Mid-Point Assessment Action Plan Final Summary
Mid–Point Assessment Action Plan Final Update
- Update is also available in Portable Document Format (PDF)
March 2018
In February 2017, the Independent Assessor (IA) presented its Mid–Point Assessment recommendations to the Project Approval and Oversight Panel (PAOP). Following PAOP´s review, the IA released the final Mid–Point Assessment recommendations to the PPS who were required to develop Mid–Point Assessment Action Plans to address the items identified in the recommendations. The PPS were required to submit the Action Plans for IA review and approval with updates on the PPS progress towards completing the Action Plans as part of the DY3, Q1 and DY3, Q2 PPS Quarterly Reports. Through the Action Plans, the PPS were asked to demonstrate a plan for addressing the recommendations, the process the PPS would implement to correct the area of concern, and the timeline for completion of all tasks. All Action Plan activities were required to be completed by no later than the end of DY3, Q2 (September 30, 2017).
The following is a summary of the results of PPS efforts on the Mid–Point Assessment Action Plans following the close of DY3, Q2.
Funds Flow and Partner Engagement
The most common recommendation made during the Mid–Point Assessment was for PPS to address concerns related to their Funds Flow and Partner Engagement activities, with 14 of the 25 PPS receiving the PAOP Standard Modification. The PAOP Standard Modification called for PPS to,
- develop a detailed plan for engaging partners across all projects with specific focus on Primary Care, Mental Health, Substance Used Disorder providers as well as Community Based Organizations (CBOs). The Plan must outline a detailed timeline for meaningful engagement.
- describe how the PPS will flow funds to partners so as to ensure success in DSRIP.
As Table 1 below illustrates, $414M in funds had been distributed at the time the Mid–Point Assessment was conducted (DY2, Q2). In the four quarters following the completion of the Mid–Point Assessment, PPS increased their distributions to partners by over $685M to a total of $1.1B in funds distributed to PPS partners, an increase of over 165%. Further, the PPS responded to the specific feedback related to distributing more funds outside of the hospital and PPS PMO categories and increased distributions to partners outside of the hospital and PMO by $231M or 204% over this same period.
Table 1: PPS Funds Flow Distributions as of DY2, Q2 and DY3, Q2
| As of MPA (DY2, Q2) | As of DY3, Q2 | Change since MPA | ||||
|---|---|---|---|---|---|---|
| Partner Category | Funds Distributed | % of Funds Distributed | Funds Distributed | % of Funds Distributed | Additional Funds Distributed | Increase in Funds Distributed |
| Practitioner – Primary Care Provider (PCP) | $ 14,659,935 | 3.54% | $ 63,754,315 | 5.80% | $ 49,094,381 | 334.89% |
| Practitioner – Non–Primary Care Provider (PCP) | $ 2,654,701 | 0.64% | $ 6,223,342 | 0.57% | $ 3,568,641 | 134.43% |
| Hospital | $ 121,775,967 | 29.40% | $ 182,521,398 | 16.59% | $ 60,745,431 | 49.88% |
| Hospital – IP/ED | $ – | 0.00% | $ 147,358,192 | 13.40% | $ 147,358,192 | 100.00% |
| Hospital – Ambulatory | $ – | 0.00% | $ 29,612,421 | 2.69% | $ 29,612,421 | 100.00% |
| Clinic | $ 29,687,182 | 7.17% | $ 87,904,817 | 7.99% | $ 58,217,635 | 196.10% |
| Case Management / Health Home | $ 5,973,274 | 1.44% | $ 17,408,904 | 1.58% | $ 11,435,631 | 191.45% |
| Case Management | $ – | 0.00% | $ 4,670,951 | 0.42% | $ 4,670,951 | 100.00% |
| Health Home | $ – | 0.00% | $ 3,255,815 | 0.30% | $ 3,255,815 | 100.00% |
| Mental Health | $ 9,741,485 | 2.35% | $ 35,291,921 | 3.21% | $ 25,550,436 | 262.28% |
| Substance Abuse | $ 4,319,963 | 1.04% | $ 12,780,469 | 1.16% | $ 8,460,506 | 195.85% |
| Nursing Home | $ 5,476,856 | 1.32% | $ 18,177,581 | 1.65% | $ 12,700,725 | 231.90% |
| Pharmacy | $ 305,708 | 0.07% | $ 1,461,616 | 0.13% | $ 1,155,908 | 378.11% |
| Hospice | $ 739,659 | 0.18% | $ 3,279,031 | 0.30% | $ 2,539,372 | 343.32% |
| Community Based Organizations | $ 11,993,454 | 2.90% | $ 33,990,664 | 3.09% | $ 21,997,210 | 183.41% |
| All Other | $ 23,297,909 | 5.62% | $ 39,802,885 | 3.62% | $ 16,504,976 | 70.84% |
| Uncategorized | $ 2,356,252 | 0.57% | $ 7,566,139 | 0.69% | $ 5,209,887 | 221.11% |
| Non–PPS Network | $ 2,201,865 | 0.53% | $ 5,520,555 | 0.50% | $ 3,318,691 | 150.72% |
| PPS PMO | $ 179,083,029 | 43.23% | $ 395,752,021 | 35.98% | $ 216,668,992 | 120.99% |
| Home Care | $ – | 0.00% | $ 2,503,255 | 0.23% | $ 2,503,255 | 100.00% |
| County Agency | $ – | 0.00% | $ 116,200 | 0.01% | $ 116,200 | 100.00% |
| CBO Tier 3 | $ – | 0.00% | $ 92,696 | 0.01% | $ 92,696 | 100.00% |
| Other | $ – | 0.00% | $ 1,002,427 | 0.09% | $ 1,002,427 | 100.00% |
| Total Non–Hospital and Non–PMO Distributions | $ 113,408,240 | 27.38% | $ 344,803,581 | 31.34% | $ 231,395,341 | 204.04% |
| Total Funds Distributed – All Partners | $ 414,267,236 | $ 1,100,047,613 | $ 685,780,376 | 165.54% | ||
For the 14 PPS that received the PAOP Standard Modification, Table 2 illustrates similar trends in the distribution of funds to PPS partners. At the time of the Mid–Point Assessment, PPS had distributed $264M to PPS partners. At the end of DY3, Q2, that figure increased to $699M, an increase of over $434M or 164%. PPS distributions to non–hospital and non–PPS PMO partners also saw a significant increase from $71M at the time of the Mid–Point Assessment to $210M at the end of DY3, Q2.
Table 2: PPS Funds Flow Distributions as of DY2, Q2 and DY3, Q2 (PAOP Standard Modification Only)
| As of MPA (DY2, Q2) | As of DY3, Q2 | Change since MPA | ||||
|---|---|---|---|---|---|---|
| Partner Category | Funds Distributed | % of Funds Distributed | Funds Distributed | % of Funds Distributed | Additional Funds Distributed | Increase in Funds Distributed |
| Practitioner – Primary Care Provider (PCP) | $ 11,703,793 | 4.42% | $ 51,322,092 | 7.34% | $ 39,618,299 | 338.51% |
| Practitioner – Non–Primary Care Provider (PCP) | $ 2,136,190 | 0.81% | $ 5,576,547 | 0.80% | $ 3,440,357 | 161.05% |
| Hospital | $ 72,126,205 | 27.24% | $ 100,475,721 | 14.36% | $ 28,349,516 | 39.31% |
| Hospital – IP/ED | $ – | 0.00% | $ 117,828,496 | 16.84% | $ 117,828,496 | 100.00% |
| Hospital – Ambulatory | $ – | 0.00% | $ 15,982,839 | 2.28% | $ 15,982,839 | 100.00% |
| Clinic | $ 17,886,239 | 6.76% | $ 49,520,263 | 7.08% | $ 31,634,025 | 176.86% |
| Case Management / Health Home | $ 3,462,626 | 1.31% | $ 7,214,609 | 1.03% | $ 3,751,982 | 108.36% |
| Case Management | $ – | 0.00% | $ 1,966,990 | 0.28% | $ 1,966,990 | 100.00% |
| Health Home | $ – | 0.00% | $ 1,145,040 | 0.16% | $ 1,145,040 | 100.00% |
| Mental Health | $ 6,735,971 | 2.54% | $ 25,234,622 | 3.61% | $ 18,498,651 | 274.62% |
| Substance Abuse | $ 2,669,425 | 1.01% | $ 8,255,026 | 1.18% | $ 5,585,601 | 209.24% |
| Nursing Home | $ 1,233,657 | 0.47% | $ 6,340,459 | 0.91% | $ 5,106,802 | 413.96% |
| Pharmacy | $ 277,797 | 0.10% | $ 1,214,378 | 0.17% | $ 936,581 | 337.15% |
| Hospice | $ 563,842 | 0.21% | $ 1,395,542 | 0.20% | $ 831,700 | 147.51% |
| Community Based Organizations | $ 4,283,943 | 1.62% | $ 13,638,510 | 1.95% | $ 9,354,567 | 218.36% |
| All Other | $ 18,748,126 | 7.08% | $ 28,934,675 | 4.14% | $ 10,186,548 | 54.33% |
| Uncategorized | $ 1,259,757 | 0.48% | $ 4,054,421 | 0.58% | $ 2,794,664 | 221.84% |
| Non–PPS Network | $ 598,467 | 0.23% | $ 2,468,289 | 0.35% | $ 1,869,822 | 312.44% |
| PPS PMO | $ 121,068,638 | 45.73% | $ 254,734,060 | 36.41% | $ 133,665,422 | 110.40% |
| Home Care | $ – | 0.00% | $ 1,311,535 | 0.19% | $ 1,311,535 | 100.00% |
| County Agency | $ – | 0.00% | $ 37,410 | 0.01% | $ 37,410 | 100.00% |
| Other | $ – | 0.00% | $ 952,966 | 0.14% | $ 952,966 | 100.00% |
| Total Non–Hospital and Non–PMO Distributions | $ 71,559,831 | 27.03% | $ 210,583,372 | 30.10% | $ 139,023,541 | 194.28% |
| Total Funds Distributed – All Partners | $ 264,754,674 | $ 699,604,489 | $ 434,849,814 | 164.25% | ||
PPS Partner Engagement efforts followed a similar path as that reflected in the PPS Funds Flow distributions following the Mid–Point Assessment. Table 3 below highlights the overall increase in partners engaged from 266,425 at the Mid–Point Assessment to 552,277 as of DY3, Q2. This increase of 285,852 partners was driven by significant increases in the number of Primary Care and Non–Primary Care practitioners as well as the number of Mental Health partners.
Table 3: PPS Partner Engagement as of DY2, Q2 and DY3, Q21
| As of MPA (DY2, Q2) | As of DY3, Q2 | Change since MPA | |||||
|---|---|---|---|---|---|---|---|
| Partner Type | Committed (in DSRIP Project Plan Application) | Partners Engaged | % of Committed Partners Engaged | Partners Engaged | % of Committed Partners Engaged | Additional Funds Distributed | % Increase in Partners Engaged |
| Practitioner – Primary Care | 58,599 | 44,912 | 77% | 90,572 | 155% | 45,660 | 102% |
| Practitioner – Non–Primary Care | 113,253 | 111,924 | 99% | 264,725 | 234% | 152,801 | 137% |
| Hospital | 268 | 788 | 294% | 1,180 | 440% | 392 | 50% |
| Clinic | 1,823 | 2,095 | 115% | 3,231 | 177% | 1,136 | 54% |
| Case Management / Health Home | 1,346 | 1,402 | 104% | 2,265 | 168% | 863 | 62% |
| Mental Health | 10,365 | 10,841 | 105% | 26,273 | 253% | 15,432 | 142% |
| Substance Abuse | 1,395 | 1,312 | 94% | 1,979 | 142% | 667 | 51% |
| Nursing Home | 887 | 1,448 | 163% | 1,429 | 161% | (19) | –1% |
| Pharmacy | 1,004 | 452 | 45% | 809 | 81% | 357 | 79% |
| Hospice | 99 | 222 | 224% | 243 | 245% | 21 | 9% |
| Community Based Organizations | 2,876 | 2,592 | 90% | 3,422 | 119% | 830 | 32% |
| All Other | 75,371 | 88,437 | 117% | 156,149 | 207% | 67,712 | 77% |
| TOTAL – All Partners | 267,286 | 266,425 | 99.68% | 552,277 | 207% | 285,852 | |
For the 14 PPS that received the PAOP Standard Modification, there was a similar improvement in the engagement of partners in the four quarters following the Mid–Point Assessment. Overall Partner Engagement increased from 185,682 to 344,907; an increase of 159,225 partners engaged. Like the overall Partner Engagement efforts, these PPS saw significant increases in the number of Primary Care and Non–Primary Care practitioners and in the number of Mental Health partners.
In reviewing the data for the 14 PPS that received the PAOP Standard Modification it should be noted that one of the PPS, Advocate Community Partners (ACP), experienced reductions to the number of partners engaged following the Mid–Point Assessment. As a result of these reductions, the data in Table 4 below shows a smaller increase and in some cases, like Community Based Organizations, a reduction in the number of partners engaged by these PPS. The data in Table 5 represents the partner engagement data for the 13 PPS that received the PAOP Standard Modification with ACP excluded from the analysis.
When the IA explored these reductions further with ACP, it was determined that the previously reported figures included partners with which ACP did not have a formal agreement but rather only a Memorandum of Understanding (MOU), which does not constitute engagement of the partner. The figures reflected in the DY3, Q2 PPS Quarterly Report therefore represent a more accurate reporting of the number of partners engaged by ACP.
Table 4: PPS Partner Engagement as of DY2, Q2 and DY3, Q2 (PAOP Standard Modification Only)2
| As of MPA (DY2, Q2) | As of DY3, Q2 | Change since MPA | |||||
|---|---|---|---|---|---|---|---|
| Partner Type | Committed (in DSRIP Project Plan Application) | Partners Engaged | % of Committed Partners Engaged | Partners Engaged | % of Committed Partners Engaged | Additional Funds Distributed | % Increase in Partners Engaged |
| Practitioner – Primary Care | 40,565 | 31,101 | 77% | 58,565 | 144% | 27,464 | 88% |
| Practitioner – Non–Primary Care | 80,622 | 81,387 | 101% | 168,053 | 208% | 86,666 | 106% |
| Hospital | 164 | 557 | 340% | 780 | 476% | 223 | 40% |
| Clinic | 1,112 | 1,278 | 115% | 1,785 | 161% | 507 | 40% |
| Case Management / Health Home | 799 | 809 | 101% | 1,218 | 152% | 409 | 51% |
| Mental Health | 6,853 | 7,713 | 113% | 18,648 | 272% | 10,935 | 142% |
| Substance Abuse | 911 | 814 | 89% | 1,115 | 122% | 301 | 37% |
| Nursing Home | 494 | 1,036 | 210% | 911 | 184% | (125) | –12% |
| Pharmacy | 874 | 269 | 31% | 417 | 48% | 148 | 55% |
| Hospice | 57 | 161 | 282% | 176 | 309% | 15 | 9% |
| Community Based Organizations | 1,873 | 997 | 53% | 770 | 41% | (227) | –23% |
| All Other | 52,186 | 59,560 | 114% | 92,469 | 177% | 32,909 | 55% |
| TOTAL – All Partners | 186,510 | 185,682 | 99.56% | 344,907 | 185% | 159,225 | |
Table 5: PPS Partner Engagement as of DY2, Q2 and DY3, Q2 (PAOP Standard Modification Only, excluding ACP))3
| As of MPA (DY2, Q2) | As of DY3, Q2 | Change since MPA | |||||
|---|---|---|---|---|---|---|---|
| Partner Type | Committed (in DSRIP Project Plan Application) | Partners Engaged | % of Committed Partners Engaged | Partners Engaged | % of Committed Partners Engaged | Additional Funds Distributed | % Increase in Partners Engaged |
| Practitioner – Primary Care | 35,383 | 23,613 | 67% | 52,118 | 147% | 28,505 | 121% |
| Practitioner – Non–Primary Care | 74,035 | 70,819 | 96% | 160,220 | 216% | 89,401 | 126% |
| Hospital | 150 | 469 | 313% | 750 | 500% | 281 | 60% |
| Clinic | 998 | 1,046 | 105% | 1,659 | 166% | 613 | 59% |
| Case Management / Health Home | 751 | 649 | 86% | 1,152 | 153% | 503 | 78% |
| Mental Health | 6,238 | 6,145 | 99% | 16,488 | 264% | 10,343 | 168% |
| Substance Abuse | 751 | 462 | 62% | 917 | 122% | 455 | 98% |
| Nursing Home | 467 | 692 | 148% | 811 | 174% | 119 | 17% |
| Pharmacy | 849 | 141 | 17% | 297 | 35% | 156 | 111% |
| Hospice | 54 | 113 | 209% | 158 | 293% | 45 | 40% |
| Community Based Organizations | 1,768 | 469 | 27% | 651 | 37% | 182 | 39% |
| All Other | 42,757 | 43,240 | 101% | 87,597 | 205% | 44,357 | 103% |
| TOTAL – All Partners | 164,201 | 147,858 | 90.05% | 322,818 | 197% | 174,960 | |
Project Specific Recommendations
In addition to the recommendations related to Funds Flow and Partner Engagement, 16 of the PPS received at least one recommendation related to their efforts to implement specific projects. These recommendations were made based on the progress demonstrated through the PPS Quarterly Reports towards meeting the specific commitment dates for the completion of project milestones.
As of the DY3, Q2 PPS Quarterly Reports, PPS had successfully completed over 95% of all project milestones that were scheduled for completion by this point of the DSRIP Program. PPS Quarterly Reports indicate that PPS continue on a path for the successful implementation of a similar percentage of the remaining project implementation requirements due through the end of DY4, Q4, pending validation by the IA.
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1. The counts of engaged partners does not represent an unduplicated count of partners. PPS may engage a single partner across multiple projects resulting in that partner being counted for each project in which it has been engaged. A single partner may also be engaged across multiple PPS. 1
2. The counts of engaged partners do not represent an unduplicated count of partners. PPS may engage a single partner across multiple projects resulting in that partner being counted for each project in which it has been engaged. A single partner may also be engaged across multiple PPS. 2
3. The counts of engaged partners do not represent an unduplicated count of partners. PPS may engage a single partner across multiple projects resulting in that partner being counted for each project in which it has been engaged. A single partner may also be engaged across multiple PPS. 3
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