Achievement Value Guide For Performing Provider Systems

  • Guide also available in Portable Document Format (PDF)

Publication date: March 9th, 2016
Version 2

Guidance

The purpose of this document is to provide additional information on the processes associated with earning Achievement Values (AV) and subsequent payments as part of the New York State Department of Health (NYS DOH) Delivery System Reform Incentive Payment (DSRIP) Program. This document covers the definition of what an AV is, how AVs relate to measures and DSRIP payments as well as how Performing Provider Systems (PPS) can earn AVs and the associated timelines.

Additional guidance is available through the following DSRIP Webinars and Presentations page.

Access to DSRIP information is available on the main DSRIP website (link).

Contents

Chapter 1: What are Achievement Values?

As part of the Delivery System Reform Incentive Payment (DSRIP) Program, Performing Providers Systems (PPS) have each selected between 8 and 11 projects from the DSRIP project list. Throughout the five Demonstration Years (DYs), PPS will report on progress on process milestones and be evaluated using specific measures associated with their projects. Each project is associated with a set of defined process or performance measures. DSRIP payments are all incentive–based and may be earned by PPS if they meet (either predefined or self–chosen) milestones and demonstrate sufficient progress towards relevant performance measures for their selected projects.

PPS progress on milestones and performance measures is tracked through a system of Achievement Values (AVs). AVs are points received by a PPS for reaching process milestones or a specified performance on measure targets during a specific reporting period.3 AVs are used to determine incentive payments based on process and performance on a project– by–project basis. Total PPS performance payments per project are scaled according to the number of AVs obtained in the relevant reporting periods for that project. AVs are typically scored as a zero (not meeting) or one (meeting) the process measure milestone(s) or performance measure targets per project.

All DSRIP measures are organized into 4 Domains:

  • Domain 1 – Overall Project
  • Progress Domain 2 – System Transformation
  • Domain 3 – Clinical Improvement
  • Domain 4 – Population–wide

Each Domain has specific type of measures as outlined in Table 1.

Table 1: Measure Types by Domain
Domain Types of Measures
Domain 1 Process Measures:

Requires PPS progress towards Organizational milestone(s) and Project Specific milestones by specified target dates.
Domain 2, 3 & 4 Performance Measures:

Pay for Reporting (P4R) Measures: PPS earn incentive payments for successfully and accurately reporting the measures to New York State Department of Health (NYS DOH) within the timeframes.

Pay for Performance (P4P) Measures: PPS earn incentive payments for results that meet or exceed the annual improvement target.

Publication date: January 29th, 2016. Version 1.

Additional information on process and performance measures can be found in the DSRIP Measure Specification and Reporting Manual.4

How AVs relate to PPS payments

Each AV that a PPS can obtain is linked either directly to a milestone, set of milestones, or to demonstrating progress on performance targets for specific metrics. Each DSRIP project is associated to a specific number of AVs per payment period. A PPS will be paid the relative share of the allocated project award (as determined at the onset of the DSRIP program as part of project valuation5) for a given payment period based on the share of potential AVs earned for that project. In each of the semi–annual payment periods, the total payment that a PPS can earn is the sum of the payments that it can potentially earn for its chosen projects.

Figure 1: How AVs translate into PPS Project Payments
PPS meets milestone(s)
or targets		 → PPS earns AV associated
to the milestone or target		 → PPS earns share of
project payments based
on relative share of AVs
obtained for project

Publication date: January 29th, 2016. Version 1.

Figure 1 illustrates how AVs translate into PPS project payments. The timing of payments is described in further detail in Chapter 3: Demonstration Years, Payments and Measurement Period Timelines. The exact calculation process for converting AV scores into payments is covered in Appendix A.

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Chapter 2: How to Earn Achievement Values

For each project, a Performing Provider System (PPS) is able to obtain both Domain 1 Achievement Values (AVs) and the AVs corresponding to the Domain from which the project was chosen (either Domain 2, 3 or 4). The total set of AVs that can be obtained for any given project is therefore the available Domain 1 AVs combined with the available Domain 2, 3 or 4 AVs.

Earning AVs in Domain 1

Domain 1 represents the set of process measures that include project management milestones and metrics that a PPS must meet to demonstrate credible progress towards DSRIP goals. Domain 1 process measures are divided into two Categories: (1) Organizational and (2) Project Specific Measures.

Each quarter, PPS are expected to submit a Quarterly Report to the Independent Assessor (IA) through the Medicaid Analytics and Performance Portal (MAPP) with status updates to organizational and project implementation activities. Progress towards Domain 1 process measure milestones is self–reported by the PPS and evaluated by the IA to determine if sufficient progress, that can be validated and warranted, has been met to earn the corresponding AVs. The IA determination on the PPS earning of AV is based on the PPS meeting the requirements and submitting the required documentation as defined the ´DSRIP Domain 1 Milestones – Minimum Standards for PPS Supporting Documentation and Independent Assessor Validation Process´ document1. PPS are expected to submit the minimum documentation as part of the quarterly report submissions for the purpose of IA validation.

Timing of Domain 1 AV awards

With the exception of the first Demonstration Year (DY1), payments for DSRIP occur twice a year. Yet PPS must submit reports on a quarterly basis. Each payment period, the evaluation of whether an AV is earned will be based on the two most recent Quarterly Reports. A full description of how payment periods align with quarterly reporting periods is given in Chapter 3: Demonstration Years, Payments and Measurement Period Timelines.

Organization Measures

There are four Organizational measures, each worth one AV:

  1. Governance
  2. Workforce
  3. Cultural Competency / Health Literacy
  4. Financial Sustainability

Criteria to earn Organizational Measure AVs6,7

  • Governance, Cultural Competency/ Health Literacy, Financial Sustainability:
    One AV for each measure will be awarded if the PPS demonstrates progress towards completion of milestones by target dates specified by New York State Department of Health (NYS DOH) or by the PPS itself. In order to earn any AV, the PPS must submit all Quarterly Reports in a timely manner. Failure to submit any Quarterly Report and all supporting documentation will result in failure to obtain these AVs.
  • Workforce:
    An AV will be awarded based on adherence to workforce spending commitments and sufficient explanation of any deviation from implementation plan projections. PPS must also indicate progress towards the completion of the Compensation and Benefit Survey to earn the AV for workforce.

Timing of Organizational Measure AVs
A PPS can earn AVs for Organizational Measures twice a year: after Quarter 2 (Q2) and Q4 for all DYs in the DSRIP program (See Table 2).

Organizational Measures apply across all of a PPS´ selected projects
Organizational measure AVs are not awarded for each project separately, but are carried through all projects. This means that once a PPS earns an AV for an Organizational measure, this AV is awarded for all projects in the PPS portfolio.

Project Specific Measures

There are three Project Specific measures, each worth one AV:

  1. Quarterly Progress Reports, Project Budget, Flow of Funds
  2. Patient Engagement Speed
  3. Project Implementation Speed

Project Specific Measures apply to each PPS selected project
Contrary to the Organizational measures, where an awarded AV applies to all of the PPS´ selected projects, AVs for Project Specific measures are evaluated and awarded for each project separately.

Criteria to earn Project Specific Measure AVs6,7

  • Quarterly Progress Reports, Project Budget, Flow of Funds:
    An AV is awarded based on timely and accurate Quarterly Report submissions. This includes reporting of budget, funds flow, and project implementation progress.
  • Patient Engagement Speed:
    An AV is awarded if the PPS meets 80% or higher of the committed patient engagement target for that project in a given quarter. The Patient Engagement AV does not apply to Project 2.a.i. and Domain 4 projects as no AV is available for these projects.8
  • Project Implementation Speed:
    An AV is awarded if the PPS completes all the project requirements on the dates that it committed to in their implementation plan for the corresponding reporting periods.

Timing of Project Specific Measure AVs
PPS can earn AVs for Quarterly Progress Reports, Project Budget, Flow of Funds and for Patient Engagement (for applicable projects) AVs twice a year: after Q2 and Q4 for all DYs in the DSRIP program (See Table 2).

For Project Implementation Speed this is different. A PPS can earn a maximum of 3 AVs for Project Implementation Speed over the duration of the DSRIP program. These AVs are awarded at the following moments:

  1. In the quarter in which a PPS has reached committed milestones related to Project Implementation Speed. DY4, Q4 is the last Quarter PPS were allowed to commit to milestones.
  2. In DY2, Q4
  3. In DY3, Q4

If the quarter in which a PPS has committed milestones related to Project Implementation Speed coincides (a above) with either DY2, Q4 or DY3, Q4 (b or c above) only one AV will be available for that quarter (instead of two) based on meeting the Project Implementation Speed commitment made by the PPS. In this situation, a PPS can earn a maximum of 2 AVs for Project Implementation Speed over the duration of the DSRIP program (see Table 2).

Table 2: Total Allowable AVs Awarded for Domain 1 for each DSRIP project

Reporting Period →
AV Category		 DY1* DY2 DY3 DY4 DY5
Q2 Q4 Q2 Q4 Q2 Q4 Q2 Q4 Q2 Q4
Organizational Governance 1 1 1 1 1 1 1 1 1 1
Workforce 1 1 1 1 1 1 1 1 1 1
Cultural Competency/ Health Literacy 1 1 1 1 1 1 1 1 1 1
Financial Sustainability 1 1 1 1 1 1 1 1 1 1
Project Specific Reporting Quarterly Progress, Project Budget and Flow of Funds reporting 1 1 1 1 1 1 1 1 1 1
Patient Engagement Speed** 1 1 1 1 1 1 1 1 1 1
Project Implementation Speed *** *** *** 1 *** 1 *** *** N/A N/A
Total possible AVs 6 + 6 + 6 + 7 6 + 7 6 + 6 + 6 6

Publication date: January 29th, 2016. Version 1.
* An overview of the dates associated to the DY1 – DY5 is provided in Chapter 3.
** Not applicable to Project 2.a.i and Domain 4 projects: no AVs for Patient Engagement Speed are available.
*** An AV is only allowable if a PPS committed to achieving milestones related to Project Implementation Speed in that Quarter, but the latest it can be earned is DY4, Q4.9
+ If a PPS commits to achieving milestones related to Project Implementation Speed in this Quarter, the total number of allowable AVs becomes 7 in that Quarter.

Earning AVs in Domain 2, 3 and 4

Each project from the selection of Domain 2, 3 and 4 projects is associated with a set number of performance measures. All performance measures start out as Pay for Reporting (P4R) in DY1. Some of the performance measures in Domains 2 and 3 may transition into Pay for Performance (P4P) in later DYs. The DSRIP Measure Specification and Reporting Manual4 contains the list of the performance measures and provides specifics as to whether a given measure is P4R or P4P and the timing of these transitions.

With a few exceptions for some component performance measures, each performance measure is worth one AV. The total number of AVs that a PPS can obtain per project per payment period is therefore (in most cases) the sum of the number of Domain 1 measures plus the Domain 2, 3 or 4 measures relevant to that project. Performance measures and associated AVs can be found in the DSRIP Measure Specification and Reporting Manual4.

Timing of Domain 2, 3 and 4 AV awards

Results for P4R and P4P measures in these Domains are calculated once a year. Therefore the IA will evaluate if PPS met their requirements to earn AVs only once a year. However project payments are done twice a year. This means that the AV awarded for meeting a P4R or P4P target is carried over to the following payment period. As such, the AV awarded to the second payment of a DY is carried over to the first payment of the following DY. This implies that the same AV for a P4R or P4P measure will drive two payments since it is not re–calculated halfway through the year. The payment periods and the associated measurement periods are described in Chapter 3: Demonstration Years, Payments and Measurement Period Timelines.

Criteria for earning Domain 2, 3 and 4 AVs

Criteria for earning P4R AVs
AVs for P4R measures are awarded based on the PPS successfully and accurately reporting the required measure information. Since many of the performance measures are claims–based and calculated by the NYS DOH, the PPS will automatically receive the AV for any claims–based P4R measure without reporting additional information. There are certain non–claims based measures, such as those based on medical records and survey information where the PPS is the key reporting agent. Successful reporting is defined as adherence to NYS DOH guidance and procedures as well as responding to information requests from the NYS DOH or the IA.

Criteria for earning P4P AVs
AVs for P4P measures are awarded based on the PPS´ ability to close the gap between their own performance and the statewide performance goal by at least 10% over the duration of the measurement year. If the PPS´ own performance score surpasses the statewide goal, the PPS will receive an AV in the following years if their score remains better than the statewide goal, regardless of whether there was improvement during the measurement period. However this does not apply to baseline results as explained in point 1 below.

No P4P AV will be awarded if:

  1. The baseline score (the initial measurement year results) for the PPS is at or better than the statewide performance goal. In this situation, no AVs can be earned for this P4P measure for the duration of the DSRIP program. The number of AVs that a PPS can obtain for that project is therefore reduced by one.
  2. Measures with less than 30 members or events in the denominator will not be eligible for AV calculation. The number of AVs that a PPS can obtain for that project is therefore reduced by one in this situation. Once this occurs, the measure must display a denominator greater than 30 for two consecutive measurement years to be included in the AV calculations again.
  3. The PPS does not close the gap between its own performance score and the statewide performance goal by at least 10% over the duration of the measurement period.

Exceptions to the Rule

  1. For Project 2.d.i, performance measures, there are no statewide performance targets therefore different criteria apply for earning AVs since they cannot be based on a 10% annual closure of gap to goal. Those criteria are specified in the DSRIP Measure Specification and Reporting Manual4.
  2. Due to insufficient data some measures do not have a statewide performance goal at this time. The statewide performance goals for these measures will be defined based on the results of the first measurement period. In the unlikely situation that there is no statewide performance goal available for a measure that becomes P4P, the measure will be converted into a P4R measure.
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Chapter 3: Demonstration Years, Payments and Measurement Period Timelines

The DSRIP Demonstration Years (DYs), payments and measurement periods align to the calendar year in different ways:

  • DSRIP DYs run from April 1st to March 31st of the following year.
    • Quarter 1 (Q1): April 1st to June 30th
    • Q2: July 1st to September 30th
    • Q3: October 1st to December 31st
    • Q4: January 1st to March 31st
  • Two payments are made per DY. The first payment is made in January (Q4) and the second payment is made six months later in July (Q2 of the following DY). DY1 has three payments, the first payment made in May to launch the PPS organizational activities, the second payment made in January and the third payment made in July.
  • Performing Provider Systems (PPS) submit Quarterly Reports four times in each DY. Quarterly Reports are due one month after closing of the Quarter (see Table 3 below for due dates).
  • Measurement periods for Domain 2, 3 and 4 measures are called measurement years (MY). MYs run from July 1st to June 30th of the following year.
  • Figure 2 and Table 3 show the relationship between the DYs, the payments, the quarterly reporting periods and the MYs.
Figure 2: Timelines: Relating Demonstration Years, Payments, Quarterly Reporting Periods and Measurement Years
Timelines: Relating Demonstration Years, Payments, Quarterly Reporting Periods and Measurement Years

Publication date: January 29th, 2016. Version 1.
* Quarterly reports are generally due on the last day of the month following the close of the quarter

Table 3: Timelines: Relating Demonstration Years, Payments, Quarterly Reporting Periods and Measurement Years
Demonstration Year (DY) Payments Quarterly Reports Due* Quarterly Reporting Period that drives Domain 1 payments Measurement Years (MY) that drives Domain 2, 3 and 4 payments
DY1:
4/1/2015 to 3/31/2016		 Payment 1: May 2015 N/A Implementation plan N/A
Payment 2: January 2016 8/7/15 & 10/31/15 Q1 & Q2: 4/1/2015 to 9/30/2015 N/A
Payment 3: July 2016 2/3/16 & 4/30/16 Q3 & Q4: 10/1/2015 to 3/31/2016 MY 1: 7/1/2014 to 6/30/2015
DY2:
4/1/2016 to 3/31/2017		 Payment 1: January 2017 7/31/16 & 10/31/16 Q1 & Q2: 4/1/2016 to 9/30/2016 MY 1: 7/1/2014 to 6/30/2015
Payment 2: July 2017 1/31/17 & 4/30/17 Q3 & Q4: 10/1/2016 to 3/31/2017 MY 2: 7/1/2015 to 6/30/2016
DY3:
4/1/2017 to 3/31/2018		 Payment 1: January 2018 7/31/17 & 10/31/17 Q1 & Q2: 4/1/2017 to 9/30/2017 MY 2: 7/1/2015 to 6/30/2016
Payment 2: July 2018 1/31/18 & 4/30/18 Q3 & Q4: 10/1/2017 to 3/31/2018 MY 3: 7/1/2016 to 6/30/2017
DY4:
4/1/2018 to 3/31/2019		 Payment 1: January 2019 7/31/18 & 10/31/18 Q1 & Q2: 4/1/2018 to 9/30/2018 MY 3: 7/1/2016 to 6/30/2017
Payment 2: July 2019 1/31/19 & 4/30/19 Q3 & Q4: 10/1/2018 to 3/31/2019 MY 4: 7/1/2017 to 6/30/2018
DY5:
4/1/2019 to 3/31/2020		 Payment 1: January 2020 7/31/19 & 10/31/19 Q1 & Q2: 4/1/2019 to 9/30/2019 MY 4: 7/1/2017 to 6/30/2018
Payment 2: July 2020 1/31/20 & 4/30/20 Q3 & Q4: 10/1/2019 to 3/31/2020 MY 5: 7/1/2018 to 6/30/2019

Publication date: January 29th, 2016. Version 1.
* Quarterly Report due dates starting in Demonstration Year 3 through Year 5 are approximate

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Appendix A: Calculation of Payment Amounts per Payment Period

The total amount of DSRIP payments due to a Performing Provider Systems (PPS) in a given payment period is the sum of payments earned through:

  1. Successfully meeting Domain 1 process measure milestones
  2. Completing requirements for Domain 2,3, and 4 measures (Pay for Reporting (P4R) and/or Pay for Performance (P4P))
  3. The High Performance Fund (HPF)

This section will focus on determining the non–HPF or ´regular´ performance payments. Additional information on the HPF is available in the DSRIP High Performance Fund Standard Operating Procedure10.

´Regular´ performance payments can be calculated using the process outlined below using Project 3.a.i for the fictional Forestland11 PPS for Demonstration Year 3 (DY3), Payment 1 as an example.

Step 1: Calculate Potential Dollar Amount for the Project

Calculation

Potential dollar amount for a project in a DY = project valuation × Special Terms and Conditions (STC)12 Percentage

In which:

  • Project valuation: Net project value as presented in award letter for a given project and PPS. This will vary by project and by PPS.
  • STC Percentage: STC percentage reflects the percentage of DSRIP funds allocated to each DY (See Table 4).
Table 4: STC Percentages by Demonstration Year
Demonstration Year (DY) STC Percentage (%) 12
DY1 15.84
DY2 16.88
DY3 27.29
DY4 24.16
DY5 15.84

Publication date: January 29th, 2016. Version 1.

Example Calculation for Step 1

For this example, Project 3.a.i was valued at $18,090,239 for the Forestland PPS for the 5–year duration of the DSRIP Program.

Potential Dollar Amount for Project 3.a.i in DY3 for Forestland = $18,090,239 × 27.29% = $4,936,720

Step 2: Calculate Potential Dollar Amount per Measure Type within the Project

Calculation

Potential dollar amount per measure type = potential dollar amount for project (Step 1) × Annual Funding Percentage

In which:

  • Potential dollar Amount for Project: calculated in step 1
  • Annual Funding Percentage: Percentage belonging to the measure type within a Domain and payment period (See Table 5).
Table 5: Annual Funding Percentages by Measure Type13
Demonstration Year (DY) Payments Measure Type
Domain 1 Domain 2 Domain 3 Domain 4
P4R P4P P4R P4P P4R
DY1 Payment 1: May 2015 60% 0% 0% 0% 0% 0%
Payment 2: January 2016 10% 10% 0% 10% 0% 10%
Payment 3: July 2016 10% 10% 0% 10% 0% 10%
DY2 Payment 1: January 2017 30% 20% 0% 8% 0% 20%
Payment 2: July 2017 30% 20% 0% 8% 24% 20%
DY3 Payment 1: January 2018 20% 6% 0% 5% 25% 30%
Payment 2: July 2018 20% 6% 48% 5% 25% 30%
DY4 Payment 1: January 2019 10% 5% 35% 5.5% 34.5% 40%
Payment 2: July 2019 10% 5% 35% 5.5% 34.5% 40%
DY5 Payment 1: January 2020 0% 4.5% 45.5% 6.25% 43.75% 50%
Payment 2: July 2020 0% 4.5% 45.5% 6.25% 43.75% 50%

Publication date: January 29th, 2016. Version 1.

Example Calculation for Step 2

Project 3.a.i has both Domain 1 (D1) process measures and Domain 3 (D3) P4R and P4P measures. The potential dollar amount for each measure type for 3.a.i in DY3, Payment 1 is calculated as follows:

Potential amount for D1 process measures = $4,936,720 (step 1) × 20% = $987,344
Potential amount for D3 P4R measures = $4,936,720 × 5% = $246,836
Potential amount for D3 P4P measures = $4,936,720 × 25% = $1,234,180

Note: The sum of the percentages relating to D1 and the D3 P4R and D3 P4P payments add up to 50% in DY3 Payment
1. This is due to the fact that there are two payment periods in DY3. Funding has been divided between Payment 1 and Payment 2 in every period for each Domain.

Step 3: Calculate the Actual Dollar Amount per Measure Type per Project based on the number of Achievement Values (AVs) earned

Calculation

Earned dollar amount for a measure type = potential dollar amount for a measure type (Step 2) × Percent Achievement Value14,15 (PAV) earned for each measure type in the project

In which:

total achieved AVs for measure type
PAV = _______________________________________________________
maximum possible AVs for measure type


Example Calculation for Step 3

In this example, Project 3.a.i has 6 D1 process measures, 2 D3 P4R measures and 8 D3 P4P measures tied to it for DY3. If Forestland meets the milestones for 5/6 D1 AVs, 1/2 of its requirements for D3 P4R AVs, and 6/8 requirements for D3 P4P AVs:

PAV (D1) = 5/6 or 83%
PAV (D3 P4R) = 1/2 or 50%
PAV (D3 P4P) = 6/8 or 75%

Earned dollar amount (for Project 3.a.i in DY3 from Step 2) =

D1 Earned dollars = $987,344 (step 2) × 83% = $819,496
D3 P4R Earned dollars = $246,836 (step 2) × 50% = $123,418
D3 P4P Earned dollars = $1,234,180 (step 2) × 75% = $925,635

Total dollars earned for 3.ai in DY3, Payment 1 is the sum of the dollars earned per measure type = $1,868,549

Step 4: Calculate Total for the PPS in the Specified DY and Payment Period by Summating the Actual Dollars Earned Over All the Projects

In order to calculate the total payment to Forestland for DY3, Payment 1, Steps 1 to 3 must be repeated for all the selected projects in the Forestland portfolio. The total payment in DY3, Payment 1 is calculated by simply summating the result across all projects.

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Appendix B: AV Scoring Rules Exceptions

Below is a listing of exceptions to the Achievement Value (AV) scoring rules and the resolution identified by the Independent Assessor (IA).

This list will be amended as Centers for Medicare & Medicaid Services (CMS) approved updates become available.

Exception 1

Situation:
No statewide goal exists for a Pay for Performing (P4P) measure, therefore performance cannot be measured against a baseline.

Resolution:
The Pay for Performance (P4P) measure will be converted into a Pay for Reporting (P4R) measure. The dollars allocated to P4P for the Domain specific to the measure via the Annual Funding Percentages based on the Demonstration Year (DY) in question will be paid based on successful reporting.

Exception 2

Situation:
A Domain 3 project has no P4R measures in Demonstration Year 4 (DY4) or DY5, however there are dollars allocated via the Annual Funding Percentages to P4R in those DYs.

Resolution:
For the project identified the P4R measures and associated AVs in DY3 will be utilized in DY4 and DY5. This means that in DY4 and DY5 AVs are awarded if a PPS successfully reports the P4R measures of DY3.

Exception 3

Projects 3.a.v, 3.d.i, 3.d.ii, and 3.d.iii have no P4R measures in DY2 and DY3, but there are P4R dollars allocated via the Annual Funding Percentages for P4R in those Demonstration Years.

Resolution:
The P4R measures and associated AVs in DY1 will be utilized as the P4R measures in DY2 and DY3. This means that in DY2 and DY3 AVs are awarded if a PPS successfully reports the P4R measures of DY1.

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Appendix C: Due Dates for Domain 1 Process Measure Milestones

Table 6 provides additional information on milestones and the due dates related to Domain 1 Organizational and Project Specific measures. In order for a Performing Provider Systems (PPS) to earn an Achievement Value, all of the milestones associated with the measure must be completed by the prescribed or self– committed due date in accordance with the ´DSRIP Domain 1 Milestones – Minimum Standards for PPS Supporting Documentation and Independent Assessor Validation Process´ document1. The due dates refer to the quarter in which the PPS has to complete the milestone. PPS are required to provide evidence of completing the milestone in the corresponding quarterly report (see Table 3).

Table 6: Due Dates for Domain 1 Process Measure Milestones
Due Dates for Domain 1 Process Measure Milestones

Publication date: March 9th, 2016. Version 2.
*Actuals need to be updated in Q2 and Q4 of each DY
**Subsequent compensation and benefits analysis reporting required
***If Project implementation speed commitment coincides with 2. Project system implementation Changes and/or 3. Project requirements, only one AV will be available for that quarter based on meeting Project Implementation Speed commitment.

________________________________________

1. The ´DSRIP Domain 1 Milestones – Minimum Standards for PPS Supporting Documentation and Independent Assessor Validation Process´ document was released to PPS on October 15, 2015. For additional questions please email dsrip@health.ny.gov.  1
2. This document will be revised to reflect the latest policy updates.  2
3. NYS DSRIP Glossary.  3
4. DSRIP Measure Specification and Reporting Manual: Measurement Year 1. February 25, 2016  4
5. Project Valuation as determined by NYS DOH. Additional guidance available in Attachment I – NY DSRIP Program Funding and Mechanics Protocol.  5
6. The Domain 1 process measure milestones and the associated due dates are described in Appendix C: Due Dates for Domain 1 Process Measure. PPS must complete milestones in accordance with the ´DSRIP Domain 1 Milestones – Minimum Standards for PPS Supporting Documentation and Independent Assessor Validation Process´ document1 and by the required completion dates as defined by the IA to avoid loss of AVs and payments for those milestones.  6
7. In the event that not all milestones or targets are met, the IA reserves the right to adjudicate an exception process. Additionally, the Centers for Medicare & Medicaid Services (CMS) and NYS DOH have the right to enforce a corrective action plan for any PPS that is deemed low–performing. If the PPS fails to complete a milestone within the timeframe selected by the PPS, there will be opportunity to edit timeframes as long as the PPS´ rationale to delay is approved.  7
8. DSRIP Webinar: Revised DSRIP Actively Engaged: Project Specific Definitions and Clarifying Information. October 28, 2015  8
9. In the webinar Delivery System Reform Incentive Program (DSRIP) Domain 1 Achievement Values (AVs) this table shows there is 1 allowable AV in DY4, Q4 to reflect the Quarter most PPS committed to. However not all PPS committed to this quarter. In Table 2 the AV tied to the PPS commitment is denoted by ´***´.  9
10. High Performance Fund Standard Operating Procedure. September 2015  10
11. Forestland 5–Year Valuation Example. Revised – February 8, 2016. This document will be revised to reflect the latest policy updates.  11
12. MRT Waiver Amendment/DSRIP Special Terms and Conditions (STC)  12
13. This table reflects policy updates as communicated by New York State Department of Health (NYS DOH) on October 26, 2015.  13
14. PAV is calculated for the measurement period belonging to the payment period as shown in Table 3.  14
15. If a P4P measure of Domain 2 or Domain 3 has denominator of less than 30, then the AVs associated with the measure are removed from the  15

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