REGIONAL HEALTHCARE PARTNERSHIP 20
1115 WAIVER – TEXAS TRANSFORMATION AND QUALITY IMPROVEMENT PROGRAM
Waiver Renewal (Demonstration Years 9-10)
In January 2018, the U.S. Centers for Medicare and Medicaid Services (CMS) approved renewal of the Texas Healthcare Transformation and Quality Improvement Program, commonly referred to as the 1115 Medicaid Waiver. As part of the renewal, the Delivery Reform Incentive Payment Program (DSRIP) has transitioned from a program focused on project-level reporting and outcomes to a program that is now focused on activities at the provider-system level with more emphasis placed on improvement of system and regional level health outcomes to address community needs. As a result of this DSRIP transition, new rules and protocols have been developed for demonstration years 7-10 (DY7-10), and all regional healthcare partnerships are required to submit regional plans covering DY9-10 to the Texas Health and Human Services Commission and CMS.
The plan update process included every DSRIP provider completing a provider plan template. Every Anchor Team has also completed a template that documents participation by those providers only receiving uncompensated care funds in the region, as well as outlines the process for updating community needs, updating learning collaborative plans and engaging stakeholders.
The following are the Plan Updates submitted by each performing provider in Region 20:
• Border Region Behavioral Health
• City of Laredo Health Department
• Doctors Hospital of Laredo
• Laredo Medical Center
The
RHP20 Plan Update for DY9-DY10 was submitted to HHSC on November 26, 2019 with HHSC setting a tentative date of January 15, 2020 to complete their initial review of all twenty (20) RHP plans submitted. Providers and anchors will have until January 31, 2020 to respond to HHSC’s requests for additional information. HHSC anticipates final approval or disapproval of RHP Plan Updates for DY9-DY10 by February 28, 2020.
Waiver Extension (Demonstration Years 7-8)
In January 2018, the U.S. Centers for Medicare and Medicaid Services (CMS) approved the renewal of the Texas Healthcare Transformation and Quality Improvement Program, commonly referred to as the 1115 Medicaid Waiver. As part of the renewal, the Delivery Reform Incentive Payment Program (DSRIP) has transitioned from a program focused on project-level reporting and outcomes to a program that is now focused on activities at the provider-system level with more emphasis placed on improvement of system and regional level health outcomes to address community needs. As a result of this DSRIP transition, new rules and protocols have been developed for demonstration years 7 and 8 (DY7-8), and all regional healthcare partnerships were required to submit updated regional plans to the Texas Health and Human Services Commission and CMS.
The RHP20 Plan Update was submitted to HHSC on April 30, 2018 and received final plan approval on June 29, 2018. The plan update process included having every DSRIP provider complete a provider plan template update. Webb County, as anchor, completed the anchor entity template that documents participation by those providers only receiving uncompensated care funds in the region, as well as outlined the process for updating community needs, updating learning collaborative plans and engaging stakeholders.
April 30, 2018 - Plan Update Submission
June 15, 2018 - Provider response to HHSC feedback
June 29, 2018 – RHP20 Final Plan Update
RHP Plan (Demonstration Years 1-6)
In December 2011, Texas received approval from the Centers for Medicare and Medicaid Services (CMS) for a waiver to upcoming changes in federal support for state Medicaid programs. Texas Health and Human Services Commission (HHSC) applied for the waiver, at the direction of the Texas Legislature, to identify innovative, state-based solutions to Texas’ health care needs.
Under the Texas Transformation and Quality Improvement Program 1115 Waiver, communities and hospitals will form regional healthcare partnerships that support more localized health care solutions. The partnerships will identify ways to improve health services that address the specific needs of their region in order to qualify for incentive payments.
March 8, 2013 – Final Plan Submission
October 15, 2013 – Proposed 3-year DSRIP projects
December 20, 2013 – Plan Modification Request – 3-year DSRIP Projects