Consumer Perspective on Hospital Transformation Program (HTP) - - PowerPoint PPT Presentation

Consumer Perspective on Hospital Transformation Program (HTP)

November 27,2018 CHASE Board

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HTP

• New way to distribute provider fee dollars.
• Must seek federal authority through an 1115 waiver.
• HQIP remains in place ($97.6 M).
• Will put all other non-eligibility related payments

(except for DSH) at risk.

• No payment through provider fee if don’t

participate.

• Statute says must start program “no earlier than”

October 1, 2019. (SB17-267)

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HTP Payments

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DSRIP (HTP) Goals

• Moving states to new care delivery and

payment models

• Pay for performance – moving to value

based payment.

• Broad population and care coordination

goals.

• Generally paired with managed care.
• Uncertain how payment will work.

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Questions

• What is different about this new program?
• How does it fit with other initiatives?
• What do we expect to achieve?
• How does payment work?
• What is the incentive for broader

participation?

• Where is the accountability for

performance?

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Coordination- Other Initiatives

– HQIP- how will this be coordinated so there are not duplicate payments? – ACC/RAEs – no hospital payment in ACC but RAEs and hospitals encouraged to work together to benefit both. – Are metrics sufficient to ensure that we know what changes are influencing quality/performance? – SIM- where is this headed? Global payment? – Community benefit obligations – how do investments tie in with HTP?

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Coordination

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Incentives

• Provider fee $ earned through performance

(no new money).

• Program success based, in part, on community

support, participation, investment.

– Who makes up front investment(s)? – Who realizes benefits of investments?

• RAEs?
• Hospitals?
• Other?

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Oversight/Participation

• 1115 Waiver – Public comment process
• HQIP sub-committee

– Hospitals, CHA and HCPF. Develop and oversee performance metrics and payment.

• HTP

– Rural/urban hospital subcommittees in place – metrics and

• verall plan.

– Requirement of community consultation/engagement in planning phase and development of action plan. Specific requirement to engage RAEs.

• ACC-

– PIAC – state and regional and MIAC.

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Going Forward

• Role of the Board:

– How will oversight work going forward? – Who will be engaged in subcommittee work? – Development of metrics and payment methodology? – Coordination with other efforts- how will payment transformation be integrated? – Community/consumer participation – particularly important given community based nature of project.

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Contact information

Elisabeth Arenales, Esq. Health Care Program Director Colorado Center on Law and Policy earenales@cclponline.org; (303) 573-5669 x 302

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