DSRIP Weekly Update-July 28, 2015

Long-awaited information on PPS Networks, and movement on the Value Based Payment Roadmap are the big news in the DSRIP world this week. 

PPS Provider Network Lists Available

The Department of Health (DOH) has posted the Performing Provider Network Lists to the DSRIP website, here. The lists show a combination of the providers and entities that are partnering with each of the State’s 25 Performing Provider Systems (PPSs), for both valuation and/or performance.  

It is important to note that  Each PPS has two network lists:

1. Network for Valuation (N4V): original network list used to attribute members to a PPS for the purposes of calculating PPS valuation; and,
2. Network for Performance (N4P): network list utilized to set performance baselines and to evaluate metric achievements going forward. N4Ps were developed after, and built-off of PPS.

Below are some items of note, according to the DOH website. Note we have bolded points that are key to LeadingAge NY members:

• Network lists were created using PPS Networks for Performance (N4P) in the Medicaid Analytics Performance Portal (MAPP).
• Performance networks (N4P) may include additional providers that were not used in calculating a PPS´s initial valuation. N4V was used for calculating a PPS initial valuation.
• Providers and entities are allowed to be partners in multiple PPS networks.
• DOH has worked to scrub the lists where possible. DOH has only removed multiple listings of the same provider but has not removed any individual provider.
• During timeframes specified by DOH, PPS will be allowed to add new providers to their N4P. Notices will be sent out to the MRT Listserv when network lists can and are updated.
• Each PPS Network for Performance (N4P) list has the date of creation delineated, so that the viewer can identify the most recent list. The most current N4P lists were created on July 15, 2015.
• Any modification to an existing PPS network (N4P), including the potential removal of a PPS provider or partner, must follow the guidelines in the DSRIP STCs (specifically: Section X of Attachment I).

Value Based Payment Roadmap Approved

The Centers for Medicare and Medicaid Services (CMS) approved the State’s  Value Based Payment Roadmap.  The final Roadmap along with CMS’s approval letter is now available on the DSRIP VBP Webpage, and be viewed here.  LeadingAge NY was a part of this workgroup and contributed a great deal of input and feedback. Details of the plan will be further developed in sub-workgroups, which LeadingAge will also participate in to ensure our member’s needs and concerns are addressed.

KPMG DSRIP Webcast Postponed

KPMG’s webscast entitled Getting DSRIP Done for Your PPS scheduled for July 30, 2015 is being postponed. As we reported last week, the webcast was designed to address how you and your PPS can organize your teams to be successful at implementing your DSRIP program, while achieving your organization's broader strategic objectives. We will let members know when it is rescheduled.

Contact: Diane Darbyshire, ddarbyshire@leadingageny.org, 518-867-8828