Delivery System Reform Incentive Payment (DSRIP)

PPS Project Valuation Webinar

  • Presentation is also available in Portable Document Format (PDF)

October 29, 2015

Agenda

Introduction

PPS Project Valuation Breakdowns are intended to provided PPS with more detail regarding valuations by project.

  • DOH will be releasing PPS specific workbooks that show PPS anticipated valuation per project, per domain and by Pay for Reporting (P4R) and Pay for Performance (P4P) for each payment period.

Project valuations are consistent with the total net DSRIP valuation amounts communicated to PPS in previously distributed award letters and are based on PPS’ DSRIP plan application score, PMPM, attribution, and DSRIP year funding percentages as specified in the CMS waiver special terms and conditions.

The evaluation of AVs and the calculation of payments will tie back to the project valuations and will ultimately be reflected in the AV Scorecard.

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Previous Webinars and Resources

DOH has provided PPS with guidance regarding the calculation of payments and funding sources in previous webinars and presentations:

  • Information about attribution methodology and the calculation procedures for project valuations can be found in the "DSRIP Update: New Project, Attribution and Valuation" webinar presented August 1, 2014
  • Information about allocation of funds to P4P and P4R and an overview of the 5–year payment model can be found in the "Earning Payments D1–D4 AVs" webinar presented August 21, 2015
  • Information about the High Performance Fund and Distribution Methodology was presented on September 24, 2015
  • Information about the Equity Infrastructure, the Equity Performance and the Additional High–Performance Programs can be found in the "Supplemental DSRIP Programs – Equity Performance and Additional High Performance" presentation distributed to PPS leads through the DOH DSRIP e–mail October 7, 2015
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Example Project Valuation Datasheet – Forestland PPS

Project Domain Reporting Level DY1 DY2 DY3 DY4 DY5 Net Valuation by Project
Payment 1 Payment 2 Payment 3 Payment 1 Payment 2 Payment 1 Payment 2 Payment 1 Payment 2 Payment 1 Payment 2
2.a.i 1 P4R $ 2,594,067 $ 432,345 $ 432,345 $ 1,382,211 $ 1,382,211 $ 1,490,140 $ 1,490,140 $ 659,756 $ 659,756 $           – $           – $ 27,302,524
2 P4P $           – $           – $           – $           – $           – $ 1,788,167 $ 1,788,167 $ 2,309,148 $ 2,309,148 $ 1,967,168 $ 1,967,168
P4R $           – $ 432,345 $ 432,345 $ 921,474 $ 921,474 $ 447,042 $ 447,042 $ 329,878 $ 329,878 $ 194,555 $ 194,555
2.a.iv 1 P4R $ 2,088,823 $ 348,137 $ 348,137 $ 1,112,999 $ 1,112,999 $ 1,199,906 $ 1,199,906 $ 531,256 $ 531,256 $           – $           – $ 21,984,836
2 P4P $           – $           – $           – $           – $           – $ 1,439,888 $ 1,439,888 $ 1,859,397 $ 1,859,397 $ 1,584,024 $ 1,584,024
P4R $           – $ 348,137 $ 348,137 $ 742,000 $ 742,000 $ 359,972 $ 359,972 $ 265,628 $ 265,628 $ 156,662 $ 156,662
2.b.ii 1 P4R $ 1,884,008 $ 314,001 $ 314,001 $ 1,003,866 $ 1,003,866 $ 1,082,252 $ 1,082,252 $ 479,165 $ 479,165 $           – $           – $ 19,829,157
2 P4P $           – $           – $           – $           – $           – $ 1,298,702 $ 1,298,702 $ 1,677,078 $ 1,677,078 $ 1,428,706 $ 1,428,706
P4R $           – $ 314,001 $ 314,001 $ 669,244 $ 669,244 $ 324,676 $ 324,676 $ 239,583 $ 239,583 $ 141,301 $ 141,301
2.b.iv 1 P4R $ 1,908,787 $ 318,131 $ 318,131 $ 1,017,070 $ 1,017,070 $ 1,096,486 $ 1,096,486 $ 485,467 $ 485,467 $           – $           – $ 20,089,957
2 P4P $           – $           – $           – $           – $           – $ 1,315,783 $ 1,315,783 $ 1,699,135 $ 1,699,135 $ 1,447,497 $ 1,447,497
P4R $           – $ 318,131 $ 318,131 $ 678,046 $ 678,046 $ 328,946 $ 328,946 $ 242,734 $ 242,734 $ 143,159 $ 143,159
2.d.i 1 P4R $ 2,213,544 $ 368,924 $ 368,924 $ 1,179,455 $ 1,179,455 $ 1,271,551 $ 1,271,551 $ 562,977 $ 562,977 $           – $           – $ 23,297,524
2 P4P $           – $           – $           – $           – $           – $ 1,525,862 $ 1,525,862 $ 1,970,419 $ 1,970,419 $ 1,678,604 $ 1,678,604
P4R $           – $ 368,924 $ 368,924 $ 786,303 $ 786,303 $ 381,465 $ 381,465 $ 281,488 $ 281,488 $ 166,016 $ 166,016
3.a.i 1 P4R $ 1,718,790 $ 286,465 $ 286,465 $ 915,832 $ 915,832 $ 987,344 $ 987,344 $ 437,145 $ 437,145 $           – $           – $ 18,090,239
3 P4P $           – $           – $           – $           – $ 732,666 $ 1,234,180 $ 1,234,180 $ 1,508,149 $ 1,508,149 $ 1,253,284 $ 1,253,284
P4R $           – $ 286,465 $ 286,465 $ 244,222 $ 244,222 $ 246,836 $ 246,836 $ 240,430 $ 240,430 $ 179,041 $ 179,041
3.a.ii 1 P4R $ 1,294,596 $ 215,766 $ 215,766 $ 689,807 $ 689,807 $ 743,670 $ 743,670 $ 329,258 $ 329,258 $           – $           – $ 13,625,608
3 P4P $           – $           – $           – $           – $ 551,846 $ 929,587 $ 929,587 $ 1,135,941 $ 1,135,941 $ 943,976 $ 943,976
P4R $           – $ 215,766 $ 215,766 $ 183,949 $ 183,949 $ 185,917 $ 185,917 $ 181,092 $ 181,092 $ 134,854 $ 134,854
3.b.i 1 P4R $ 1,361,478 $ 226,913 $ 226,913 $ 725,444 $ 725,444 $ 782,089 $ 782,089 $ 346,269 $ 346,269 $           – $           – $ 14,329,539
3 P4P $           – $           – $           – $           – $ 580,355 $ 977,612 $ 977,612 $ 1,194,627 $ 1,194,627 $ 992,744 $ 992,744
P4R $           – $ 226,913 $ 226,913 $ 193,452 $ 193,452 $ 195,522 $ 195,522 $ 190,448 $ 190,448 $ 141,821 $ 141,821
3.c.i 1 P4R $ 1,390,817 $ 231,803 $ 231,803 $ 741,077 $ 741,077 $ 798,943 $ 798,943 $ 353,731 $ 353,731 $           – $           – $ 14,638,335
3 P4P $           – $           – $           – $           – $ 592,862 $ 998,679 $ 998,679 $ 1,220,370 $ 1,220,370 $ 1,014,138 $ 1,014,138
P4R $           – $ 231,803 $ 231,803 $ 197,621 $ 197,621 $ 199,736 $ 199,736 $ 194,552 $ 194,552 $ 144,877 $ 144,877
4.a.iii 1 P4R $ 983,104 $ 163,851 $ 163,851 $ 523,833 $ 523,833 $ 564,736 $ 564,736 $ 250,036 $ 250,036 $           – $           – $ 10,347,156
4 P4R $           – $ 163,851 $ 163,851 $ 349,222 $ 349,222 $ 847,103 $ 847,103 $ 1,000,142 $ 1,000,142 $ 819,253 $ 819,253
4.b.ii 1 P4R $ 933,949 $ 155,658 $ 155,658 $ 497,641 $ 497,641 $ 536,499 $ 536,499 $ 237,534 $ 237,534 $           – $           – $ 9,829,798
4 P4R $           – $ 155,658 $ 155,658 $ 331,761 $ 331,761 $ 804,748 $ 804,748 $ 950,135 $ 950,135 $ 778,291 $ 778,291
Subtotal by Payment Period $ 18,371,962 $ 6,123,987 $ 6,123,987 $ 15,086,530 $ 17,544,258 $ 26,384,040 $ 26,384,040 $ 23,362,967 $ 23,362,967 $ 15,309,968 $ 15,309,968 $ 193,364,673
Subtotal by DSRIP Year $30,619,936 $32,630,788 $52,768,080 $46,725,933 $30,619,936
  Public Equity Guarantee $           –
Public Equity Performance $           –
Net High Performance (3%) $ 22,219,463
Additional High Performance $ 17,919,374
Total Valuation $233,503,510
DSRIP Vision - How Should an Integrated Delivery System Function?
DSRIP Vision - How Should an Integrated Delivery System Function?
DSRIP Vision - How Should an Integrated Delivery System Function?
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Step–by–Step Example

Step 1 – Annual Funding Distribution

  • DSRIP funding is not distributed evenly over the life of the waiver. Annual funding percentages, as defined in the STCs, factor into the allocation of project funding by Demonstration Year (DY).
    Project 3.c.i Valuation $14,638,335
    Year DY1 DY2 DY3 DY4 DY5
    Funding Percentage 15.84% 16.88% 27.29% 24.16% 15.84%
    Funding Amount $2,318,029 $2,470,257 $3,994,715 $3,537,305 $2,318,029

Step 2 – P4R and P4P Allocation

  • DSRIP annual funding is distributed by Domain and P4R and P4P payment allocation percentages in accordance with the STCs. The payment allocation percentages are applied to the funding amounts to delineate the possible payment amount per DSRIP Year.
    Domain Payment Annual Domain Funding Percentages
    DY1 DY2 DY3 DY4 DY5
    Payment   P1 P2 P3 P1 P2 P1 P2 P1 P2 P1 P2
    Domain 1
    (Project Process Milestones)    		 P4R 60% 10% 10% 30% 30% 20% 20% 10% 10% – –
    Domain 2
    (System Transformation Milestones)    		 P4P – – – – – 24% 24% 35% 35% 45.5% 45.5%
    P4R – 10% 10% 20% 20% 6% 6% 5% 5% 4.5% 4.5%
    Domain 3
    (Clinical Improvement Milestones)    		 P4P – – – 0% 24% 25% 25% 34.5% 34.5% 43.75% 43.75%
    P4R – 10% 10% 8% 8% 5% 5% 5.5% 5.5% 6.25% 6.25%
    Domain 4
    (Population Health Milestones)    		 P4R – 10% 10% 20% 20% 30% 30% 40% 40% 50% 50%

Step 3 – Allocation to P4R and P4P per DSRIP Payment Model

  • Using P4R/P4P Percentages for Domain 3, potential payment amounts per payment period can be calculated.
  • Valuations by project represent maximum potential payment amounts assuming PPS earns 100% of the available AVs in a quarter.
    Project Domain Reporting Level DY1 DY2 DY3 DY4 DY5 Net Valuation by Project
    Payment 1 Payment 2 Payment 3 Payment 1 Payment 2 Payment 1 Payment 2 Payment 1 Payment 2 Payment 1 Payment 2
    3.c.i 1 P4R $1,390,817 $231,803 $231,803 $741,077 $741,077 $798,943 $798,943 $353,731 $353,731 $          – $          – $14,638,335
    3 P4P $          – $          – $          – $          – $592,862 $998,679 $998,679 $1,220,370 $1,220,370 $1,014,138 $1,014,138
    P4R – $231,803 $231,803 $197,621 $197,621 $199,736 $199,736 $194,552 $194,552 $144,877 $144,877
    Subtotal by Payment Period $1,390,817 $463,606 $463,606 $938,698 $1,531,559 $1,997,358 $1,997,358 $1,768,653 $1,768,653 $1,159,014 $1,159,014  
    Subtotal by DSRIP Year $2,318,029 $2,470,257 $3,994,715 $3,537,305 $2,318,029
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Next Steps

PPS specific project valuation breakdown templates will be distributed to PPS leads tomorrow, October 30, 2015

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