Equity Programs (EP) Monthly Update Webinar

  • Webinar also available in Portable Document Format (PDF)

October 2016

Today´s Agenda

  1. EPP DY1 Performance Results
  2. EPP DY1 Payments
  3. EIP Underpayment Update
  4. EIP Activity – Medicaid Accelerated eXchange (MAX) Update
  5. EIP DY2 Q2 Reporting
  6. Next Steps and Open Forum

Equity Performance Program (EPP) Updates

EPP DY1 Performance Results

  • Remaining EPP DY1 performance results from the Independent Assessor (IA) were released on Tuesday, October 25th, 2016.
  • The achievement/non–achievement of EPP measures chosen by partnered PPS are clearly displayed in the IA's report to each MCO.
    • For DY1, MCOs were notified by the IA via e–mail and PPS were cc'd (so long as the primary contact information had been submitted).
  • Going forward, DY2–DY5 EPP performance reports will still be sent to MCOs via e-mail and the results will also be made available to PPS in the Q4 IA reports.
    • For DY2–5, EPP performance reports will be published in July annually.
  • PPS EPP measure selections for DY1 and DY2-DY5 have been made available on the EP website.
  • PPS EP DY1 performance has been posted on the EP website. EP Performance results will be updated annually and made available on the EP website.

EPP DY1 Payments

  • Similar to Equity Infrastructure Program (EIP) payments in 2015, EPP payments to MCOs have been delayed, due to the postponement in the approval of the April 2016 rates.
  • Although PPS may have received EPP DY1 results from the IA, MCOs have not received funds to pay EPP awards.
  • EPP payments cannot be made to PPS until MCOs receive the EPP payments later this year, which will be retroactive to April 2016.
Milestone Due Date
IA releases final EPP DY1 performance results to MCOs October 25, 2016
DOH to publish all PPS EPP measures and EIP activities selections as well as performance achievement online October 25, 2016
MCOs receive EPP payment retroactive to April 2016 Nov. – Dec. 2016

EIP Updates

EIP DY1/DY2 Underpayment Update

  • DOH continues to work with CMS on a set of January 2016 EIP rate adjustments, which will close the gap between actual EIP DY1 payments and expected EIP DY1 payments.
  • EIP rate adjustments are still pending CMS approval.
    • DOH will notify affected MCOs and PPS once the rate adjustments are approved.
  • EIP funds in DY2 will continue to flow at the lower rate that was set in April 2015 until the January 2016 rate adjust is approved.

Medicaid Accelerated eXchange (MAX) Update

  • The DY2 Max Series (Targeting Avoidable Readmissions for High Utilizers) officially launches in November 2016 with workshops beginning in January and February 2017.
    • 20 Action Teams, representing approximately 200 clinicians and administrators, have the opportunity to participate in this series.
      • Action Teams must attend three workshops in the series and are responsible to implement the process improvements that they commit to within those Workshops.
    • DOH will end enrollment for the next MAX Series on October 28th, 2016.
    • If you would like to enroll in this series, or have any questions regarding the program, please email MAX Series Manager, Joshua Sorin jsorin@kpmg.com.
  • Beyond the formal MAX workshops available in DY2, DOH introduced the Train the Trainer (TTT) MAX series, which involves training participants to host their own MAX workshops.
    • MAX TTT recruitment ends October 28, 2016, with the program then beginning in November 2016.
      • Up to 40 participants from across all 25 PPS, as well as provider sites and other organizations, have the opportunity to participate in the program.
    • MAX TTT enables PPS to continue to select MAX as an EIP Activity throughout the duration of DSRIP.
    • If you would like to enroll in this opportunity, or have any questions regarding the program, please email the MAX Series TTT Program Manager, Shireen Saxena (shireensaxena@kpmg.com).

EIP DY2 Q2 Reporting

  • DY2 Q2 ended September 30, 2016. If PPS elected to report quarterly or semiannually, reports for the period should be sent to the listed entity at the appropriate email address noted below:
Report Completed by Submitted to Frequency Location
EP Contracts PPS & MCO IA & DOH Annually dsrip_ia@pcgus.com
dsrip_ssp@health.ny.gov
MCO EP Frequency Table MCO IA & DOH Annually dsrip_ia@pcgus.com
dsrip_ssp@health.ny.gov
MCO EIP Activity Table MCO IA & DOH Based on EP Contracts dsrip_ia@pcgus.com
dsrip_ssp@health.ny.gov
MCO EIP Payment Table MCO IA & DOH Based on EP Contracts dsrip_ia@pcgus.com
dsrip_ssp@health.ny.gov
MCO EPP Payment Table MCO IA & DOH Based on EP Contracts dsrip_ia@pcgus.com
dsrip_ssp@health.ny.gov
PPS EIP Activity Table PPS MCOs Based on EP Contracts MCO contact emails
Supporting Documentation for EIP Activity participation PPS MCOs Based on EP Contracts MCO contact emails
Supporting Documentation for EIP Activity participation MCO (reviewed by MCO after being sent by PPS) IA Based on EP Contracts dsrip_ia@pcgus.com

Next Steps and Open Forum

  • The next EP Monthly Update Webinar is scheduled for Friday, November 18th, 2016 from 2:00 pm – 3:00 pm.
    • Changed from the original date of Wednesday, November 23rd due to the Thanksgiving Holiday.
  • For any further questions, please contact the Supplemental Programs inbox: dsrip_ssp@health.ny.gov.
  • The remainder of this webinar is reserved for an open forum session.

Thank you for your continued support with EP!