TEXAS RHP 7 (REGIONAL HEALTHCARE PARTNERSHIP 7)

RHP 7 is a Partnership of 6 Counties in Central Texas. Central Health is the Anchor for RHP 7.

RHP 7 PLANS & OUTCOMES

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PROVIDER TOOLS

Texas RHP7 Provider Tools

STAKEHOLDERS

Texas RHP7 Stakeholder Events

Texas Health and Human Resources (HHSC) created 20 Regional Healthcare Partnerships (RHPs) comprised of public and private hospitals and participating providers. RHP 7 is comprised of Bastrop, Caldwell, Fayette, Hays, Lee, and Travis Counties. Currently, eleven hospitals are participating in the Uncompensated Care program. Providers performing DSRIP projects include one public health department, three local mental health authorities, and five hospitals. The Community Care Collaborative, classified under the 1115 Waiver as a physician practice, performs community-based DSRIP activities to support the development of an integrated healthcare delivery system.

Beginning in 2018 under the terms of the Waiver Renewal for the DSRIP Program, RHP 7 providers began working toward the achievement of clinical outcomes in the following areas: chronic disease management (diabetes and heart disease), primary care and prevention, behavioral health, cancer screening, palliative care, hospital safety, asthma management (pediatric), chronic pain management, maternal care, palliative care, and dental care.

During the Initial Waiver period, RHP 7 providers performed 76 DSRIP projects focused on critical health needs including behavioral health and chronic disease management, and specialty care access. Overall, projects transformed the delivery of healthcare services that serve the needs of the uninsured and underinsured populations of Central Texas.

CENTRAL HEALTH & RHP 7

As the designated anchor organization for RHP 7, Central Health guides and informs RHP 7 members, interprets 1115 waiver policies and requirements, collects and reports data, and communicates with HHSC on behalf of the region. The Anchor is also responsible for conducting a regional community needs assessment. In 2018 and 2019, the Anchor will host community stakeholder events to engage DSRIP providers, the public and other community partners in continued discussions about health system transformation. During the Initial Waiver period, Central Health implemented a multi-year learning collaborative where DSRIP providers gathered for shared learning and exchange best practices. During the Waiver Renewal period, learning collaborative goals will focus on (1) sustainability strategies for the uninsured; (2) integration in Medicated managed care and (3) methodologies for quantifying the benefit of a DSRIP activity.

ABOUT THE 1115 WAIVER

1115 WAIVER RENEWAL – 2018 to 2021

The Center for Medicare and Medicaid Services approved a renewal of Texas’ 1115 Transformation Waiver in December 2017. The renewal authorizes four more years of continued funding for the Delivery System Reform Incentive Payment (DSRIP) program. Funding will cease on October 1, 2021.

Under the renewal, the DSRIP program has shifted from rewarding project-based work to achieving measurable health outcomes at a health system level. DSRIP providers will measure outcomes of their entire patient population, rather than measuring only patients served by DSRIP projects. The renewal also provides financial incentives to continue services to Medicaid and low-income/uninsured individuals. See also Waiver Renewal Explained and Beyond the Waiver.

INITIAL 1115 WAIVER – 2012-2017

On December 12, 2011, Texas received federal approval of a section 1115 Demonstration waiver intended to preserve a critical hospital funding source under a new methodology and allow for managed care expansion to additional areas of the state. The Texas Healthcare Transformation and Quality Improvement 1115 Waiver, commonly called the 1115 Waiver is designed to build on existing Texas health care reform and redesign the health care delivery in Texas consistent with CMS goals to improve the experience of care, improve population health and reduce the cost of health care without compromising quality. Funding for the 1115 Waiver is supported by savings from historical upper payment (UPL) funds and managed care. Funds are distributed through two pools: (1) an uncompensated care (UC) pool to reimburse hospitals for costs of care provided to low-income, uninsured individuals and for Medicaid under-reimbursement; and (2) a Delivery System Reform Incentive Payment (DSRIP) pool to incentivize hospitals and other providers to transform their service delivery practices for populations. The initial waiver period was for five years, followed by a a two-year extension period (2011 through 2017). During the initial waiver period, 298 providers performed 1457 DSRIP projects across the state. Additional background information about the 1115 Waiver can be found at Texas Health and Human Resources’ (“HHSC’s”) website.

Local Funding Entities – DSRIP

DSRIP projects are jointly funded through local government funds and federal funds. Local governments are investing nearly $269 million in Central Texas through DSRIP projects designed to transform healthcare in Region 7. Performing Providers must prove completion of performance-based metrics to be eligible for funding.