Equity Programs (EP) Monthly Update Webinar

  • Webinar also available in Portable Document Format (PDF)

September 2016

Today´s Agenda

  1. EP Contact List
  2. EP & DSRIP Timelines
  3. EP Contract
  4. EPP Demonstration Year (DY 1 Performance Results
  5. EPP DY1 Payments
  6. EIP Underpayment Update
  7. Medicaid Accelerated Exchange (MAX) Update
  8. EIP DY2 Quarter 2 Reporting
  9. Next Steps and Open Forum

EP General Updates

EP Contact List

  • The Department of Health (DOH) distributed the most recent EP contact list to EP participants on Friday, September 16th.
    • DOH compiled contact information submitted by EP participants.
    • The information includes contacts names, titles, organizations, phone numbers, and email addresses.
    • DOH will use the contact list for EP communications going forward.
  • The EP Contact List has been uploaded to the DSRIP Digital Library.

EP & DSRIP Timelines

  • How the EIP and the EPP timelines relate to the DSRIP Program timeline:
    • EIP perfectly aligns with DSRIP. Both are five–year programs and have the exact same start (April 1, 2015) and end (March 31, 2020) dates.
      • EIP activities occur within each DSRIP Year and payment follows once activity is reported on at the end of each EIP reporting period (monthly, quarterly, semi–annual or annual basis).
    • EPP does not directly align with DSRIP. EPP is a five year program, but EPP lags one year behind DSRIP. EPP begins exactly one year later (April 1, 2016) and similarly ends one year after DSRIP (March 31, 2021).
      • PPS are paid within each EPP year based on their performance within the corresponding DSRIP Measurement Year (MY). The alignment between the DSRIP MY performance and the EPP payment is linear (EPP DY1 payment is based on DSRIP MY1 results, EPP DY2 payment is based on DSRIP MY2 results, etc.)
  • PPS should select EPP measures in reference to EPP years, not DSRIP DYs or DSRIP MYs.
    • If a PPS would like to select the same EPP measures for all five years, the timing would be from April 1, 2016 – March 31, 2021.
    • If a PPS would like to change its EPP measures after DY1, the contract should list its EPP DY1 measures from April 1, 2016 – March 31, 2017, and then separately list its revised EPP measures for EPP in DY2–DY5 (April 1, 2017 – March 31, 2021).
award

EP Contracts

  • DOH has updated the EP FAQs to include questions from the July EP Monthly Update Webinar.
  • The updated FAQs document can be found on the EP webpage.
  • DOH will no longer be distributing a copy of the updated FAQs to participants as the most recent version will now be placed at the webpage above.

EP Contracts

  • EP contracts are due to DOH and the Independent Assessor (IA) by Friday, September 30th, 2016 at 5pm.
    • Contracts must contain the four EIP activities and six EPP measures chosen by each MCO/PPS partnership.
  • DOH urges MCOs that have not submitted their EP partner contracts to send them as soon as possible, as EIP and EPP payments cannot be effectuated until EP contracts are submitted.
    • Contracts should be submitted via email to both dsrip_ssp@health.ny.gov and dsrip_ia@pcgus.com with "Equity Programs Contract" and the MCO´s and PPS´ name in the subject line.
    • MCOs are expected to copy PPS partners when submitting their contracts to DOH and the IA to keep all parties informed.
  • Partnerships that do not submit contracts by September 30th, 2016 deadline will forfeit corresponding EIP and/or EPP payment for DY1 and DY2.

EPP Updates

EPP DY1 Performance Results

  • MCOs that have submitted their select EPP DY1 measures by July 29th, 2016 received EPP DY1 performance results from the IA on Friday, September 16th.
    • Although EPP measures are Pay for Reporting (P4R) in DY1, payment from the MCO to the PPS cannot be effectuated until the IA receives an EP contract for each MCO/PPS pairing and the IA releases EPP results for the EPP year.
  • The achievement/non–achievement of all partnered PPS´ chosen EPP measures are clearly displayed in the Ia´s report to each MCO.
    • For DY1, MCOs will be notified by the IA via email and PPS will be cc´ (so long as the primary contact information has been submitted).
  • Going forward, DY2–DY5 EPP performance reports will still be sent to MCOs via email, but the results will also be made available to PPS in the Q4 IA reports.
    • For DY2–5, EPP performance reports will be published in July.

EPP DY1 Payments

  • Similar to EIP payments in 2015, EPP payments to MCOs have been delayed, due to the postponement in the approval of the April 2016 rates.
  • Although PPS may have received EPP DY1 results from the IA, MCOs have not received funds to pay EPP awards.
  • EPP payments cannot be made to PPS until MCOs receive the EPP payments later this year, which will be retroactive to April 2016.
Milestone Due Date
MCOs submit EP contracts to DOH & IA September 30, 2016
IA releases DY1 performance results to MCOs October 14, 2016
MCOs receive EPP payment retroactive to April 2016 Oct. – Dec. 2016
DOH to publish all PPS EPP measures and EIP activities selections as well as performance achievement online Mid–Late October 2016

EIP Updates

EIP DY1 Underpayment Update

  • DOH continues to work with CMS on a set of January 2016 EIP rate adjustments, which will close the gap between actual DY1 EIP payments and expected DY1 EIP payments.
  • EIP rate adjustments are still pending CMS approval.
    • DOH will notify affected MCOs and PPS once the rate adjustments are approved.
  • EIP funds in DY2 will continue to flow at the lower rate that was set in April 2015 until the January 2016 rate adjust is approved.

Medicaid Accelerated Exchange (MAX) Update

  • The DY2 Max Series (Targeting Avoidable Readmissions for High Utilizers) begins in November 2016.
    • 20 Action Teams, representing approximately 200 Clinicians and Administrators have the opportunity to participate in this series
      • Action Teams are to attend the three Workshops in the series and are responsible to implement the process improvements that they commit to within those Workshops.
    • DOH has already begun recruiting teams for this series, with enrollment ending on October 31st, 2016.
    • If you would like to enroll in this series, or have any questions regarding the program, please email MAX Team members Joshua Sorin (jsorin@kpmg.com) and/or Shireen Saxena (shireensaxena@kpmg.com).
  • Beyond the formal MAX workshops available in DY2, DOH introduced the Train the Trainer (TTT) MAX series, which involves training participants to host their own MAX workshops.
    • MAX TTT recruitment began in September 2016 and ends October 31, 2016, with the workshops then beginning in November 2016.
      • Up to 40 Participants from across all 25 PPSs, as well as, provider sites and other organizations have the opportunity to participate in the program.
    • MAX TTT enables PPS to continue to select MAX as an EIP Activity throughout the duration of DSRIP.
    • If you would like to enroll in this opportunity, or have any questions regarding the program, please email the MAX Series Train–the–Trainer Lead, Shireen Saxena, at shireensaxena@kpmg.com.

EIP Demonstration Year (DY2) Q2 Reporting

  • DY2 Q2 ends September 30th, 2016. If PPS elected to report quarterly or semiannually, reports for the period should be sent to the listed entity at the appropriate email address noted below:
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 Open Forum

  • Please submit your finalized contracts to DOH and the IA as soon as possible.
    • Friday, September 30th, 2016 at 5pm is the deadline for materials to be 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´ name in the subject line.
    • Contracts that are not submitted by the deadline will forfeit corresponding EIP and/or EPP payment for DY1 and DY2.
    • Be sure to copy your PPS partner in the e–mail submission to DOH and the IA.
  • The next EP Monthly Update Webinar is scheduled for Wednesday, October 26th from 1:00 pm – 2:00 pm.
  • For any further questions, please contact the Supplemental Programs inbox: dsrip_ssp@health.ny.gov.
  • The remainder of this webinar is reserved for an open forum session.

Thank you for your continued support with EP!

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