DSRIP Weekly Update-Nov. 10, 2014
The Department of Health (DOH) issued new information about attribution, which should highlight what work is left to do in PPSs, as announcements came out last week of further Performing Provider System (PPS) consolidation in Central New York, the Hudson Valley and Long Island. As we get closer to the application deadline for Delivery System Reform Incentive Payment (DSRIP) program projects, members are urged to solidify their place as partners in PPS.
Attribution Results
DOH shared the results of the second run of DSRIP Initial Attribution. Attribution is the process connecting Medicaid beneficiaries to providers that are partners in PPS networks. The member attribution results were calculated based on the logic described in Attachment I of the DSRIP STCs and as elaborated in the DSRIP Attribution and Valuation Webinar. To view the 2nd Round Attribution Results Summary as of Oct. 27, 2014, please click 2nd Round Attribution Results. Note that the report excludes non and low utilizing members; these members will be attributed during final attribution. DOH developed a webinar reviewing the summary, which can be accessed by clicking Webinar and Slides.
Individual PPSs have received their specific attribution results, which do not contain any personal health identifying data. The State will be running a 3rd round of initial attribution on Tues., Nov. 11, and PPSs are expected to have their updated partner lists in the Network Tool by 4 p.m. on Tues., Nov. 11. Given these timeframes, we urge members not yet affiliated with a PPS to reach out to PPS leads to ensure that they are named as a partner in that PPS.
LeadingAge NY Audio Programs for Members
A recording of Dialogue on DSRIP: A LeadingAge NY Discussion for Members, is available here. A recording of the Nov. 10 program, DSRIP: An Overview and Legal Implications for Non-Lead Providers, will be available soon. Both programs will help members consider what they should be doing now to be a successful participant in a DSRIP PPS.
Chartbook Resources
The United Hospital Fund has developed useful regional chartbooks that provide a high-level overview of service utilization for Medicaid beneficiaries. The chartbooks will be useful for stakeholders involved in DSRIP PPS; however the resources are publicly available. The data includes information on enrollment, basic enrollee demographics, total claims, top inpatient providers, visit rates, potentially preventable emergency room visits and most common diagnostic categories for inpatient admissions across all payers. Click here to view these resources.
MRT Innovation eXchange
DOH announced the MRT Innovation eXchange, also known as the MIX. According to the announcement, “the MIX is a forum for building solutions to the complex challenges we face in our health delivery system surrounding New York’s Medicaid Program. The MIX is an idea bank, which allows users to post new ideas as well as build on the ideas of others. This crowdsourcing of ideas will benefit users in different ways: some may use it as an inspiration bank, while others may apply what is posted to reframe and reposition their approach to transformational challenges.”
The MIX is intended for anyone currently involved with or interested in Medicaid Redesign; including care providers, stakeholders, policy makers and members of the public, including care recipients. To use MIX, you must go to www.NY-MIX.org and set up a profile. Two “challenges” have already been set up, asking for input regarding aspects of DSRIP. Questions regarding the MIX should be directed to info@ny-mix.org.
Financial Stability Test
PPS leads must submit the completed Financial Stability test application documents to DOH by Nov. 10, 2014. Only organizations that pass the stability test will be able to serve as PPS leads.
HCBS Provider Application for HARP services in NYC
The New York State Office of Mental Health (OMH) and Office for Alcoholism and Substance Abuse Services (OASAS) have released the Home and Community Based Services (HCBS) provider application for NYC behavioral health providers. This application allows behavioral health providers to attest to provide new behavioral health HCBS services, which will be available for eligible individuals in Health and Recovery Plans (HARPs) in NYC beginning in April 2015. These services are recovery oriented and designed to assist individuals with significant behavioral health needs living in the community. This application and subsequent designation does not mandate providers to offer these services. The deadline for submitting the application form to the State is Dec. 5, 2014. For more information and to access instructions on the application, the HCBS provider manual with service definitions and the application form, click here. Questions regarding this opportunity can be directed to OMH at: BHO@omh.ny.gov.
As always, please let us know how we can be of help to you in your work with your DSRIP partners.
Contact: Diane Darbyshire, ddarbyshire@leadingageny.org, 518-867-8828