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Tools and Guidelines for Regional Healthcare Partnership Participants

Change Requests (Plan Modification and Technical Change Requests)

Please find links to Change Request (Plan Modification and Technical Change Request) instructions and documents below.

If you have difficulty downloading these files, particularly those in newer versions of Excel (such as those labeled XLSM), please try using a browser other than Internet Explorer.

Updated DSRIP Protocols

The document below contains the following updated items approved by CMS: 1115 Waiver Standard Terms & Conditions, Program Funding and Mechanics Protocol, RHP Planning Protocol and Anchor Administrative Claiming Protocol.

1115 Waiver STCs, PFM, RHP Planning Protocol, Anchor Admin Claiming

April DY3 Reporting

Please find links below to April DY3 reporting templates and instructions.

Category 3

The documents below relate to Category 3 and will enable providers to complete the Category 3 Selection Template.  Please note that the previously-posted "Texas Category 3" Excel file has been removed along with the Emergency Department Measures Specifications; all of the necessary Cat 3 information can be found in the Compendium of Category 3 Measures.

New 3-Year DSRIP Projects

Please find links below to the template and guidance for new 3-year DSRIP Projects. Links are included to the revised Category 1 and Category 2 sections of the RHP Planning Protocol to be used for 3-year projects.  HHSC has removed project areas 2.4, 2.5, and 2.8, and project area 1.10 is limited to learning collaborative projects for the 3-year projects.  The revised menu also clarifies and cleans up project metrics and designates the Quantifiable Patient Impact (QPI) metric(s) to be used for each project area.  Category 3 will be revised at a later date and DSRIP providers should continue to follow the original RHP Planning Protocol for 4-year projects.

Phase 4 Regional Folders and Documents:

Please find links below to Phase 4 documents and instructions for review by Regional Healthcare Partnership (RHP) participants.

Immediate Guidance to Regional Healthcare Partnerships (RHPs):

  • RHP Annual Report Template (DOCX) (posted 11/20/13).  The Program Funding and Mechanics Protocol requires each Anchor to submit an RHP annual report by December 15, 2013.
  • Draft Revised Category 3 Quality Improvements: (updated 9/11/13): HHSC has received feedback from CMS that, of the measures proposed, CMS did not have comments or questions on 75% of the measures, which means that these look approvable to add to the menu. The measures are listed in this spreadsheet (XLSX) that includes both existing and new measures proposed. For measures about which CMS had questions, there are columns included that list "CMS Flag," "CMS Question" and "HHSC Response."

    HHSC has also submitted additional information to CMS on assessment tools (PDF) that have been proposed by providers. Most assessment tools that were proposed by providers are included. The following assessment tools have not been submitted at this time due to lack of information on either validity or reliability: Health Center Patient Satisfaction Survey; EORTC Quality of Life Questionnaire (QLQ); Barthel Index of Activities of Daily Living (ADL); Client Oriented Scale of Improvement (COSI); Traumatic Events Screening Inventory (TESI); Brief Negative Symptom Assessment (BNSA); and Addiction Severity Index (ASI).HHSC is sharing the draft revised Category 3 Menu (PDF) submitted to CMS for approval, and a summary document (PDF) that gives an overview of the proposed revisions to Category 3. This submission by HHSC to CMS is under review at this time; NO action is required by providers.
  • Draft Process for Adding Additional 3-year DSRIP Projects: HHSC is sharing a draft process (PDF)for RHPs to add DSRIP projects in Demonstration Year 3 of the Transformation Waiver.
  • Phase II - FAQs for Completing the Quantifiable Patient Impact Spreadsheets: These QPI FAQs (PDF) (posted 7/15/13) should help answer frequently asked questions about filling out the QPI spreadsheets. Please also remember to read the instructions included in the QPI workbook carefully.
  • Phase II – List of Recommended QPI Metrics by Project Option: HHSC is providing a list of recommended Quantifiable Patient Impact (QPI) metrics (PDF) (posted 7/8/2013) to help guide completion of the QPI spreadsheet in Phase II and future RHP Plan submissions.
  • Summary data for CMS Initial Review Findings: HHSC is providing a list of the initial CMS review (PDF) findings(updated 6/14/2013) for all projects. This document is subject to change as performing providers respond to review guidance.
  • Phase 3 Overview and Guidance Document: HHSC is providing an overview of Phase 3 (PDF) (updated 6/10/2013) to help providers understand the process and timeline for revising DY2 milestones and metrics for August DSRIP reporting.  
  • Companion Document: HHSC has revised the DRAFT version of a companion document (PDF) that can be used to help providers understand the next steps they should take to revise projects in response to CMS Initial Review Findings about RHP Plans (updated 5/17/13). This document will be finalized after receiving CMS and stakeholder input
  • Collaboration: On January 18, a notice was sent to all stakeholders of the Texas 1115 Transformation Waiver providing Centers for Medicare and Medicaid Services (CMS) guidance regarding Delivery System Reform Incentive Payment (DSRIP) projects that were proposed under the collaboration option (PDF) (posted 1/22/2013) in the Program Funding and Mechanics (PFM) Protocol.
  • Project Valuation: Formal feedback on each Regional Healthcare Partnership (RHP) plan will include review of project valuation. This feedback is intended to help providers improve projects to justify the proposed project values based on variables the Centers for Medicare and Medicaid Services (CMS) has indicated are priorities. This guidance on project valuation (PDF) (posted 1/18/2013) was provided on January 16, 2013.
  • Next Steps, Common Issues, & Summary Information: HHSC is providing Immediate Guidance (PDF) (posted 12/6/2012) to RHPs about the next steps in the plan review process, common issues identified through a high-level review of Pass 1 projects, and  summary information that HHSC is requesting that providers add to the beginning of each project. HHSC requests that for the full RHP plan submission, each project (including Pass 1 projects) include key project information at the beginning of the Section V Project Description. The specific requested information is contained in the Immediate Guidance (PDF) (posted 12/6/2012).


Regional Healthcare Partnership (RHP) Planning Protocol

CMS has granted final approval (PDF) of this Regional Healthcare Partnership (RHP) Planning Protocol document (PDF). This document was updated Oct. 1, 2012, to include minor technical corrections (PDF). The protocol provides the menu of project options approved by HHSC and the Centers for Medicare & Medicaid Services (CMS) that contribute to delivery transformation and quality improvement. The only projects eligible for payments from the DSRIP pool are those contained in this menu that are implemented as outlined in an RHP Plan approved by HHSC and CMS, with corresponding measures, milestones and performance improvement targets. The links below open individual sections of the approved protocol and include the Oct. 1, 2012 technical corrections.

CMS has provided a list of Category 3 Outcomes that will be acceptable for Workforce Projects (posted 11/2/2012).

Category 4 Guidance (posted 11/12/2012)

DSRIP Allocation:

Quality Tools:

The Agency for Healthcare Research and Quality (AHRQ) provides the following information that may be useful to Performing Providers when selecting measures for waiver projects:

  • Tutorial on Quality Measures details the attributes of desirable quality measures, discusses validity of measures, and provides guidance on selecting, applying and interpreting quality measures.

  • Quality and Patient Safety provides links to a variety of tools and toolkits.

National Quality Measures Clearinghouse (NQMC) includes links to the HHS Measures Inventory (a repository of measures currently being used by the U.S. Department of Health and Human Services) and a database of National Quality Forum (NQF) Endorsed Measures.

Regional Healthcare Partnership (RHP) Plan Template:

Program Funding and Mechanics Protocol:

A change to the Program Funding and Mechanics Protocol is effective September 6, 2013 to allow HHSC to require that DSRIP intergovernmental transfer (IGT) entities transfer additional funds to fund the non-federal share of waiver monitoring costs.  This change is reflected in the Program Funding and Mechanics Protocol (PDF) (see attachment J), paragraphs 42 and 49(e) (posted 9/11/13).

A summary of the DSRIP Project Requirements (PDF) (posted 8/31/2012) also is available.

Uncompensated Care Tool:

Please visit the Rate Analysis for Hospital Services website for information regarding the Uncompensated Care Reporting Tools and Transition Payments.

Regional Healthcare Partnership Information:

Other Planning Tools:

Each regional healthcare partnership must submit a plan to HHSC. The following documents are intended to help with the planning process.

Other HHSC Guidelines: