Welcome to RHP 9 – Transforming Healthcare Now 

Waiver Information


  • Medicaid 1115 Waiver renewed October 1, 2017 – September 30, 2022. Information on the existing waiver details and transition plans can be found at the Texas Health & Human Services Waiver Renewal.
  •  Click here to reivew the updated RHP 9 Plan for demonstration years DY9-10. 
  • Aligns with the Triple Aim of the Centers for Medicare and Medicaid Services (CMS): Improve the experience of care, Improve the health of populations, and Reduce the per capita costs of healthcare without compromising quality.
  • Creation of Regional Healthcare Partnerships (RHP) that support coordinated, efficient delivery of quality care, and a plan for system transformation that is driven by the needs of the community.
  • Provides incentive payments for quality improvement and healthcare delivery system reform

Quick Facts on RHP 9:      

  • 3 Counties: Dallas, Denton, & Kaufman
  • 2,530 square miles
  • Population of 3.1 million
  • 40% are low income
  • 22 providers participating in Delivery System Reform Incentive Payment (DSRIP) projects
  • Needs assessment: Gaps in access, behavioral health, and overall care coordination.

UPCOMING EVENTS:

 

TO BE ANNOUNCED

 

 

There are currently no upcoming events. Please check back later.

 

 

 

 

 

Making a Difference

Update on DY10/CY 2021 COVID-19 Accommodations

CMS has agreed to maintain flexibilities approved for Categories B and C for DY9 reporting into DY10. HHSC is currently updating the PFM to reflect the following accommodations:

 

Category B:

CMS approved use of a higher Allowable Variation than the standard 5 percent. DY10 Allowable Variation will be updated to a flat percentage of 15% for all providers (please note that this is a reduction from 35% that was used for DY9). This final value took into consideration the average decrease in reported MLIU PPP between DY8 and DY9 by DSRIP providers and trends in national encounter data (e.g., studies by the Commonwealth Fund and Journal of the American Medical Association on the impact of COVID-19 on patient visits). Providers participating in the studies saw a decrease in patient visits between 5-10% between October 2020 and June 2021. DSRIP providers saw an average decrease in MLIU PPP of 8% between DY8 and DY9. The final value was rounded up to 15% to also account for the original 5% maximum allowable variation.

 

As a result of this change, the payment tiers for DY10 Category B metrics will be 100%, 75%, 50%, and 0%.

 

Category C:

Providers are required to report calendar year 2021 data to be eligible for payment on the Category C DY10 achievement milestones.

 

For measures selected for DY7-10, the PY4 achievement value for DY10 achievement milestones and DY9 carryforward achievement milestones will be based on the greater of:

  • Provider’s approved DY8 achievement value for the measure;
  • Average approved DY8 achievement value for the measure if 10 or more providers selected the P4P measure for DY7-8, rounded down to the quartile;
  • Average approved DY8 achievement value for the Measure Bundle if less than 10 providers selected the P4P measure for DY7-8, rounded down to the quartile; or
  • Percent of DY10 goal achieved in CY2021 for DY10 achievement milestones, and Percent of DY9 goal achieved in CY2021 for DY9 carryforward achievement milestones.

 

For measures that were newly-selected for DY9-10, the PY4 achievement value for DY10 achievement milestones and DY9 carryforward achievement milestones will be based on the greater of:

  • Average approved DY8 achievement value for the measure if 10 or more providers selected the P4P measure for DY7-8, rounded down to the quartile;
  • Average approved DY8 achievement value for the Measure Bundle if less than 10 providers selected the P4P measure for DY7-8, rounded down to the quartile; or
  • Percent of DY10 goal achieved in CY2021, and Percent of DY9 goal achieved in CY2021 for DY9 carryforward achievement milestones.

 

The “Category C Achievement Values for CY2020” file is posted to the online reporting system bulletin board under the Category C Resources section and can be used to view the estimated average achievement values by measure or bundle. This data is provided for informational purposes. The actual average achievement value for an AM-10 milestone is based on all PY2 reporting as of the October DY10 Needs More Information (NMI) reporting period (February 2021).

Upcoming Meetings:
  • Partner Engagement & Executive Waiver Committee Combined meeting:  Thursday, September 23, 2021 at 10:00 am.  Click here to register.
  • DY10R2 October Reporting Webinar:  Tuesday, October 5, 2021, 10:00 am – 12:00 pm.  Click here to register.
DY10 October Reporting
  • DY10 October reporting materials:
    • Will be made available towards the end of September on the DSRIP bulletin board as HHSC finalizes them.
  • CATA-Cost & Savings Template: 
    • HHSC has received the template form their vendor and are in the process of doing final checks. 
    • They will release it and the companion as soon as it is ready,
    • No exact ETA.
  • DY10 COVID-19 Flexibility:
    • HHSC is still in discussion with CMS
    • Proposed 10-15% allowable variation for Cat B
    • Proposed same allowances for CAT C in place for DY9
    • CMS has not approved either as of today
Compliance Monitoring - MSLC
  • Completed open CAT 1, CAT 2, & CAT 3 measure audits
  • Completed Round 3 CAT C audits
  • Updates to the CAT C workbooks will be completed and posted on the DSRIP bulletin board by 9/13/201.
  • Round 4 CAT C audits will run SEP 2021 – FEB 2022
DSRIP Transition:
  • No new updates
  • HHSC and CMS are in daily (sometimes multiple) meetings each day to arrive and agreements on programs. 
  • For links to the Directed Payment Program (DPP) information see attached Anchor Call Notes.