On December 21, 2017, the Centers for Medicare and Medicaid Services approved a five-year extension of the Texas Section 1115 Demonstration waiver.  The extension preserves Uncompensated Care (UC) pool and Delivery System Reform Incentive Payment (DSRIP) pool funding at current levels for two years.  The UC pool amount for the third and subsequent years will be determined during 2019.  DSRIP will be phased out by the fifth year.  The combined pools consist of at least $25 billion in All Funds for the extension period.

The waiver requires the state to make significant changes to UC and DSRIP reporting and operations in a short period of time.  HHSC staff will be holding a meeting January 11 at 8:30 am in the Brown-Heatly public hearing room to review these changes with you and your colleagues.  A conference call line will be available for those unable to attend in person.

Agenda Summary

Texas Medicaid Waiver Renewal Summary

RHP 6 is excited to release a new report:

Assessing Progress and Opportunities to Improve Health and Transform Care in RHP 6: Summary of available regional performance measures related to the Medicaid 1115 Waiver

This report presents data currently available by region so we can assess the waiver’s impact beyond the project level. These measures have been produced by HHSC (and/or its contracted External Quality Review Organization) using Medicaid Claims data.

Further, HHSC has identified many of these measures as candidates for a proposed Performance Bonus Pool (PBP) if the waiver is extended beyond September 30, 2016. Additional measures being considered for the PBP can be found on HHSC’s website (http://www.hhsc.state.tx.us/1115-docs/012616/Performance-Bonus-Pool.pdf) but are not included here because regional-level subsets are not yet available.

While we await further guidance from HHSC on waiver extension, this subset of measures can help us evaluate progress, reassess priorities, and promote additional collaboration across our region. Providers and stakeholders are encouraged to review these data and reflect on areas of strength and opportunity for further improvements. These measures will also be integral to our regional dialogue as we prepare for the development of the RHP 6 PBP plan and continue to transition our focus from individual project outcomes to regional transformation. Please communicate your ideas, questions, and concerns to Carol Huber at Carol.Huber@uhs-sa.com.