the necessary functional population health management tools in place to help identify, monitor, and report on patient populations. To access the recordings and slides, click here.
How Do You Measure Successful Behavioral Health Integration? Presented on June 25, 2014 Co-Sponsored by: Community Health Care Association of New York State (CHCANYS); Association of Alcoholism and Substance Abuse Providers (ASAP); Healthcare Association of New York State (HANYS); Home Care Association of New York State (HCA); LeadingAge New York; Mental Health Association of New York State (MHANYS); New York Association of Psychiatric Rehabilitation Services (NYAPRS); and New York State Council for Community Behavioral Healthcare.
The focus of this presentation, co-sponsored by CHCANYS and a number of other New York provider associations, was how to measure the successful integration of behavioral health with primary care and nursing homes as it relates to the New York State Medicaid waiver and the Delivery System Reform Incentive Payment (DSRIP) Program.
Delivery System Reform Incentive Payment (DSRIP) Plan A presentation by Greg Allen, Director of Program Development and Management, Office of Health Insurance Programs, NYSDOH Presented on Monday, February 24, 2014 Click the link above to watch a video of this presentation.