DSRIP Weekly Update-July 14, 2015
PPS Operating Agreement, Reporting and Responsibilities
PPS partners are in the process of implementing provider partner operating agreements. The timing of the implementation of these agreements will vary by PPS, however, many PPS leads have provided those proposed agreements. Members should review these agreements closely, as these agreements are a contract between the PPS Lead and the participant regarding payment.
The PPS Operating Agreement should clearly define the Provider responsibilities with respect to:
- Project implementation and performance;
- Timely and accurate reporting including financial sustainability assessment and project reporting across all Domains where data is required from the PPS;
- Funds Flow Plan Term Sheet used to define Provider Responsibilities and specific performance requirements.
According to the Funds Flow presentation DOH posted a few weeks ago, the PPS should develop a PPS Level Funding Requirements Matrix, which would become the basis for the Provider Level Term Sheet –with items specified and defined as applicable. The matrix would address:
- What is required to receive the full payment for each Domain level for reporting and performance of the PPS selected projects?
- What data and results must be reported by the PPS vs. data provided or accessed by DOH.
The presentation also references a Project Responsibilities Chart (PPS Level) and a Provider Responsibilities Chart. The chart(s) will define the specific roles and responsibilities of the PPS and the Provider related to each project, and will provide the basis for the provider to qualify for Incentive and/or Bonus payments.
It may be instructive to reference the materials from the PPS meeting in February, which provide an overview of the finance function and flow of funds.
DOH Wants to Hear Your Ideas on PPS Disbursement of Initial DSRIP Funds
It should also be noted that DOH has posted another challenge on the MRT Innovation Exchange, known as the “MIX”. Challenge 9 asks, “How might a PPS disburse initial DSRIP funds prior to the availability of performance data?”
According to the DOH message, “This challenge explores options and ideas for how a PPS might disburse their first DSRIP payment to downstream providers. Beginning in May 2015, PPS across the state received their first DSRIP Year 1 payment. Now PPS are confronted with complexities associated with developing funds flow mechanisms that adhere to the requirements of the Special Terms and Conditions with the federal government and distributing funds prior to the availability of performance data. We encourage you to join the conversation today.”
For more information on the MIX, including the ability to respond to the Challenge, click here.
Medicaid Analyst Performance Portal
DOH has posted a webinar related to the Medicaid Analytics Performance Portal (MAPP). Click here for the webinar and here for the slides.The MAPP is a statewide system to support both Health Homes and DSRIP technology needs, providing data in a user-friendly format. Among the tools available on the MAPP are the DSRIP Performance Dashboard, which will host all of the PPS performance measures, This dashboard should help the PPS identify what is driving results, along with the ability to manipulate variables to make decisions about future action items. The calculations are automated and will be updated monthly. PPSs will also be able to access information regarding their attributed members, including demographic information, managed care information, and claims information. DOH will be providing further webinars in the future on how to use the MAPP.
Members are encouraged to let us know if you have any questions or needs regarding the above information and your participation in a DSRIP PPS.
Contact: Diane Darbyshire, ddarbyshire@leadingageny.org, 518-867-8828