NJ DSRIP May 2020 Office of Healthcare Financing Robin Ford, MS - - PowerPoint PPT Presentation

NJ DSRIP May 2020

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Today’s Speakers: Emma Trucks, PCG Office of Healthcare Financing Robin Ford, MS Executive Director Michael D. Conca, MSPH Health Care Consultant Alison Shippy, MPH

Agenda and Objectives

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DSRIP Program Updates

• DY8 Reporting Extension
• DY8 Payment Timeline and Mechanics
• DY8 Appeals Process

DY8 Reporting Extension

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• CMS approved an extension for remaining DY8 reporting.
• The following materials are now due on June 30th, 2020:
• Standard Reporting Workbooks (SRW);
• Measure Validation Templates (MVT); and
• DY8 Semi-Annual 2 Progress Reports.
• Materials will be accepted on a rolling basis until the June 30th deadline.
• Submit all materials via NJ SFTP Outbound folder.

DY8 Payment Timeline & Mechanics

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DY8 Payment Estimated Distribution Mechanics Interim July / August 2020 MMIS Performance

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DY8 Payment Estimated Distribution Mechanics Interim July / August 2020 MMIS Performance

• Approx. 51% – 79% of potential

payment in Stages 1, 2, 3 and UPP Carveout Does not include any amount from UPP remainder

DY8 Payment Timeline & Mechanics

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DY8 Payment Estimated Distribution Mechanics Interim July / August 2020 MMIS Performance Final December 2020 Chart Based Performance DY7 post-appeals adjustments DY8 post-appeals adjustments UPP Remainder

• Revised and CMS approved Funding and Mechanics Protocol has been

posted on the DSRIP website

DY8 Payment Timeline & Mechanics

DY8 Appeals Process

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DY8’s new two-part payment structure will prompt two separate appeals cycles. Appeal Cycle 1 – Post Interim Payment: Occurs after hospitals receive their DY8 claims-based (MMIS) measure results and interim payment (estimated end of July). Appeal Cycle 2 - Prior to Final Payment: Occurs after hospitals receive their DY8 non-claims-based (chart-based) measure results, prior to the final payment. All appeals adjustments will be reconciled in the DY8 final payment.

DY8 Payment Overview

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DY8 Payment Estimated Start of Appeal Cycle Estimated Payment Distribution Payment Mechanics Interim July / August 2020 July / August 2020 MMIS Performance Final September / October 2020 December 2020 Chart Based Performance DY7 post-appeals adjustments DY8 post-appeals adjustments UPP Remainder

• Email njdsrip@pcgus.com with questions

Announcements

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Rutgers to begin key informant interviews in May and June Rutgers Center for State Health Policy will begin stakeholder interviews for the qualitative component of the DSRIP evaluation. Rutgers staff will email invitations to individuals to schedule telephone interviews. Interviews will be about 60-90 minutes in length and are voluntary. Questions cover various aspects of interviewees' perceptions of DSRIP. No identifying information on interview subjects will be included in report of findings. If you have any questions, please reach out to: Sujoy Chakravarty, Associate Research Professor- schakravarty@ifh.rutgers.edu Kristen Lloyd, Senior Research Scientist - klloyd@ifh.rutgers.edu Oliver Lontok, Research Project Manager - olontok@ifh.rutgers.edu

Announcements

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SFY21 Program Update DOH and DHS are actively working with CMS on plans for SFY21 and will provide an update to NJ hospitals as soon as possible. For updates about Covid19 from DOH, check these websites: https://covid19.nj.gov/ https://www.nj.gov/health/cd/topics/ncov.shtml

Glossary

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• DY = Demonstration Year
• MVT = Measure Validation Template
• SA = Semi-Annual
• SRW = Standard Reporting Workbook