Additional High Performance Program (AHPP)

The NYS Department of Health (DOH) is currently developing a program designed to award $250 million of state–funded performance–based payments through Managed Care Organizations (MCOs) to Performing Provider Systems (PPS) in the Additional High Performance Program (AHPP). The program is designed to further incentivize PPS participating in the DSRIP program to maximize their achievement of key measures that were selected to be a part of the federally funded DSRIP High Performance Program (HPP).

Through State–Invested funds, AHPP incentivizes high performance for DSRIP Program participants by focusing in on HPP measures that all PPS are undertaking.

AHPP Pairings Table

All PPS participating in the DSRIP Program are eligible to participate in AHPP. The table below displays the potential annual AHPP awards if all PPS meet their AHPP targets. PPS were paired with MCOs based on the overlap between the MCO service areas and PPS locations.

The proposed distribution rates identified below were calculated under the assumption that all PPS achieved their performance requirements for the year. These amounts are based on the distribution of attributed lives in DSRIP among the PPS. As unearned award amounts for the year are redistributed into the AHPP funding pool and disbursed to PPS who qualify for AHPP awards in a weighted manner within the same year, these rates are the lowest payments a PPS can earn if they meet the performance requirements for AHPP, each year.

AHPP Programmatic Guidance Document

AHPP Webinars

AHPP Payments

AHPP Timeline

Please note that the dates included herein are proposed dates for funds flow and reporting associated with AHPP. A revised timeline denoting the Department´s recommended completion dates for past, present, and upcoming AHPP milestones may be added at a later date.

Milestone Due Date
DOH releases AHPP Pairings to program participants October 2016
Paired Managed Care Organizations (MCOs) and PPS develop AHPP contracts October 2016 – December 31, 2016
Independent Assessor (IA) releases annual performance results pertaining to AHPP AY 1 results released: October 2016
AY 2 results released: July 2017
AY 3 results released: July 2018
AY 4 results released: July 2019
AY 5 results released: July 2020
DOH includes AHPP add–on into per member per month (PMPM) rates to participating MCOs:
  • Year 1: Funds added in April 2016 rates
  • Years 2–5: Funds added in July rates annually
Due to CMS delays in rate approval process, funds flow process at the beginning of each year may be delayed. Once approved, payments will be retroactive to AHPP Year start date.
Full award amounts will be paid out over 12 months in AHPP Year 1 and over 9 months in AHPP Years 2–5
DY1 payments time period: April 2016 – March 2017 (12 months)
DY2 payments time period: July 2017 – March 2018 (9 months)
DY3 payments time period: July 2018 – March 2019 (9months)
DY4 payments time period: July 2019 – March 2020 (9 months)
DY5 payments time period: July 2020 – March 2021 (9 months)

AHPP Metrics and Payments

All program measures for AHPP are taken from the twelve measures that make up the federally funded DSRIP High Performance Program (HPP). Of the 12 HPP measures, nine are applicable to all 25 PPS, and therefore those nine were chosen as the AHPP measures. All PPS participating in AHPP are evaluated on all nine program measures:

Projects Measure Name Pay For Performance (P4P) Timing
2.a.i–2.a.v Potentially Preventable Emergency Department Visits (PPV) (All Population) DY3
2.a.i–2.a.v Potentially Preventable Readmissions (PPR) (All Population) DY3
3.a.i–3.a.iv Antidepressant Medication Management – Effective Acute Phase Treatment DY2
3.a.i–3.a.iv Antidepressant Medication Management – Effective Continuation Phase Treatment DY2
3.a.i–3.a.iv Cardiovascular Monitoring for People with Cardiovascular Disease (CVD) and Schizophrenia DY2
3.a.i–3.a.iv Diabetes Monitoring for People with Diabetes and Schizophrenia DY2
3.a.i–3.a.iv Follow–up after hospitalization for Mental Illness – within 30 days DY2
3.a.i–3.a.iv Follow–up after hospitalization for Mental Illness – within 7 days DY2
3.a.i–3.a.iv Potentially Preventable Emergency Department Visits (Behavioral Health (BH) Population) DY2

Each of the nine AHPP metrics will be evaluated as either achieved or not achieved, each year. All AHPP measures are weighted evenly and all measures count every year regardless of whether the measure is P4R or P4P. If a PPS meets at least five of the nine metrics, they will have met the performance requirements to receive AHPP payment. PPS will be evaluated annually for AHPP, using the fourth quarter (Q4) Independent Assessor (IA) analysis results to determine achievement of measures.

Each year, the Independent Assessor (IA) will determine whether each PPS succeeds in each of the AHPP metrics. If a metric meets either of the two requirements below, it is considered achieved for the year:

  • The PPS improves its performance in the metric by 10% or more of the gap to goal within the year; or,
  • The PPS´ performance in the metric reaches and stays within the 90th percentile of the statewide average for the year.

    Note: PPS do not have to meet both requirements for the metric to be considered achieved.

AHPP awards will be distributed by the DOH on a monthly basis, through the PMPM rates, to the MCOs. Unclaimed AHPP funds derived from unearned AHPP payments from that year will be disbursed proportionally based on the relative weighting of lives for those PPS that qualify for their AHPP awards in that year. Unearned Equity Program funds will flow into the AHPP fund pool on an annual basis. These additional funds will only be earnable through AHPP by PPS who are also participating in the Equity Programs (see highlighted PPS Pairings Table section).

AHPP Frequently Asked Questions

AHPP Additional Information

Questions related to AHPP should be directed to the State Supplemental Programs inbox:

Please include ´AHPP´ in the subject name.