Value Based Payment (VBP) Pilot Webinar: June Update

Update Webinar

  • Webinar also available in Portable Document Format (PDF)

June 26, 2017

Agenda

Topic Duration
Target Budget Update 10 min
MCO DEAA and HCS Accounts 10 min
Quality Measurement Update: Measure Feasibility Task Force 10 min
DOH Internal Lessons Learned 10 min
Next Steps and Open Forum 20 min

Target Budget Update

Target Budget Calculations Using 2015 Claims Data

  • In an effort to provide the most recent data to the program participants, the State ran attribution and target budget calculations based on the 2015 claims data.
    • The State has distributed the 2015 attribution to all Pilot Contractors
    • 2015 target budgets are forthcoming
  • As a reminder, all Pilots are welcome to calculate their own target budgets using their own calculation methodology
  • Additionally, target budgets will be accessible in the VBP Dashboards when they are released (October 2017)
  • Note: previously communicated stimulus and performance adjustment amounts remain final.
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Data Exchange Application and Agreement (DEAA) for Pilot Participants

UPDATE: Data Exchange Application and Agreement

  • A DEAA is required from all Pilot provider organizations and MCOs in order for the State to share Medicaid data with VBP Pilot participants
  • MCOs should complete a DEAA in order to access VBP Dashboards when they go live in October
  • MCOs can still receive data from their Pilot providers so long as the partners have a BAA in place
  • Updated DEAA is to be sent out in July/August timeframe
  • At that time VBP contractors and MCOs that wish to receive or access DOH Medicaid data will need to complete or revise their DEAAs.

The June 23rd deadline has been changed because there have been additional updates to the DEAA.

Forthcoming Requirement:
Health Commerce System (HCS) Account Set Up for Pilot Participants

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
  • 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

VBP Dashboard Access Form

Example of a VBP Dashboard Access Form
  • The form will be distributed to multiple contacts at your MCO: please delegate responsibility for form completion
  • Information needs to be 100% accurate
    • VBP MCO 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

Form Released: June 27th
Due to DOH: July 14th

HCS Account Set Up: MCOs

A VBP Dashboard Access Form will be sent out to VBP Pilot MCOs on Tuesday, June 27.

All VBP MCOs will be required to submit their completed forms by Friday, July 14.

Steps for HCS Account Set Up

June 27th
  • DOH provides VBP Dashboard Access Form
July 14th
July 21st
  • DOH provides Director/Coordinator Account Request Forms electronically
August 25th
  • VBP Pilot MCO 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
Sept 15th
  • DOH will mail Personal Identification Number (PIN) Letter and account activation instructions via USPS mail to VBP Pilot MCO

HCS Account Set Up Update: VBP Contractors

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
July 28th
  • 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
Aug 18th
  • DOH will mail Personal Identification Number (PIN) Letter and account activation instructions via USPS mail to VBP Contractor
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Quality Measurement Update:
Measure Feasibility Task Force

VBP Transformation: Overall Goals and Timeline

Goal: To improve population and individual health outcomes by creating a sustainable system through integrated care coordination and rewarding high value care delivery.

VBP Transformation: Overall Goals and Timeline

By DSRIP Year 5 (2020), all Managed Care Organizations must employ non– fee–for–service payment systems that reward value over volume for at least 80–90% of their provider payments (outlined in the Special Terms and Conditions of the waiver).

Acronym Definition:
New York State (NYS)
Performing Provider System (PPS)
Managed Care Organization (MCO)

VBP Measure Set Development: Crawl, Walk, Run!

Status in VBP
  • Several measures require final specifications and/or clinical or other data elements
  • Work with measure stewards to develop and finalize specifications
  • Fully developed VBP measures included in Measurement Years 2018 and 2019
Data Availability and Sources
  • Assess data availability
  • Identify and investigate potential data sources
  • Survey technological capabilities
  • Implement new data and reporting flows
  • Develop additional data sources
  • Coordination established with Qualified Entities (QEs) for clinical data integration
Data Collection and Infrastructure
  • Gather requirements for data collection
  • Begin developing infrastructure to support new data sources
  • Initiate testing and evaluation of data collection methodologies
  • Work closely with technology vendors
  • Data and reporting flows established
  • New data sources infrastructure established

Note: timelines will vary. The intent is to make substantive contributions within each phase to help realize NYS VBP Roadmap goals.

VBP Quality Measure Task Force Survey

  • The New York State Department of Health is interested in obtaining information from the Pilots in the following categories to help inform the current and future timeline for Value Based Payment (VBP) clinical quality measures:
    1. Data Collection
    2. Unit of Analysis
    3. Measure Efficiency
    4. Measure Development Process
  • A survey will be distributed to all Pilots on Friday, June 30th.
  • Please respond by July 14th, regardless of participation in a Task Force sub–team.
  • Responses will inform Task Force sub–team discussions and activities.
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DOH Internal Lessons Learned

DOH Lessons Learned

Lessons Learned:

  • DOH was not sufficiently equipped to expeditiously review incoming Contracts (hence the development of contract review tools).
  • The Provider Contract Statement and Certification form (DOH–4255) can be further improved to capture pertinent contract information more clearly (off–menu contract information, Tier vs. Level confusion, etc.) through the development of supplemental tools.
  • DEAA form completion is a very iterative process and can be simplified and streamlined (new DUA process forthcoming).
  • Given that there are a large number of IT vendors responsible for various parts of data management, calculation, etc., it creates interdependencies between the vendors that cause delays in completion of final data outputs.

Release Forthcoming: Contracting Checklist Tool

  • Depicted below is a visual of a checklist that DOH has created to review contracts.
  • This tool will help VBP contractors to develop and negotiate future VBP contracts.
  • Our team will notify you when the checklist is posted on the web.
Release Forthcoming: Contracting Checklist Tool
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Next Steps and Open Forum

Reminder: Upcoming Deadlines

The following deadlines apply to participating VBP Pilots:

Friday, June 30

Submit your updated contracts back to DOH. These contracts should be updated based on the feedback provided		 June / July 2017

Grace Period Ends
for Program Drop Out
Friday, July 14

VBP Pilot MCOs return the HCS Forms to DOH inbox: VBP@health.ny.gov		 Friday, July 14

Response to survey from Quality Measurement Task Force requested

Next Steps: Summer/Fall 2017

Lessons Learned → Quality Measure Feasibility Task Force → VBP Dashboard Release
  • DOH will be reaching out to the Pilot organizations to collect feedback on their contracting experience once the State review is complete
  
  • VBP Pilot organizations are expected to actively participate in the Taskforce
  
  • VBP Pilot organizations will receive access to the VBP dashboards in the MAPP in October 2017
  • Dashboards will include content such as attributed members by VBP arrangement, managed care plan, PCP and health homes, etc.

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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