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Tags Posts tagged with "P4P"

P4P

The PA Office of Developmental Programs (ODP) hosted a Supports Coordination Organization (SCO) Forum to provide status updates and data related to the recently completed desk review for Performance-Based Contracting. All PBC submissions have been scored, and results will be emailed to SCOs shortly, with final results published on the DHS website in January 2026. The new contract cycle is effective from January 1, 2026, to June 30, 2027.

Pay-for-Performance (P4P) and Portal Feedback

  • P4P Updates: Capacity building investments continue, with $3.835 million available for Credentialing and another $3.835 million available for Technology. A total of 45 SCOs submitted for at least one of these two investments.
  • MyPBC Portal: ODP requested feedback on SCOs’ experience using the new MyPBC Portal for submissions.

Notification Letters and the Critical Resolution Process

Notification letters regarding determination are now being sent, which will include a list of any performance measures the SCO did not meet.

  • Mandatory QM Plans: SCOs with unmet measures are required to create and implement a Quality Management Plan (QMP) to meet the standards before the next PBC submission period.
  • Resolution Deadline is Strict: The most crucial detail shared is the deadline for challenging an unmet measure determination. SCOs will have only seven calendar days from the receipt of their determination letter to initiate the Resolution Process.
  • Process Guidance: The Resolution Process is strictly for submitting existing documentation that was inadvertently omitted or contained typographical errors to refute ODP’s determination. This is not an opportunity to create new materials solely to meet the standard, and newly created policies, plans, or comments on the process will not be reviewed.

Top Unmet Measures

The presentation included a breakdown of the top unmet measures across all SCOs, highlighting specific compliance challenges:

Measure Measure Description Number of SCOs Unmet Percent of SCOs Unmet
PCP.01.2 90% compliance with monitoring frequency by waiver type 38 73%
QDI.01.6 Restrictive procedure data is 86% accurate as compared to the most current BSP. 30 58%
RN.01 Register in PA Navigate Resource Platform as a CBO 15 23%

QDI (Quality Data Integrity) Measures: The purpose of QDI measures is to stress that SCOs are the primary source of data collection, and data integrity is essential for data-driven policies. ODP plans to drop these measures over time as performance improves.

  • For QDI.01.1 (Demographic Data), ODP focused on Completeness (86% threshold) this cycle, as checking for both ‘Complete AND Accurate’ resulted in nearly every SCO failing the measure. The threshold is set to increase to 93% for the FY 2027/28 contract cycle.
  • The target for PCP.01.2 (Monitoring Frequency Compliance) is 90% (P/FDS: once every three months; Consolidated/Community Living: once every two months). This threshold is also scheduled to increase to 93% in the FY 2027-2028 contract cycle.

Restrictive Procedures and Dissatisfaction Measures

  • Restrictive Procedures (RP): ODP presented details on the calculation for QDI.01.6, which compares the restrictive procedure checkbox in HCSIS against the most current Behavior Support Plan (BSP) summary text. Data showed a continued overall decrease in the rate of Restrictive Procedures incidents from 2022 to 2024.
  • Dissatisfaction Measure: For the Dissatisfaction Measure, ODP will utilize the data submitted by SCOs (the number of individuals who chose another SCO due to dissatisfaction and the reasons why) to establish a baseline for the measure and determine how to proceed with it in the future.

The presentation slide deck can be found here. SCO Providers are encouraged to continue to submit feedback and questions to ODP via the PBC Inbox.

For questions or comments, please contact Tim Sohosky.

On September 15, 2025, the Office of Developmental Programs (ODP) leadership conducted their fourth SCO Performance-Based Contracting educational session. This session focused on Pay for Performance (P4P) and billing systems changes ODP anticipates. The slide deck for the session can be found here.

The full recording of the session will be posted at a later date to the ODP Performance-Based Contracting (PBC) Resource Page.

Please direct any questions or feedback to Tim Sohosky, RCPA IDD Division Director.

The Office of Developmental Programs (ODP) has begun distributing notifications related to Performance-Based Contracting (PBC) and Pay-for-Performance (P4P) awards to designated representatives of residential providers.

If you have not yet received your PBC or P4P notification, please contact ODP electronically.

If you believe there is a discrepancy in your tier determination or P4P award, please reach out directly to Tim Sohosky for assistance with resolving the issue.

The Office of Developmental Programs (ODP) held a Quarterly Provider Forum today, April 1, to discuss Performance-Based Contracting (PBC) submission status updates and tier assignments, Pay 4 Performance (P4P) status updates, upcoming important dates, stakeholder notification letters, and to announce the new Performance Analysis Services (PAS) vendor. Updated CIE and IM data is available on the forum handouts, as well.

ODP staff shared that 366 residential providers submitted their data for PBC by the deadline of March 15. Submissions included Primary: 307; Select: 33; and Clinically Enhanced: 26. 39 providers failed to submit (receiving DCAPs).

ODP is on schedule with scoring for May. Tier notification letters are anticipated to be sent by May 15, 2025. Provider data was re-run from the first submission period using CY 2024 data; 5 providers from option 1 period advanced tiers and were notified on February 25, 2025.

P4P approval notifications are to be sent no later than April 20, 2025.

For any questions, please contact Tim Sohosky, IDD Division Director, or Cathy Barrick, IDD Policy Analyst.

The Office of Developmental Programs (ODP) reminds providers that submissions for Performance-Based Contracting (PBC) Data and Pay for Performance (P4P) are due on March 15, 2025. Both Data Submission Tools became available on February 15, 2025. It is recommended that Providers complete the required PBC Data Submission tool prior to submitting for P4P, as providers will be given the option in the P4P tool to use the same documents submitted for Credentialing (Primary) and Employment from the PBC tool.

Please view ODPANN 25-019 and ODPANN 25-020 for additional information and details.

Photo by Markus Winkler on Unsplash

The ODP Announcement 25-019, which was issued Friday, February 14, 2025, has been re-issued with a corrected link for the Provider P4P Data Submission Tool Link. The tool is available here. The link in the initial announcement was pointed to the Primary survey. The Primary survey is NOT the P4P Survey.

Please view the announcement for additional information and details.

ODP Announcement 25-020 is to inform residential providers that the link to the Performance-Based Contracting (PBC) Data Submission Tool will be available on February 15, 2025. The Residential Services Provider PBC Data Submission Tool is for all providers who did not submit PBC information in August 2024 and will instead be submitting data and documentation during the current review period (February 15, 2025 – March 15, 2025).

The Data Submission Tool is web-based in QuestionPro and was created as a mechanism for providers of Residential Habilitation, Supported Living, and Life Sharing services to submit data and documentation related to their organization’s performance. In addition to this communication, ODP will send a notification with instructions to applicable residential providers via the QA&I listserv with details for completing the PBC Data Submission Tool.

In addition, ODP Announcement 25-019 informs residential providers that the link to the Pay for Performance (P4P) Data Submission Tool will be available on February 15, 2025. The same P4P Data Submission tool will be used for all tier categories. All responses are captured electronically via data input or document upload. Participation in each area is optional; providers may submit data for one, two, all three initiatives, or none.

It is recommended that providers complete the required Performance-Based Contracting (PBC) Data Submission Tool prior to submitting for P4P, as providers will be given the option in the P4P tool to use the same documents submitted for Credentialing (Primary) and Employment from the PBC tool.

The Provider P4P Data Submission Tool is available here. Again, the tool will be available February 15, 2025.

Please direct any questions about this information to the ODP PBC inbox.