Equity Programs (EP) Update Webinar

  • Webinar also available in Portable Document Format (PDF, 220KB)

July 2016

Today´s Agenda

  1. EP Webpage Update
  2. EP Reporting Tables
  3. EP New Email & Primary Contacts
  4. EP Contracts
  5. EPP DY1 Results
  6. EPP Measure Selection/Diversification
  7. EIP Updates
  8. Next Steps and Q&A

Equity Programs General Updates

Equity Programs Webpage Update

  • The Equity Programs (EP) webpage on the DSRIP website has been updated!
  • The following documents were revised or added:
    • EP DY2 Focus Webinar
    • EP DY2 Guidance Packet
    • EIP Financial Substantiation Document
    • EP Manual Reporting Tables
    • EP Automated Reporting Tables
    • EP Reporting & Payment Scenarios
    • EP Updated FAQs
  • DOH sent an e-mail to EP participants on Monday, July 18th notifying them of website updates.

Equity Programs Reporting Tables

  • DOH received feedback from a number of EP MCOs that were unable to populate the EP Automated Reporting Tables due to Excel compatibility issues.
  • EP Manual Reporting Tables were developed to allow participants experiencing Excel compatibility problems to manually populate the reporting tables.
    • The manual version removes much of the auto-populating capabilities of the Automated Reporting Tables, so it should no longer be incompatible with certain versions of Excel.
    • The instructions for each of the Reporting Tables have been revised accordingly.
  • Participants can access both the Automated and Manual EP Reporting Tables on the Equity Programs website (see prior slide).

Equity Programs New Email & Primary Contacts

  • There is a new Supplemental Programs BML! Please submit all Equity Programs related questions and reporting to dsrip_ssp@health.ny.gov.
  • To allow for easier and more efficient communications, DOH is requesting that all participants send in two EP primary contacts to dsrip_ssp@health.ny.gov.
    • The primary contacts´ information should include both contacts´ names, titles, organizations, phone numbers, and email addresses.
  • DOH will share the complete list of EP primary contacts to all program participants once the list is updated.
  • Please send this information by July 29th, as primary contacts will be used by DOH for all Equity Programs communications going forwards.

Equity Programs Contracts

  • MCOs are required to submit a copy of their signed EP contracts to DOH and the Independent Assessor (IA) as part of the EP reporting process.
    • The contract will inform the IA of the six EPP measures chosen by the PPS.
    • EPP payments cannot be effectuated until EP contracts are submitted. Contracts should be submitted via email to dsrip_ssp@health.ny.gov and dsrip_ia@pcgus.com with "Equity Programs Contract" and the MCO´s and PPS´s name in the subject line.
  • Contracts must be submitted by Friday, July 29th to ensure that EPP payments can be processed without delay.
  • MCOs are expected to copy PPS partners when submitting their contracts to DOH and the IA, to keep all parties informed.

Equity Performance Program (EPP) Updates

EPP DY1 Results

  • MCOs can expect EPP DY1 performance results from the IA on or about August 26th.
    • Note that only one MCO has submitted its EP contracts at this time.
    • Note that all EPP measures are P4R in DY1, but payment cannot be completed until the IA has all EP contracts
  • In the IA´s report to each MCO, the achievement/non-achievement of all of its partnered PPS´ chosen EPP metrics will be clearly displayed.
  • Note that like in EIP in 2015, EPP payment to MCOs has been delayed until the April 2016 rates are approved, meaning EPP payments cannot be made to PPS at this time. Later this year, MCOs will receive EPP payment retroactive to April 2016.
Milestone Due Date
MCOs submit EP contracts to DOH & IA July 29, 2016
DOH reviews EPP DY1 performance August 19, 2016
IA releases EPP DY1 performance results to MCOs August 26, 2016
MCOs receive EPP payment retroactive to April 2016 ˜October 2016

EPP Measure Selection/Diversification

  • PPS have asked for the opportunity to diversify their risk of not achieving EPP measures by choosing different EPP measures with each of their MCO partners.
    • For this one time exception, PPS may alter their EPP measures. The newly selected measures will be in place for the remainder of EPP (DY2-DY5).
    • Measures can only be changed if both the MCO and PPS in the partnership agree. If the PPS does not want to alter its measures, or the MCO does not agree to amend the contract to change the measures, then the originally chosen measures remain.
    • This should not be used as an excuse to alter other contract terms.
    • By September 29th, MCO-PPS partnerships must submit their amended EP contract containing the new EPP measures to the IA or the new measures will not be accepted.
    • PPS should recognize the risks inherent in both a ´wide net´ (many measure across their MCOs) and a ´narrow net´ (same six measures across all MCOs).
  • MCO-PPS partnerships will not be allowed to make any further changes to EPP measures in their contracts after September 29th, 2016.

Equity Infrastructure Program (EIP) Updates

EIP DY1 Underpayment Update

  • In EIP DY1, there were instances where a PPS received less than the full annual amount that was allocated to it from at least one of its paired MCOs, despite submitting satisfactory information pertaining to the completion of its selected EIP activities for the year.
  • MCOs were unable to effectuate the full payment to PPS partners due to insufficient funding from the State due to enrollment changes.
  • The January 2016 EIP rate adjustment was put in place to solve this issue. However, CMS has not yet approved the adjustment. Once approved, impacted MCOs will get the remainder of the DY1 EIP funds and will be able to distribute those funds to eligible PPS consistent with their completion of DY1 requirements.

EIP Activity Update

  • Two of the nine Activities in EIP involve participation in a series of workshops. However, there was concern that when the two series end in DY2, there will be no way to participate in the Activities for EIP. These two Activities are:
    • Participation in the MAX Series projects
    • Participation in IT TOM initiatives
  • The MAX Series has been extended into DY3, and so it can currently remain an EIP Activity. DOH will provide guidance on whether the MAX Series can be chosen in DY4 - DY5 at a later date.
  • DOH has determined that though IT TOM is ending in DY2, PPS will be able to choose it as an Activity in DY3 - DY5. Guidance on this will be released in mid-August.

EIP Reporting Frequency

  • PPS have asked to change their chosen reporting frequency for EIP.
    • Per DOH guidance, EIP reporting frequency can only be changed at the start of the year-not within it.
    • PPS will follow their current agreed to frequency of reporting for EIP until at least the start of DY3 on April 1st, 2017.
  • Before the start of DY3, EP contracts can be amended to include new activities as well as reporting and payment frequencies for EIP.
    • Changes regarding EIP activities as well as reporting & payment frequency must be submitted via an amended EP contract to the IA by March 31st 2017 to be valid for DY3.
    • Both the PPS and MCO must agree to the any changes or the original contract will remain in place in DY3.
  • DOH encourages participants to align EIP reporting and payment frequency (e.g. quarterly payment for quarterly reporting) to improve program administration.

EIP DY2 Q1 Reporting

  • If PPS are reporting quarterly, DY2 Q1 ended June 30th, 2016. Reports for the first reporting period should be sent to:
Report Completed by Submitted to Frequency Location
EP Contracts PPS & MCO IA & DOH Annually dsrip_ia@pcgus.com
dsrip_ssp@health.ny.gov
MCO EP Frequency Table MCO IA & DOH Annually dsrip_ia@pcgus.com
dsrip_ssp@health.ny.gov
MCO EIP Activity Table MCO IA & DOH Based on EP Contracts dsrip_ia@pcgus.com
dsrip_ssp@health.ny.gov
MCO EIP Payment Table MCO IA & DOH Based on EP Contracts dsrip_ia@pcgus.com
dsrip_ssp@health.ny.gov
MCO EPP Payment Table MCO IA & DOH Based on EP Contracts dsrip_ia@pcgus.com
dsrip_ssp@health.ny.gov
PPS EIP Activity Table PPS MCOs Based on EP Contracts MCO contact emails
Supporting Documentation for
EIP Activity participation		 PPS MCOs Based on EP Contracts MCO contact emails
Supporting Documentation for
EIP Activity participation		 MCO (reviewed by MCO after being sent by PPS) IA Based on EP Contracts dsrip_ia@pcgus.com

Next Steps and Q&A

  • The next Equity Programs Update Webinar is scheduled for August 24th at 2pm.
  • The remainder of today´s webinar is reserved for Q&A.

Thank you for your continued support with EP!

For any further questions, please contact the Supplemental Programs inbox: DSRIP_SSP@health.ny.gov