NOVEMBER 30 Update URGENT & DATE SENSITIVE: Dear RHP 2: As discussed at this morning's meeting, the anchor's participated in a call with HHSC this afternoon. While much of the call related to our role as anchor, a few key points need to be shared immediately.  

UC Only Hospitals:
HHSC confirmed today that you do not need to complete the narrative requirements for Category 4 if you are only participating in UC.

Immediate Guidance for All Pass 1 & Pass 2 Performing Providers:
HHSC appreciates that this is a new initiative and that RHPs are working under tight deadlines with many diverse participants.

Although some projects are well presented, the high level review of projects has revealed substantial incompleteness in many project descriptions. It has been challenging for the reviewers to determine the scope of the project (e.g. current activities vs. new, how many served), intervention and expected patient benefits of the projects.

HHSC is concerned that without revisions, many Pass 1 projects may not be approved by the Centers for Medicare and Medicaid Services (CMS) or approval may be delayed.  

HHSC is providing this immediate guidance so that RHPs can work to get their projects in the best shape possible for full plan submission that will facilitate both the HHSC and CMS review and approval of the plans.

To help address the above issue, the following is now required for ALL Pass 1 and Pass 2 Projects.

Summary Information Requested for Every Project:
It is important that project narratives clearly describe the project intervention to support the value of the project.  HHSC requests that for the full RHP plan submission, all projects (including Pass 1 projects) include the following key project information at the beginning of the Section V Project Description.  (You may use up to one additional page for this information.)

  • A brief description of the provider, including the provider’s size and role as a provider in the region’s health care infrastructure  
  • Clearly state the intervention(s).
  • A brief description of the need for the project including data as appropriate
  • Who is the target population for the project, including:
  • Number of patients the project will serve
  • How Medicaid and/or indigent patients will benefit from the project
  • Clearly state the expected benefit of the project to patients based on:
  • Category 1 or 2 milestones
  • Category 3 outcome measures

Summary Information Example:

  • Provider: Hospital ABC is a 40-bed hospital in CDF town serving a 25 square mile area and a population of approximately 21,000.
  • Intervention(s): This project will implement telemedicine to provide patient consultations by a pharmacist after hours and on weekends to reduce medication errors.
  • Need for the project: We currently only have a pharmacist onsite 40 hours per week and have noticed an increase in inpatient admissions, many of which are related to medication errors.  
  • Target population: The target population is our patients that need medication consults after hours.  Approximately 50% of our patients are either Medicaid eligible or indigent, so we expect they will benefit from about half of the consults.
  • Category 1 or 2 expected patient benefits: The project seeks to provide 200 telemedicine consults in DY4 and 400 in DY5.
  • Category 3 outcomes: IT-X.X Our goal is to reduce the 30-day potentially preventable all-cause readmission rate from X% currently to X% by DY5. (If more than one outcome, use sub-bullets.)

The above-mentioned summaries are due by 5:00 pm CST on Friday, December 7, 2012.  We apologize for the short notice; but, we just learned of this new requirement this afternoon and must have time to receive, review and incorporate into our final submission, which will be sent to HHSC the week of December 15, 2012.

Thank you once again to those who participated in the meeting this morning. We hope you found it helpful and truly appreciate the hard work from the stakeholders in RHP 2.

Thank you,

NOVEMBER 29 Update: Dear RHP 2 Stakeholders:

If you are a non-exempt Hospital Performing Provider (HPP) participating in Pass 1 or 2, your Category 4 requirements are due by 5 pm CST on Friday, December 7, 2012.

Associated with this message, the following documents have been posted for your review:

We will discuss Category 4 in more detail Friday; however, I want to share a few key points in advance for those HPP’s who want to begin this task prior to this week’s meeting.

  • Hospitals must report on Domains 1-5 (unless you are an exempt hospital according to the PFM Protocol)
  • Reporting on Domain 6 is optional, but will affect your category 4 valuation.
    • If you do not report on Domain 6, your maximum valuation for category 4 can only be 10%.
      • The other 5% can be reallocated to Categories 1, 2 and 3.
    • If you do report on category 6, you can allocate up to 15% to Category 4. 
  • Category 4 is pay for reporting (not pay for performance and/or improvement)
  • A narrative must be completed for each Domain, and is limited to 2 pages
    • Narrative includes:
      • How your Category 4 measures relate to your category 1-3 projects, if applicable.
      • Hospitals must report on all measures in each required Domain (1-5), unless you do not have statistically valid data for a particular measure
      • If you are not reporting on a particular domain measure, please state the reason in your narrative.
  • The Category 4 table includes all domains (i.e. you do not need a separate table for each Domain)
  • You must choose a reporting period for each Domain, as Category 4 measures will be reported only once each year.
    • Reporting Period 1 (October 1-March 31)
    • Reporting Period 2 (April 1-September 30)
  • HHSC will provide the data for reporting Domains 1-3, generated by the risk-adjusted 3M tool.   Early conversations with HHSC indicate that the first set of data is likely to be released in June 2013.  This will likely be a resource which allows you to download the data in excel. 
    • Performing provider hospitals will still need to take this data, and re-submit it to HHSC for the waiver Category 4 reporting.

We have received several questions about how reporting on DSRIP project outcomes will occur, and whether there will be a state-mandated reporting mechanism.  HHSC indicates that reporting for DY 2 will be manual (i.e. Excel-based). Reporting in DY 3-5 will be through a state mandated reporting system.  HHSC will be putting out an RFP within the next few months to procure a software reporting system. They envision that Performing Providers will enter data into this web-based reporting system and Anchors can access regional data for the required RHP Annual Reports.

Once again, the deadline of 5 pm CST on Friday, December 7, 2012 is firm to allow the Anchor Team the required time to compile stakeholder’s submissions into Region 2’s complete/final Regional Health Plan.

If you have any questions, please feel free to contact me personally by phone or e-mail

Thank you,

NOVEMBER 26 Update: I hope each of you had a wonderful Thanksgiving holiday.  Now that we are back from the break, I want to take this opportunity to remind RHP 2 stakeholders about Pass 2 deadlines associated with the 1115 Medicaid Waiver and announce a RHP 2 meeting this Friday, November 30, 2012.

This week’s meeting will provide a debriefing of the Pass 1 submission and discuss on-going plans for RHP 2’s Pass 2 submission to HHSC. We will also discuss Category 4 requirements (mandated for participating hospital providers who are unable to opt out due to size).  The meeting will begin at 9 am at UTMB’s Specialty Care Center at Victory Lakes in League City, Texas.  If unable to attend in person, please feel free to conference in:

Number:                 877.226.9790
Participant code:   3020674

As of today, the following RHP 2 stakeholders have indicated plans for DSRIP projects in Pass 2:  1) Angleton-Danbury Medical Center, 2) Burke Center, 3) Gulf Coast Center, 4) Liberty Dayton Regional Medical Center, 5) Nacogdoches Memorial Hospital, 6) Sabine County Hospital, 7) Shriner’s Hospital for Children, 8) Spindletop Center, 9) Tyler County Hospital and 10) The University of Texas Medical Branch at Galveston.

If you plan to participate and are not listed above, please respond by noon tomorrow, Tuesday, November 27, 2012, via e-mail to Bobbie Guyton at: with a cc: to me at:  Please indicate Pass 2 Submission followed by your facility/entity name in the subject line (i.e. Pass 2 Submission-Angleton-Danbury Medical Center).

All Pass 2 project narratives, Pass 2 workbooks and Category 4 requirements are due in final form on/before 5 pm, Friday, December 7, 2012.  Once received, they will be reviewed by the anchor review team and suggested modifications and/or missing requirements will be communicated to each performing provider.  Each performing provider will then have up to 48 hours to make revisions and resubmit a final DSRIP project.  RHP 2’s target submission date to HHSC is the week of December 17, 2012.  It is critical that all providers adhere to this timeline to ensure their project(s) is/are included in the final RHP 2 submission. 

Please Note:  If you are a UTMB Health employee working on a Pass 2 submission, please contact Bobbie Guyton (x29867) or myself (x64047) for specific internal submission instructions.

Thank you,

NOVEMBER 19 Update:

The RHP 2 submission from November 16 is now posted.
[download Pass 1 Waiver Submission from Nov. 16]

Pass 1 Waiver submissionNOVEMBER 15 Update: RHP 2 has completed the Pass 1 Waiver submission.  The regional plan will be delivered to HHSC tomorrow, November 16.

Katrina Lambrecht and Tom Riley join me in extending sincere appreciation to the stakeholders in RHP 2.  Likewise, kudos to the incredible Anchor Construction Team for their diligence and guidance to both the RHP 2 leadership team and the regional partners.

(In photo, left to right are Craig Kovacevich, Katrina Lambrecht and Tom Riley, with the submission).

PLEASE NOTE:  The 1115 Waiver meetings for tomorrow, Friday, November 16, 2012 and next Friday, November 23, 2012 have been cancelled.

At this time, we are tentatively scheduling a meeting for RHP 2 stakeholders participating in Pass 2 DSRIP on Friday, November 30, 2012 at UTMB’s Victory Lakes location in League City.  Details will be sent out closer to the date.  Also, the November 16th RHP 2 submission will be posted on the regional website by close of business, Monday, November 19, 2012.

Have a fantastic evening,

NOVEMBER 15 Update: Dear RHP 2 Stakeholders:

As announced last week, RHP 2 has made it to Pass 2 under the 1115 Medicaid Waiver.  The Anchor Workbook has been completed, and Pass 2 allocations have been determined. 

The total allocation of DSRIP funds moving into Pass 2 for RHP 2 is $129,782,865. 

Per the Pass 2 Allocation Summary, the allocation by provider type follows:

If you fall into one of the above categories, please pay special attention to the Pass 2 Timeline below:

  • By 5 pm CST, Tuesday, November 20, 2012:  Notify UTMB if you are planning to participate in Pass 2 so that we may generate a  Pass 2 workbook for you. Please e-mail Bobbie Guyton ( with a cc: to me ( with Pass 2 Participant followed by your facility/entity name in the subject line (i.e. Pass 2 Participant-Angleton-Danbury Medical Center).  Please also indicate the number of projects you plan to submit for Pass 2.
  • By 5 pm CST, Friday December 7, 2012:   All Pass 2 projects and Pass 2 Workbooks due in final form.  Projects need to be submitted in the same format as Pass 1 projects (narrative and tables).  Please e-mail Bobbie Guyton ( with a cc: to me ( with Pass 2 Submission followed by your facility/entity name in the subject line (i.e. Pass 2 Submission-Angleton-Danbury Medical Center).
  • Special Note:  If you are a UTMB employee working on a Pass 2 submission, please contact Bobbie Guyton for specific internal instructions. 

In light of the fast-approaching holiday season, the RHP 2 Anchor Team is targeting our Pass 2 submission to HHSC on/before Monday, December 17, 2012; therefore the above timeline is critical to us meeting this mid-December date. 

Thank you once again to the many engaged stakeholders in RHP 2 for your hard work and dedication to the 1115 Waiver planning process.  We will post RHP 2’s November 16, 2012 submission to HHSC on our regional website by close of business, Monday, November 19, 2012. 

Thank you,

NOVEMBER 9 Update: Dear RHP 2 Stakeholders:

I am excited to announce that RHP 2 has satisfied both requirements necessary for our region to move to Pass 2!  This provides a wonderful opportunity for additional healthcare transformation efforts within our 16-county region under the Texas Healthcare Transformation and Quality Improvement Program (1115 Medicaid Waiver).

All three RHP 2 Safety Net Hospitals, Baptist Hospital (Beaumont), CHRISTUS St. Elisabeth (Beaumont) and The University of Texas Medical Branch (Galveston), have submitted Pass 1 DSRIP projects, and the region has collectively met the 15% tier 3 private hospital participation requirement.    

Please remember that all finalized Pass 1 DSRIP projects and completed workbooks are due today, Friday, November 09, 2012, by 5 pm CST.  Please send them to me (, with a cc: to Bobbie Guyton (

Again, on behalf of the RHP 2  Anchor Team, I want to thank the regional stakeholders for their continued support of the ever-changing 1115 Waiver planning process.  Additionally, I would like to recognize the tenacious spirit of teamwork and collaboration that has unified 16 diverse counties and brought forth projects that will truly transform healthcare for those who are in most need. 

Andrew Carnegie’s quote, “Teamwork is the ability to work together toward a common vision, the ability to direct individual accomplishments toward organizational objectives and the fuel that allows common people to attain uncommon results,” speaks to what RHP 2 has done, and will continue to do, as we navigate the next four demonstration years of the 1115 Medicaid Waiver TOGETHER. 

Have a fantastic weekend!

  • The minutes are now availble from the November 2, 2012 full Region 2 meeting. [download]


NOVEMBER 8 Update: Dear RHP 2 Stakeholders: Please remember that the RHP 2 deadline for your completed Pass 1 DSRIP projects and workbook is tomorrow, Friday, November 9, 2012, 5:00 pm CST.

If you have completed your certification letter and/or affiliation agreement(s), please send them as well.  If not, the deadline for these items is 5 pm CST, Friday, November 30, 2012.

Any projects/workbooks received after 5 pm CST tomorrow will not be included in next week’s submission to HHSC.  The RHP 2 Anchor team has a very short turnaround time to meet HHSC’s November 16, 2012 Pass 1 deadline.

Also, please see the linked flyer.  We would like to ask that you help by sharing it with your community contacts and posting it in a visible location in your facility. Our October 31, 2012 HHSC submission is posted on the RHP 2 website along with the entire list of proposed DSRIP projects.  The website also allows for public comment.  We will continue to update the site and post all phases of RHP 2’s 1115 Waiver submission.

On behalf of the entire RHP 2 Anchor team, I want to thank each of the stakeholders who have been engaged in the 1115 Waiver planning process and who have brought forth transformational projects that will benefit those in our 16-county region. [get flyer]

NOVEMBER 5 Update: The following is due on/before this Friday, November 9, 2012, 5:00 pm CST:

  1. Final/edited versions of your DSRIP projects for Pass 1 (only those projects with IGT funding needed)
  2. Completed Pass 1 Workbooks
  3. Signed Collaboration Agreements

Please submit the above via e-mail to Craig Kovacevich ( with a cc: to Bobbie Guyton (  If you have these requirements completed and can send them prior to Friday’s deadline, that would be greatly appreciated by the RHP 2 Waiver Team.

If you have questions about this request or about RHP 2’s 1115 Waiver submission, please do not hesitate to contact us by e-mail or phone.  Likewise, Tom Riley (409.772.6637 or and Katrina Lambrecht (409.772.1909 or are also available and most willing to assist.

NOVEMBER 1 Update: Please see the posted agenda for tomorrow’s (Friday, November 2, 2012) regional 1115 Waiver meeting. Meeting details (time, location, teleconference option) are also included on the agenda. We hope you can join us in person or dial-in, as this meeting will provide both an overview of the waiver process thus far and an update of the timeline moving RHP 2 forward towards our next two submission deadlines. [Nov. 2 Meeting Agenda]






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