DSRIP Year 1 - Quarter 4 AV Scorecard Disclaimer

The Independent Assessor provided the PPS with a detailed breakdown of Achievement Values for this period via the AV Scorecard.

The AV Scorecard details the Total AVs Possible and Total AVs Earned for the PPS for the 4th Quarterly Report including the AVs for Domain 1 milestones as well as for the Pay for Reporting (P4R) measures associated with each Domain 2, Domain 3 and Domain 4 project the PPS has chosen to implement.

The AV Scorecard does not include payment details in non-payment quarters (Q1 and Q3).

Navigating the AV Scorecard

The "AV Scorecard Summary" is a summary page of all AVs available and earned per project for each PPS for DY1, Q4.

The DY1 Q4 scorecard will indicate the aggregate AVs for the third and final Payment Period in DY1. Any AVs lost during DY1Q3 will be reflected in the AV Adjustment column and detailed in the AV Adjustment section.

The scoresheet provides a detailed breakdown of milestones, dates, status, reviewer comments, and AVs awarded. The PPS will note that all P4R AVs have been awarded for this quarter.

The Domain 1 - Organizational scoresheet explains what Organizational AVs were earned. As a reminder the Organizational AVs apply to each project and impact the payments earned for each project. AVs that are missed in non-payment quarters may impact the AVs and associated payments in future payment quarters.

DY1 Q4 Scorecard Domain 2 & 3 Updates

There were a few changes made to Domain 2 and 3 Project Measures and will be reflected in the AV Scorecards. Changes made to the AV Scorecard align with the Measurement Year 1 (MY1) Results that were distributed June 1, 2016. The value of PPS potential AV awards were not affected by this process.

The following is a list of technical updates to the scorecard:

Palliative Care projects 3.g.i and 3.g.ii -Domain 3 Pay for Performance (P4P) and Pay for Reporting (P4R) Measures were replaced with a single "Palliative Care Proxy Measure". This is because there were no results for all 5 Palliative Care measures as they were pending CMS approval during MY 1. Once CMS has made an official determination and results are able to be calculated AV scorecards will include the final project measures. In guidance released in March 2016, the DOH indicated PPS will earn Project Measure AVs if the PPS achieved Domain 1 Reporting Requirements during the measurement year. PPS will receive Domain 3 project measure AVs for the Palliative Care proxy measure if any Domain 1 reporting requirements were satisfied. PPS will not be negatively impacted by the removal of these P4R measures. The 5 measures removed are:

  • Depressive feelings - percentage of members who experienced some depression feeling ±
  • Advanced Directives - Talked about Appointing for Health Decisions
  • Percentage of members who had severe or more intense daily pain ±
  • Percentage of members who remained stable or demonstrated improvement in pain
  • Percentage of members whose pain was not controlled ±

The following list of measures received an AV value of N/A in DY1Q4 AV Scorecard because the measures are either under development or have no data associated with them for this payment period. These N/A measures apply to Domain 2, projects 2a-2d where there were no MY1 results.

  • Percent of total Medicaid provider reimbursement received through sub-capitation or other forms of non-FFS reimbursement
  • C&G CAHPS by PPS for uninsured- Getting timely appointments, care, and information
  • C&G CAHPS by PPS for uninsured- Patients" rating of the provider (or doctor)
  • C&G CAHPS by PPS for uninsured- How well providers (or doctors) communicate with patients
  • C&G CAHPS by PPS for uninsured- Helpful, courteous, and respectful office staff