Value Based Payment (VBP) Pilot Webinar: April Update

Update Webinar

  • Webinar also available in Portable Document Format (PDF)

April 27, 2017

Agenda

Topic Duration
VBP Pilot Program – Welcome! 10 min
Follow Up: Data Exchange Application and Agreement (DEAA) for VBP Contractors 15 min
Forthcoming Requirement: Health Commerce System Accounts for VBP Contractors 15 min
Next Steps and Open Forum 20 min

VBP Pilot Program – Welcome!

Welcome to our VBP Pilot Participants!

7 provider organizations and 8 managed care organizations will be working together on 13 distinct contracts as part of the VBP Pilot Program.

Arrangement Provider Managed Care Organization
HARP Maimonides Medical Center Healthfirst PHSP, Inc.
Mount Sinai Health Partners Healthfirst PHSP, Inc.
IPC Community Health IPA Affinity Health Plan, Inc.
Hudson Headwaters Health Network New York State Catholic Health Plan, Inc.
TCGP Greater Buffalo United ACO Yourcare Health Plan, Inc.
Somos Your Health IPA Affinity Health Plan, Inc.
Somos Your Health IPA HealthPlus HP, LLC
Somos Your Health IPA New York State Catholic Health Plan, Inc.
Somos Your Health IPA Healthfirst PHSP, Inc.
Somos Your Health IPA United Healthcare of New York, Inc.
Somos Your Health IPA Wellcare of New York, Inc.
St. Joseph´s Hospital Health Center New York State Catholic Health Plan, Inc.
St. Joseph´s Hospital Health Center Molina Healthcare of New York, Inc.

Forthcoming Areas of DOH Support

Below are the areas of focus for the kick off of the VBP Pilot Implementation phase:

Contract Review Monthly Webinars Data and Security Update
  • Submitted VBP Pilot contracts are currently going through the contract risk review process
  • All Level 1 contracts are undergoing an extended 30–day review, while Level 2 contracts are going through standard 90 day review
  • Representatives from the Division of Health Plan Contracting and Oversight will reach out to individual partnerships with questions/comments as needed
  • Each month the DOH will host a webinar focusing on pertinent topics such as: performance measurement, policy and contracting, and VBP Dashboards. Other topics may be discussed as well
  • Webinar frequency may change, and arrangement– specific webinars may also be held
  • Pilot organizations who complete their DEAA submissions will be able to receive non–PHI and non–PII data from the State
  • In order to access the VBP Dashboards, located in the Medicaid Analytics Performance Portal (MAPP), VBP Contractors will need HCS accounts designated for their entity
  • Once HCS accounts are complete and security requirements are met, additional data will be shared as it becomes available
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Follow Up:
Data Exchange Application and Agreement (DEAA) for VBP Contractors

Next Steps: Data Exchange Application and Agreement

REMINDER: DEAA DUE NEXT TUESDAY, MAY 2

  • A DEAA is required from all Pilot provider organizations prior to the sharing of Medicaid data with VBP Pilot participants
  • DEAA completion, submission and acceptance will allow for VBP Pilot participants to receive DOH non–PHI/PII data
  • In order for the Pilot provider organizations to share DOH data with downstream organizations, including their MCOs, they must have Business Associate Agreements (BAA) in place and filed with the Department
  • All questions and the completed DEAA can be submitted to the following email address. Please use the subject line "VBP": doh.sm.Medicaid.Data.Exchange@health.ny.gov

Guidance for Completing the DEAA Form

Please consider the following prior to submission:

  • Key sections of the DEAA (the Purpose, Data Elements, Data Years and DEAA #) have been populated for all VBP Pilot participants. Note: Please do not change the content within these sections
  • Please make sure to include the correct legal name of your provider organization
  • The DEAA must be signed in all 4 locations by the individual whose information is submitted in Section 1A, and who can bind your organization (e.g. CEO, CFO, etc.)
  • Ensure that all pages are signed and scanned in the correct order

REMINDER: DEAA DUE NEXT TUESDAY, MAY 2

DOH will aim to have submitted DEAAs approved by May 8.

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Forthcoming Requirement:
Health Commerce System Accounts for VBP Contractors

HCS Account Set Up

Creating a HCS account is the first step in gaining access to the Medicaid Analytics Performance Portal (MAPP), which houses the VBP Dashboards.

Pilot HCS Account Set Up

  • While some organizations may already have DSRIP HCS accounts, new accounts or designations unique to their VBP entities must be created to permit access to the VBP Dashboards in MAPP
  • Several pilot organizations provided Dashboard Access Forms in early January, however many were not fully completed, and thus each Pilot Organization will be required to submit a new VBP Dashboard Access Form
  • Once the initial VBP Dashboard Access Form is approved for each VBP contracting entity, the organization will then be able to add their own users to the system

HCS Account Set Up

A VBP Dashboard Access Form will be sent out to all VBP Pilot Participants on Friday, May 5.

All VBP Pilots will be required to submit their completed form by Friday, May 12.

Steps for HCS Account Set Up

May 5th
  • DOH provides VBP Dashboard Access Form
May 12th
May 26th
  • DOH provides Director/Coordinator Account Request Forms electronically
June 9th
  • VBP Contractor returns notarized Director/Coordinator Account Request Form by mail (DOH requires the hard copy) to:
    800 North Pearl Street Room 214
    Albany, NY 12204–1899
June 9th
  • DOH will mail Personal Identification Number (PIN) Letter and account activation instructions via USPS mail to VBP Contractor

VBP Dashboard Access Form

Will be sent to VBP Pilot organizations on May 5

Example of a VBP Dashboard Access Form
  • Information needs to be 100% accurate
    • VBP contractor legal name – Frequently Incorrect
  • Identify your Director and Coordinator
    • Director – A person who can bind the organization with NYSDOH (a senior leader)
    • Coordinator – A person who has the responsibility and authority to request and manage Commerce accounts
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Next Steps and Open Forum

Reminder: Upcoming Deadlines

The following deadlines apply to participating VBP Contractors:

Tuesday, May 2

Completed DEAAs due to DOH by COB to the following email address: doh.sm.Medicaid.Data.Exchange@health.ny.gov		 Friday, May 12

Completed VBP Dashboard Access Forms for HCS accounts due to the following email address: vbp@health.ny.gov

Update: VBP Pilot Financing

VBP Pilots will receive financial benefits in the form of stimulus and performance adjustments

  • To ensure that MCOs have adequate funding to facilitate stimulus and performance adjustments over the duration of the VBP Pilot Program (01/2017– 12/2018), DOH will fund the full two years of payments between July 2017 and March 2018 on a per member per month basis. Hence, participating MCOs will have received all program funds 9 full months before the end of the Program.
  • Pilot adjustments are being built into the July 2017 MCO premium updates through a rate add–on
  • Drafts of the rates should be provided to MCOs in July, with a 30–day plan review period

Program Dates: 01/2017 – 12/2018

Payment Dates: 07/2017 – 03/2018

Next Steps: VBP Data and Analytics

2015 Attribution → 2015 Target Budgets → System Security Plans (SSP) → VBP Dashboard Release
  • Anticipated release early May for population based arrangements (TCGP, HARP), and early June for episode based arrangements (IPC)
  • Will include member counts by arrangement based on 2015 encounter data
  • Data will only be shared with Pilot organizations with completed DEAAs
  
  • Anticipated release by early September
  • Target budget calculations will be based on 2015 encounter data
  • VBP Pilots are welcome to use their own target budget methodology
  
  • All VBP Pilot organizations will be asked to submit SSPs in order to receive PHI data
  • Addenda to the DEAA forms may also be required
  • The State will be working with Pilots to put the SSPs in place between June and September of 2017
  
  • VBP Pilot organizations will receive access to the VBP dashboards in MAPP in October 2017
  • Dashboards will include content such as attributed members by VBP arrangement, managed care plan, PCP and health homes etc.
  • VBP dashboards will be non–PHI unless SSPs have been completed

System Security Plan Follow Up

  • The NYS VBP Team will reach out to Pilots at a later date to begin the process of SSP completion
  • Though several Pilot organizations may have already submitted the SSP workbook, updates may be needed given some of the following:
    • New versions of the workbook have been created, and organizations will need to ensure that they have submitted the latest version
    • If new legal entities are in place, the DEAA and SSP workbook will need to be submitted by those responsible for that organization
    • Organizations may need to update the security overview sections
  • Additional information will be forthcoming

MCO Access to VBP Dashboards

  • MCOs will be receiving access to the VBP dashboards in MAPP
  • The timing of dashboard access for MCOs will be confirmed at a later date
  • The initial focus for DEAA and HCS account completion is on provider organizations, though additional documentation may later be requested from MCOs

Next Steps: Quality Measurement for Pilots

The VBP Roadmap (pg. 58) states that "... all Pilot participants (plans and providers) agree to participate in a learning diffusion process where they commit to assist in developing lessons learned for VBP implementation and reengagement with the CAGs as needed."

Important items

  • DOH will be inviting Pilots to participate in a Measure Feasibility Task Force.
    • The Task Force will include Pilot members, Data Managers from the Managed Care Organizations, and other stakeholders.
    • The Task Force´s objective is to inform and generate feedback on the data collection and reporting process and feasibility for Category 1 and 2 measures.
  • In preparation for the Task Force, the DOH is working internally with the Office of Quality and Patient Safety (OQPS) to align data submission formats between the existing Quality Improvement Program (QIP), and the data needs for VBP proper.

Open Forum

Are there any additional areas of support that VBP Pilots would like to see?

Any immediate concerns or questions?

For additional questions, or to share ideas, please contact the VBP mailbox:
vbp@health.ny.gov
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