Value Based Payment Quality Improvement Program (VBP QIP) Timeline
- Timeline is also available in Portable Document Format (PDF)
Last Edited: March 27, 2017
VBP QIP Timeline as of March 2017
Please note that the dates included herein are the Department of Health´s (DOH´s) recommended completion dates for past, present, and upcoming VBP QIP milestones. It is up to individual pairings of VBP QIP partners to determine the exact completion dates for each of the following items. To successfully participate in VBP QIP and to continue to receive payments, these milestones must be met and reported on in the proper order as detailed below, but the exact timing is left to the discretion of the Managed Care Organizations (MCOs), in coordination with its paired PPS and Facilities.
Note that dates in red must be completed by their listed times and cannot be pushed back.
Group 1 Timeline: Demonstration Year (DY) 1 – 2
The timeline for Group 1 is for participants, who began participating in VBP QIP in DY1.
| Milestone | Due Date | Completed |
|---|---|---|
| Applications / Contracts | ||
| MCOs submit VBP QIP applications to DOH | August 21, 2015 | ✓ |
| MCO VBP QIP applications approved by DOH | September 11, 2015 | ✓ |
| MCOs, Performing Provider Systems (PPS), and Facilities put VBP QIP contract agreements in place 1 | October 9, 2015 | ✓ |
| Rates / Payments | ||
| DOH finalizes rates and sends to Centers for Medicare and Medicaid Services (CMS)/ Division of Budget (DOB) for review | September 18, 2015 | ✓ |
| DOH effectuates the State share payment to the MCOs | October 14, 2015 | ✓ |
| MCOs to submit December 2015 interim report (for VIP QIP payment disbursements made during the month of October 2015 – two month lag) | December 4, 2015 | ✓ |
| January rate adjustments for DY1 approved by CMS | TBD | |
| April 2016 rates approved by CMS/DOB | November 2016 | ✓ |
| Governance Document | ||
| MCOs submit VBP QIP Governance Document 2 for DOH review | March 7, 2016 | ✓ |
| DOH completes first round of review of MCO VBP QIP Governance Document and provides comments to the MCOs | April 26, 2016 | ✓ |
| MCOs submit a revised VBP QIP Governance Document to DOH for review | September 16, 2016 | ✓ |
| DOH reviews and approves VBP QIP MCO Governance Document | October 11, 2016 | ✓ |
| Facility Plan | ||
| DOH to provide a Facility Plan 3 outline to the MCOs for review | September 30, 2015 | ✓ |
| MCOs submit Facility Plans outline comments to DOH | October 9, 2015 | ✓ |
| DOH to finalize Facility Plan template guidance with the MCOs, ensuring consistency with VBP Roadmap | October 23, 2015 | ✓ |
| MCOs develop and issue Facility Plan templates | February 18, 2016 | ✓ |
| MCOs to issue the Facility Plan template to the PPS for comments | February 18, 2016 | ✓ |
| Facilities submit draft Facility Plan to PPS for initial review | May 2, 2016 | ✓ |
| PPS review Facility Plan and return them to facilities for revision | May 27, 2016 | ✓ |
| Facilities complete Facility Plans and submit to PPS, MCO, and DOH for review | June 20, 2016 | ✓ |
| Facility Plans reviewed by MCO in collaboration with PPS (final copies should be sent to DOH) | September 16, 2016 | ✓ |
| DOH to distribute Facility Plan Guidance Packet to VBP QIP partners | January 27, 2017 | ✓ |
| DOH to release VBP QIP DY3 Guidance Document | March 17, 2017 | ✓ |
| Facilities submit their updated, MCO approved, final Facility Plan to DOH | March 31, 2017 | |
| Metrics / Benchmarks | ||
| Baseline metrics for future measurement are co–developed by facility, PPS, & MCO (submitted as part of the final Facility Plan) | March 31, 2017 | |
| Benchmarks for reporting & performance set to be revisited quarterly | Ongoing: Quarterly Starting October 1, 2017 | |
| Reporting | ||
| MCO Monthly Reporting to DOH (January to March 2016), for disbursements made October to January 2016 – Manual Submissions 4 | 4th of the Month | ✓ |
| MCO Quarterly Reporting to DOH (April 2016 – Ongoing) – MMCOR Submissions | Ongoing: 45 days after Quarter End 5 | |
Group 2 Timeline: DY2
The timeline for Group 2 is for participants who began participating in VBP QIP in DY2.
| Milestone | Due Date | Completed |
|---|---|---|
| Applications / Contracts | ||
| MCOs submit VBP QIP applications to DOH | June 13, 2016 | ✓ |
| MCO VBP QIP applications approved by DOH | June 17, 2016 | ✓ |
| MCOs, PPS, and Facilities put VBP QIP contract agreements in place | September 30, 2016 | ✓ |
| Rates / Payments | ||
| April 2016 rates approved by CMS/DOB | November 2016 | ✓ |
| DOH effectuates the State share payment to the MCOs | July/August 2016 | ✓ |
| Governance Document | ||
| MCOs submit VBP QIP Governance Document for DOH review | October 7, 2016 | ✓ |
| DOH completes first round of review of MCO VBP QIP Governance Document and provides comments to the MCOs | October 21, 2016 | ✓ |
| MCOs submit a revised VBP QIP Governance Document to DOH for review | December 9, 2016 | ✓ |
| DOH reviews VBP QIP MCO Governance Document | February 24, 2017 | ✓ |
| MCOs submit a revised VBP QIP Governance Document to DOH for review (Group 2) | March 24, 2017 | |
| DOH reviews revised VBP QIP Governance Documents and sends updated scorecards to MCOs | March 31, 2017 | |
| Facility Plan | ||
| DOH to provide a Facility Plan outline to the MCOs for review | July 10, 2016 | ✓ |
| DOH to send Facility Plan template guidance with the MCOs, ensuring consistency with VBP Roadmap | July 10, 2016 | ✓ |
| MCOs develop and issue Facility Plan templates | September 9, 2016 | ✓ |
| MCOs to issue the Facility Plan template to the PPSs for comments | September 9, 2016 | ✓ |
| Facilities submit draft Facility Plan to PPS for initial review | October 14, 2016 | ✓ |
| PPSs review Facility Plan and return them to facilities for revision | October 28, 2016 | ✓ |
| Facilities complete Facility Plan and submit to PPS, MCO, and DOH for review | November 11, 2016 | ✓ |
| Facility Plans reviewed by MCO in collaboration with PPS (final copies should be sent to DOH) | December 9, 2016 | ✓ |
| DOH to distribute Facility Plan Guidance Packet to VBP QIP partners | January 27, 2017 | ✓ |
| DOH to release VBP QIP DY3 Guidance Document | March 17, 2017 | ✓ |
| Facilities to submit updated, MCO approved, final Facility Plan to DOH | March 31, 2017 | |
| Metrics / Benchmarks | ||
| Baseline metrics for future measurement are co–developed by facility, PPS, & MCO (submitted as part of the Facility Plan) | March 31, 2017 | |
| Benchmarks for reporting & performance set to be revisited quarterly | Ongoing: Quarterly Starting October 1, 2017 | |
| Reporting | ||
| MCO Quarterly Reporting to DOH (April 2016 – Ongoing) – MMCOR Submissions | Ongoing: 45 days after Quarter End 5 | |
Group 1 and Group 2: DY3 to DY5 Timeline
Beginning in DY3, both groups will have the same timeline. This section will be populated once milestones are established for DYs 3 to 5.
| Milestone | Due Date | Completed |
|---|---|---|
| Governance Document | ||
| MCOs to make updates to the Governance Plans as appropriate (copies must be sent to DOH) | Ongoing | |
| Facility Plan | ||
| MCOs to make updates to the Facility Plans as appropriate (copies must be sent to DOH) | Ongoing | |
| Pay for Reporting (P4R): VBP Contracting | ||
| Facilities must provide paired MCO and DOH with a Letter of Intent (LOI) for at least one VBP contract by July 1, 2017 (LOI may be substituted with a Contract Attestation if a VBP contract already exists by April 1, 2017) | April 1, 2017 | |
| Facilities must provide DOH (only) with the MCO Contract List of current Medicaid Managed Care Contracts including 2015 cost data for each Medicaid Managed Care contract the facility has and should also include projections for which VBP contracts will have a Total Care for General Population (TCGP) value–based arrangement by April 1, 2018 | April 1, 2017 | |
| Facilities must provide paired MCO and DOH with at least one Contract Attestation confirming parties intend to sign a VBP contract in accordance with the NYS Roadmap | July 1, 2017 | |
| Facilities must provide paired MCO and DOH with LOIs with the remaining Medicaid MCOs for VBP contracts by April 1, 2018 (LOI may be substituted with Contract Attestations if a VBP contract already exist by July 1, 2017) | July 1, 2017 | |
| Facilities must provide DOH (only) with the updated MCO Contract List of current Medicaid Managed Care Contracts including 2016 cost data for each Medicaid Managed Care contract the facility has and should also include projections for which VBP contracts will have a TCGP value–based arrangement by April 1, 2018 | July 1, 2017 | |
| Facilities must provide paired MCO and DOH with a signed Facility Attestation related to 2016 cost data reported in the Medicaid MCO list | July 1, 2017 | |
| Facilities continue to execute contracts to meet deadline by April 1, 2018 | July 1, 2017 to March 31, 2018 | |
| Facility must provide DOH and their VBP QIP paired MCO Contract Attestations confirming that the partners have indeed signed VBP contracts and that these contracts fulfill the requirements of the NYS VBP Roadmap. The VBP QIP paired MCO will check contract attestations against LOIs submitted in July 2017 Note: The VBP QIP facility must have Medicaid MCO contracts where at least 80% of total Medicaid MCO contracted payments (based on the 2016 data reported in the July 1, 2017 MCO Contract List) to the facility are tied to at least Level 1 value–based purchasing components | April 1, 2017 | |
| Pay for Performance (P4P): VBP QIP Quality Measurement | ||
| DOH to release the statewide mean for measures for DY4 for AIT measurement | June 2017 | |
| DOH to release the statewide mean for measures for DY5 for AIT measurement | June 2018 | |
| Facilities to submit P4P measures to their paired MCOs | Quarterly: Beginning DY3 Q3, no later than 120 days after close of Quarter | |
| MCOs to review and approve reports | Quarterly: Beginning DY3 Q3, no later than 45 days after initial submission | |
| MCOs to notify facilities of decision prepare monthly payments | Quarterly: Beginning DY3 Q3, no later than 180 days after close of Quarter | |
| Reporting | ||
| MCO Quarterly Reporting to DOH (April 2016 – Ongoing) – MMCOR Submissions | Ongoing: 45 days after Quarter End | |
| Facilities report on selected measures on quarterly basis | Ongoing: Quarterly | |
Group 1 and Group 2: Timeline Diagram
Group 2 will complete the first two years of VBP QIP deliverables within one year, using the templates, guidelines, and lessons learned from Group 1 to meet their accelerated milestones
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1. It is expected that the agreements will be put in place to extend through 2020, knowing that these agreements will be amended over time as the program matures. 1
2. MCO Governance Document refers to the documents submit by MCOs that establish governance for VBP QIP. 2
3. Facility Plans should reflect a distressed facility´s overall approach to improve quality and outcomes in a way that aligns with NYS´ Payment Reform as a means to achieve long–term sustainability. 3
4. Beginning in Q2 of SFY2016–17, monthly reporting should be submitted through the Medicaid Managed Care Operating Report (MMCOR). 4
5. Visit the DOH website to view DSRIP Timelines for reporting due dates. 5
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