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Tags Posts tagged with "Performance-Based Contracting"

Performance-Based Contracting

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After reviewing hundreds of comments from stakeholders, the Office of Developmental Programs (ODP) has made some initial adjustments to the proposed Performance-Based Contracting waiver for Residential Services. Areas with high volumes of comments included:

  • Select/Clinically Enhanced Tiers being reserved for agencies serving 10 or more individuals;
  • Competitive Integrated Employment standards;
  • Populations served with average Needs Level 4.5+ and average Health Care Level 3.5+ (HCL is established using the Health Risk Screening Tool);
  • Primary providers being limited to Needs Group 1-3;
  • The number of measures; and
  • The timeline for implementation.

ODP is now offering Residential providers a choice of when they are assigned into a tier. This will be based on which data they chose for ODP to review and make a tier determination upon. The choices will be:

  • Calendar year 2023 data reviewed with notification of tier assignment occurring in November, to be effective January 1, 2025 – June 2026; or
  • Review of Calendar year 2024 data with notification of tier assignment occurring in May, to be effective July 2025 – July 2026.

ODP plans to continue their review of public comments and intends to publish additional information. On July 19, ODP hopes to submit amended the 1915(c) waivers and 1915(b)4 waiver as well as publish the following supporting documents:

  • Performance Standards;
  • Implementation Plan;
  • Attestation; and
  • Provider Data Submission Tool.

On January 1, 2025, ODP intends to begin Performance-Based Contracting (pending CMS approval).

ODP will conduct a webinar for residential providers on Monday, July 22, 2024, from 3:00 pm – 4:00 pm, to review publications, changes made as a result of public comment, and instructions for tier determination and data submission. Register here. This webinar will be posted on the PBC Resource Page located on the MyODP website.

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Photo by Markus Winkler on Unsplash

Today, both the ISAC Performance Review Subcommittee and the Medical Assistance Advisory Committee (MAAC) meetings were held. During these meetings, the Office of Developmental Programs (ODP) announced that as a result of public comments received regarding Performance-Based Contracting, some adjustments are being made to the plans. Tomorrow, ODP will release an announcement with more details, but for now, we know the following:

  • Residential providers will be offered a choice of when they are assigned into a tier. This will be based on which data they chose for ODP to review and make a tier determination upon. The choices will be:
    • Calendar year 2023 data reviewed with notification of tier assignment occurring in November, to be effective January 1, 2025 – June 2026; or
    • Review of Calendar year 2024 data with notification of tier assignment occurring in May, to be effective July 2025 – July 2026.

ODP plans to submit the proposed waiver to CMS on July 19, 2024.

In addition, the presentation from the MAAC meeting can be found here.

Documents from the Performance Review Subcommittee can be found below:

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July 11, 2024
1:00 pm – 2:00 pm
Register Here

Join RCPA to learn about enabling technology to support independent living and how SimplyHome aligns with performance-based contracting. SimplyHome designs and installs innovative and affordable technology solutions that transform how we care for individuals with disabilities, aging adults, and veterans. Their technology empowers individuals to live their own self-determined lifestyle while addressing the concerns of caregivers.

We will hear from Kristie Ondisco, PA/OH Representative, and Matt Wright, Enterprise Director of Sales.

Register here for this informative session. If you have any questions, contact Carol Ferenz.

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July 11, 2024
1:00 pm – 2:00 pm
Register Here

Join RCPA to learn about enabling technology to support independent living and how SimplyHome aligns with performance-based contracting. SimplyHome designs and installs innovative and affordable technology solutions that transform how we care for individuals with disabilities, aging adults, and veterans. Their technology empowers individuals to live their own self-determined lifestyle while addressing the concerns of caregivers.

We will hear from Kristie Ondisco, PA/OH Representative, and Matt Wright, Enterprise Director of Sales.

Register here for this informative session. If you have any questions, contact Carol Ferenz.

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The Information Sharing and Advisory Committee (ISAC) met today, June 11, 2024. Deputy Secretary Ahrens presented an update regarding Performance-Based Contracting. The office received comments from approximately 100 commentators, resulting in over 700 separate comments regarding the proposed Selective Contracting Waiver.

The Office of Developmental Programs (ODP) has released several tools for providers to utilize and has scheduled four summits to delve deeper into the specifics for the performance measures. Providers who do not meet all standards for the Primary category but are not in the conditional status will be placed in the Primary category with a corrective action plan required. Residential provider agreements will not need to be returned to ODP until the end of July, rather than June, as previously stated.

There are several federal rules that have been finalized recently, and Deputy Secretary Ahrens gave an overview of these.

Candi Walton reported on Recommendation #4: Support Families Throughout the Lifespan.

StationMD presented an overview of their services. Geoff Musti can be reached via email for more information.

Lauren House presented information on Recommendation #10: Expanding Housing Options and the ODP Housing Pilot Update.

Dr. Greg Cherpes provided an update on Recommendation #5: Promote Health, Wellness, and Safety & Recommendation, and Recommendation #6: Support People with Complex Need. Note that both recommendations are included in the same document.

For any questions, contact Carol Ferenz.

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Today, June 10, the Office of Developmental Programs (ODP) held the second of four Provider Preparedness Summits for Residential Providers. More discussion on specific performance standards for Performance-Based Contracting took place. The PowerPoint is now available, and a recording of the session will be posted shortly on the MyODP website.

ODP staff in attendance answered many questions submitted by providers, and the discussion was primarily focused on staff credentialing. Credentialing is unique to the DSP, is portable, and requires recertification every two years. A quick google search on NADSP will provide a thorough e-badge handbook.

There are two additional summits planned, and ODP will be recording each summit. Providers are encouraged to attend all four sessions as well as watch a pre-recorded webinar. All of these resources can be found on the MyODP website.

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Today, June 3, the Office of Developmental Programs (ODP) held the first of four Provider Preparedness Summits for Residential Services providers. The purpose of the summits are to take a deeper dive into the specifics that are being proposed for implementation of performance-based contracting (PBC).

The PowerPoint is now available, and a recording of the session will be posted shortly on the MyODP website.

ODP staff in attendance answered many questions submitted by providers. One of the key takeaways from today’s summit is that ODP will be postponing the due date for residential provider agreements to be signed and submitted to ODP. Originally, they were projected to be due by June 30, 2024; however, ODP has now stated that the due date will be July 31, 2024. The agreement has not yet been published, but it is expected to be released tomorrow, June 4, 2024.

There are three additional summits planned, and ODP will be recording each summit. Providers are encouraged to attend all four sessions as well as watch a pre-recorded webinar. All of these resources can be found on the MyODP website.

Contact Carol Ferenz for further information.

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RCPA has gathered feedback from our members in multiple forums and attended several listening sessions hosted by the Office of Developmental Programs (ODP) in order to hear and compile public comments on the proposed implementation of performance-based contracting (PBC) for Residential Services and waiver amendments to the Consolidated, Community Living, and Person/Family Directed Waivers. After reviewing all of the available information, we have submitted our comments to ODP.

Our members support the ideal of assuring quality services for individuals with ID/A that are integrated and person centered, enabling individuals to experience more independence and choices in their lives. Additionally, we are in favor of limiting the provider pool to only those providers that are able to demonstrate quality service provision.

RCPA wants to support this program for two reasons. First, any initiative by ODP that focuses on improving quality in the system is something we all should stand behind. Second, alternative reimbursement strategies with enhanced rates and additional funding based on quality and outcomes is certainly more innovative and progressive than traditional fee-for-service. It is time for the IDD system to move toward reimbursement policies that reward providers who are progressive in their service provision.

We are, however, concerned about the speed with which this incredibly complex systemic change is proposed to occur, and the amount of performance standards and measures proposed in this plan.

RCPA’s complete letter can be read here. For any questions, contact Carol Ferenz, Director, IDD Division.

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Photo by Markus Winkler on Unsplash

The Office of Developmental Programs (ODP) has shared a reissue of ODPANN 24-039, which highlights the proposed performance-based contracting waiver amendments and rates. It was brought to ODP’s attention that there were several items that needed clarification within the original document. All changes are in red. Please only use this version going forward.

The reissue has updated the links for submitting comments. All other information remains consistent with the original ODP Announcement.

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