Delivery System Reform Incentive Payment (DSRIP) Program

Mid-Point Assessment Overview - Updates

  • Presentation also available in Portable Document Format (PDF, 462KB)

All PPS Meeting
April 8, 2016

April 2016

Mid-Point Assessment Overview

  • The Mid-Point Assessment is a required component of the New York Delivery System Reform Incentive Payment (DSRIP) Program.
    • It is defined in Section VIII.11.d of the Standard Terms and Condition (STCs) of the 1115 waiver.
    • The requirements of the Mid-Point Assessment are further defined in Section VI.d of Attachment I to the STCs.
  • The Mid-Point Assessment is intended to provide a review of PPS progress towards the implementation of the approved DSRIP Project Plans for compliance with the program requirements identified in the STCs and to determine any modifications necessary to ensure PPS success through the remaining years of the program.
  • The requirements of the Mid-Point Assessment include an assessment of:
    • Compliance with the approved DSRIP Project Plan;
    • Compliance with the required core components for DSRIP projects described in the DSRIP Strategies Menu and Metrics;
    • Non-duplication of Federal funds;
    • Analysis and summary of relevant data on performance on metrics and indicators to this point in time;
    • The benefit of the project to the Medicaid and uninsured population and to the health outcomes of all patients served by the project;
    • Project governance including recommendations for how governance can be improved to ensure success;
    • The opportunity to continue to improve the project by applying any lessons learned or best practices that can increase the likelihood of the project advancing the three part aim; and
    • Current financial viability of all lead providers participating on the DSRIP project.

Mid-Point Assessment Updates

  • The Mid-Point Assessment Overview was released for a public comment period on February 17, 2016.
    • 60 comments were received from 14 entities including PPS, trade associations, and advocacy groups.
  • The comments covered a range of topics including the proposed timelines, removal of network partners, safety-net determinations, and the materials to be considered by the Independent Assessor (IA).
  • The comments also included recommendations for modifications to the Mid-Point Assessment approach.
  • The IA reviewed all comments and recommendations in modifying the proposed Mid-Point Assessment approach.
  • A redline version of the Mid-Point Assessment Overview document has been released and posted to the DSRIP website.
    • A summary of the public comments with IA responses has been provided with the revised Mid-Point Assessment Overview document.

Mid-Point Assessment Process - Updates

  • Topic: PPS Project Implementation through DY2, Q1
  • Comments:
    • Multiple comments were received on the initiation of the Mid-Point Assessment at the conclusion of DY2, Q1.
    • Commenters indicated that the assessment of PPS progress towards project implementation would benefit from additional details beyond the PPS Quarterly Reports.
  • Modification to Mid-Point Assessment Overview:
    • In addition to the PPS updates to the PPS Quarterly Report for DY2, Q1, the Mid-Point Assessment will require PPS to provide a narrative for each project to further detail implementation efforts to date, challenges to project implementation, and unique approaches or best practices being employed by the PPS.
      • A narrative may also be provided to highlight significant organizational achievements in areas such as VBP, Cultural Competency and Health Literacy, CBO engagement, Governance, and Workforce.

Mid-Point Assessment Process - Updates

  • Topic: PPS Preview of Independent Assessor Recommendations
  • Comments:
    • Commenters recommended an opportunity for PPS to review Independent Assessor recommendations prior to release for public comment.
    • Commenters also indicated a desire for PPS to have an opportunity to meet with the Independent Assessor to discuss the recommendations.
  • Modification to Mid-Point Assessment Process:
    • The Mid-Point Assessment Timeline has been revised to allow for PPS to have Independent Assessor recommendations for 1 week prior to the release for public comments.
    • PPS will also have the opportunity to request a meeting with the Independent Assessor to discuss the recommendations during the public comment period.

Mid-Point Assessment Process - Updates

  • Topic: PPS Network Partner Input on PPS Performance
  • Comments:
    • Commenters indicated a desire for the Mid-Point Assessment to capture input from PPS network partners on PPS performance in order to obtain a more comprehensive picture of the PPS.
  • Modification to Mid-Point Assessment Process:
    • The Mid-Point Assessment will include a ´360-like´ survey tool to capture feedback from PPS network partners.
    • The survey will be distributed to a sample of PPS network partners who will be asked to rate the PPS on their experience with the PPS in areas such as participation in governance, project development, project execution, and on PPS communications with partners, conflict resolution, and funds flow.

Mid-Point Assessment Process - Updates

  • Topic: Network partner removals
  • Comments:
    • Comments indicated a need to more clearly define the basis for calculating the percentage for removal of network partners.
    • Commenters also noted a need to consider ´voluntary removals´ of network partners and the limitation on removals to no more than 5% of the PPS provider network.
  • Modification to Mid-Point Assessment Process:
    • The Mid-Point Assessment has been revised to allow for the removal of no more than 10% of network partners.
    • The 10% will be based off the total number of PPS network partners as defined in the PPS network tool.

Mid-Point Assessment Process - Updates

  • Topic: Timeframe for PPS implementation of Project Plan modifications
  • Comments:
    • Comments indicated that a two month window for PPS to implement the recommended Project Plan modifications was not a realistic expectation.
  • Modification to Mid-Point Assessment Process:
    • The Mid-Point Assessment has been revised to allow for the PPS to develop a Mid-Point Assessment Action Plan outlining the proposed approach and timeline for implementing the Project Plan modifications.
      • Mid-Point Assessment Action Plans must be submitted to the Independent Assessor for review and approval within 30 days of final recommendations being sent to CMS by the Commissioner of Health.
    • The Independent Assessor will review and return the approved Mid-Point Assessment Action Plans to the PPS by the start of DY3.

Mid-Point Assessment Timelines - Revised

  Date
PPS Completes DY2, Q1 Quarterly Report July 31, 2016
Independent Assessor begins reviews of DY2, Q1 Quarterly Report and Initiates Mid-Point Assessment August 1, 2016
Independent Assessor finalizes results of DY2, Q1 Quarterly Report September 29, 2016
Independent Assessor finalizes initial Mid-Point Assessment recommendations October 28, 2016
Independent Assessor recommendations released for PPS review October 31, 2016
Independent Assessor recommendations released for public comment November 7, 2016
PPS response and public comment period ends December 1, 2016
Mid-Point Assessment recommendations released for 30 day public comment period December 15, 2016
Mid-Point Assessment 30 day public comment period ends January 15, 2017
Project Approval and Oversight Panel convenes to review Mid-Point Assessment recommendations; includes 1 day of public comment January 17 – 20, 2017
Project Approval and Oversight Panel recommendations submitted to Commissioner of Health January 24, 2017
Commissioner of Health submits recommendations to CMS January 31, 2017
PPS complete Mid-Point Assessment Action Plans for Mid-Point Assessment Project Plan Modifications and submit for Independent Assessor review and approval March 1, 2017
Independent Assessor approves Mid-Point Assessment Action Plans for PPS implementation in DY3 March 31, 2017

Questions and Comments

DSRIP e-mail:

dsrip@health.ny.gov