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DSRIP:
Moving from Application
to Implementation
March 4, 2015
Timeline
Dec 22: PPS
applications
submitted.
Early
March:
DSRIP
Project
Plan
awards
made.
Late March:
Final
attribution
for valuation
released.
April 1:
DSRIP Year
1 begins.
April 15:
VBP
Roadmap
submitted
to CMS.
Mid-April:
First Year
1 payment
to PPSs.
Performing Provider Systems
3
Adirondack
Health Institute
CNY PPS
Millennium
Collaborative Care
NYC Health
and Hospitals
Stony Brook
University Hospital
Advocate
Community
Partners
Ellis Hospital
Mohawk Valley
PPS (Bassett)
Refuah Health
Center
New York
Presbyterian
Hospital
Albany Medical
Center Hospital
Finger Lakes PPS
Montefiore
Medical Center
RUMC & SIUH
NY Hospital Med
Center of Queens
Bronx-Lebanon
Hospital Center
Lutheran
Medical Center
Mount Sinai
Hospitals Group
Samaritan
Medical Center
United Health
Services Hospitals
Catholic
Medical Partners
Maimonides
Medical Center
Nassau University
Medical Center
St. Barnabas
Hospital
Westchester
Medical Center
Draft Scoring (without PAOP adjustments)
4
PPS Name Average Score Sigmas from Mean
Adirondack Health Institute 90.79 -0.27
Advocate Community Partners (AW Medical) 92.41 0.62
Albany Medical Center Hospital 92.62 0.74
Bronx-Lebanon Hospital Center 88.98 -1.27
Catholic Medical Partners-Accountable Care IPA INC 90.97 -0.17
CNY DSRIP Performing Provider System 91.05 -0.13
Ellis Hospital 95.01 2.06
Finger Lakes PPS 94.6 1.83
Lutheran Medical Center 89.96 -0.73
Maimonides Medical Center 91.44 0.09
Millennium Collaborative Care PPS (ECMC) 91.11 -0.09
Mohawk Valley PPS (Bassett) 90.73 -0.3
Montefiore Medical Center 93.67 1.32
Mount Sinai Hospitals Group 89.91 -0.75
Nassau University Medical Center 90.6 -0.37
New York City Health and Hospitals-led PPS 88.94 -1.29
Refuah Health Center 91.97 0.38
Richmond Univ Med Center & Staten Island Univ Hosp 88.37 -1.6
Samaritan Medical Center 93.34 1.14
St. Barnabas Hospital (dba SBH Health System) 91.37 0.05
Stony Brook University Hospital 93.44 1.19
The New York and Presbyterian Hospital 91.5 0.12
The New York Hospital Medical Center of Queens 87.72 -1.96
United Health Services Hospitals, Inc 89.81 -0.81
Westchester Medical Center 91.62 0.19
Total/Average 91.28
Draft Attribution
5
PPS Name Attribution 11th
Project Total
Adirondack Health Institute 74,941 82,783 157,724
Advocate Community Partners (AW Medical) 769,089 769,089
Albany Medical Center Hospital 64,636 34,872 99,508
Bronx-Lebanon Hospital Center 133,117 133,117
Catholic Medical Partners-Accountable Care IPA INC 80,618 80,618
CNY DSRIP Performing Provider System 167,136 22,300 189,436
Ellis Hospital 116,624 14,715 131,339
Finger Lakes PPS 279,678 59,214 338,892
Lutheran Medical Center 104,415 104,415
Maimonides Medical Center 477,612 477,612
Millennium Collaborative Care PPS (ECMC) 230,975 81,000 311,975
Mohawk Valley PPS (Bassett) 38,406 6,518 44,924
Montefiore Medical Center 213,505 213,505
Mount Sinai Hospitals Group 279,751 279,751
Nassau University Medical Center 354,665 74,569 429,234
New York City Health and Hospitals-led PPS 634,789 55,000 689,789
Refuah Health Center 39,443 39,443
Richmond University Medical Center & Staten Island University Hospital 68,693 80,000 148,693
Samaritan Medical Center 39,049 4,000 43,049
St. Barnabas Hospital (dba SBH Health System) 344,479 344,479
Stony Brook University Hospital 148,118 45,426 193,544
The New York and Presbyterian Hospital 80,902 80,902
The New York Hospital Medical Center of Queens 25,406 25,406
United Health Services Hospitals, Inc. 95,489 89,558 185,047
Westchester Medical Center 120,232 81,500 201,732
Total/Average 4,981,768 731,455 5,713,223
Timeline
YEAR MILESTONE
DY2 (2016)
MCO-PPS combinations submit plans outlining path towards
VBPs. Greater ambition = MCO PMPM bonus.
DY3 (2017)
MCO-PPS combinations must have Level 1 VBP arrangement for
PCMH/APC care + bundle/subpopulation OR total pop Level 1.
DY4 (2018)
At least 50% of total statewide MCO payments in Level 1 VBP; aim
to have 30% of VBP payments (=15% of statewide MCO
payments) captured in Level 2 VBP.
DY5 (2019)
80-90% total MCO-PPS payments captured in Level 1 VBP; aim to
have 70% of VBP payments (=56% of statewide MCO payments)
captured in Level 2 VBP.
6
Contact
7
• Jordanna Davis
– Principal, Sachs Policy Group
– jdavis@sachspolicy.com
– www.sachspolicy.com
DSRIP:
Moving from Application
to Implementation
March 4, 2015

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NYeC DSRIP Breakfast Panel 3/04/14

  • 1. DSRIP: Moving from Application to Implementation March 4, 2015
  • 2. Timeline Dec 22: PPS applications submitted. Early March: DSRIP Project Plan awards made. Late March: Final attribution for valuation released. April 1: DSRIP Year 1 begins. April 15: VBP Roadmap submitted to CMS. Mid-April: First Year 1 payment to PPSs.
  • 3. Performing Provider Systems 3 Adirondack Health Institute CNY PPS Millennium Collaborative Care NYC Health and Hospitals Stony Brook University Hospital Advocate Community Partners Ellis Hospital Mohawk Valley PPS (Bassett) Refuah Health Center New York Presbyterian Hospital Albany Medical Center Hospital Finger Lakes PPS Montefiore Medical Center RUMC & SIUH NY Hospital Med Center of Queens Bronx-Lebanon Hospital Center Lutheran Medical Center Mount Sinai Hospitals Group Samaritan Medical Center United Health Services Hospitals Catholic Medical Partners Maimonides Medical Center Nassau University Medical Center St. Barnabas Hospital Westchester Medical Center
  • 4. Draft Scoring (without PAOP adjustments) 4 PPS Name Average Score Sigmas from Mean Adirondack Health Institute 90.79 -0.27 Advocate Community Partners (AW Medical) 92.41 0.62 Albany Medical Center Hospital 92.62 0.74 Bronx-Lebanon Hospital Center 88.98 -1.27 Catholic Medical Partners-Accountable Care IPA INC 90.97 -0.17 CNY DSRIP Performing Provider System 91.05 -0.13 Ellis Hospital 95.01 2.06 Finger Lakes PPS 94.6 1.83 Lutheran Medical Center 89.96 -0.73 Maimonides Medical Center 91.44 0.09 Millennium Collaborative Care PPS (ECMC) 91.11 -0.09 Mohawk Valley PPS (Bassett) 90.73 -0.3 Montefiore Medical Center 93.67 1.32 Mount Sinai Hospitals Group 89.91 -0.75 Nassau University Medical Center 90.6 -0.37 New York City Health and Hospitals-led PPS 88.94 -1.29 Refuah Health Center 91.97 0.38 Richmond Univ Med Center & Staten Island Univ Hosp 88.37 -1.6 Samaritan Medical Center 93.34 1.14 St. Barnabas Hospital (dba SBH Health System) 91.37 0.05 Stony Brook University Hospital 93.44 1.19 The New York and Presbyterian Hospital 91.5 0.12 The New York Hospital Medical Center of Queens 87.72 -1.96 United Health Services Hospitals, Inc 89.81 -0.81 Westchester Medical Center 91.62 0.19 Total/Average 91.28
  • 5. Draft Attribution 5 PPS Name Attribution 11th Project Total Adirondack Health Institute 74,941 82,783 157,724 Advocate Community Partners (AW Medical) 769,089 769,089 Albany Medical Center Hospital 64,636 34,872 99,508 Bronx-Lebanon Hospital Center 133,117 133,117 Catholic Medical Partners-Accountable Care IPA INC 80,618 80,618 CNY DSRIP Performing Provider System 167,136 22,300 189,436 Ellis Hospital 116,624 14,715 131,339 Finger Lakes PPS 279,678 59,214 338,892 Lutheran Medical Center 104,415 104,415 Maimonides Medical Center 477,612 477,612 Millennium Collaborative Care PPS (ECMC) 230,975 81,000 311,975 Mohawk Valley PPS (Bassett) 38,406 6,518 44,924 Montefiore Medical Center 213,505 213,505 Mount Sinai Hospitals Group 279,751 279,751 Nassau University Medical Center 354,665 74,569 429,234 New York City Health and Hospitals-led PPS 634,789 55,000 689,789 Refuah Health Center 39,443 39,443 Richmond University Medical Center & Staten Island University Hospital 68,693 80,000 148,693 Samaritan Medical Center 39,049 4,000 43,049 St. Barnabas Hospital (dba SBH Health System) 344,479 344,479 Stony Brook University Hospital 148,118 45,426 193,544 The New York and Presbyterian Hospital 80,902 80,902 The New York Hospital Medical Center of Queens 25,406 25,406 United Health Services Hospitals, Inc. 95,489 89,558 185,047 Westchester Medical Center 120,232 81,500 201,732 Total/Average 4,981,768 731,455 5,713,223
  • 6. Timeline YEAR MILESTONE DY2 (2016) MCO-PPS combinations submit plans outlining path towards VBPs. Greater ambition = MCO PMPM bonus. DY3 (2017) MCO-PPS combinations must have Level 1 VBP arrangement for PCMH/APC care + bundle/subpopulation OR total pop Level 1. DY4 (2018) At least 50% of total statewide MCO payments in Level 1 VBP; aim to have 30% of VBP payments (=15% of statewide MCO payments) captured in Level 2 VBP. DY5 (2019) 80-90% total MCO-PPS payments captured in Level 1 VBP; aim to have 70% of VBP payments (=56% of statewide MCO payments) captured in Level 2 VBP. 6
  • 7. Contact 7 • Jordanna Davis – Principal, Sachs Policy Group – jdavis@sachspolicy.com – www.sachspolicy.com
  • 8. DSRIP: Moving from Application to Implementation March 4, 2015