Nueces County Hospital District - Medicaid 1115 Waiver: Regional Healthcare Partnership Plan & Stakeholder Resources

Voluntarily improving regional access, quality, cost-effectiveness and collaboration;
Identifying transformation programs, performance metrics, and incentive payments for each participating hospital consistent with the Delivery System Reform Incentive Payment (DSRIP) menu of projects; and
Payment of funds (formerly Upper Payment Limit funding) protected under the Texas Healthcare Transformation and Quality Improvement Program 1115 waiver.

The DSRIP projects may be either three, four, or five years in length and are organized into four Categories, which are interrelated and complementary:

Category 1 - Infrastructure Development: lays the foundation for delivery system transformation through investments in technology, tools, and human resources that will strengthen the ability of providers to serve populations and continuously improve services;
Category 2 - Program Innovation & Redesign: includes the piloting, testing, and replicating of innovative care models;
Category 3 - Quality Improvements: includes outcome reporting and improvements in care that can be achieved within four years; and
Category 4 - Population-focused Improvements: the reporting of measures that demonstrate the impact of delivery system reform investments under the waiver; applicable to hospitals only.

Additional information about DSRIP project Categories is available from HHSC at RHP Planning Protocols.

RHP 4 Plan

The RHP 4 Plan describes DSRIP projects proposed by the hospitals, local mental health authorities, and a public health department located in RHP 4 (Providers). The focus of the Plan is the DSRIP projects; the Plan provides detailed information about those projects. The Plan is submitted to the Texas Health & Human Services Commission (HHSC) and U.S. Department of Health & Human Services, Centers for Medicare & Medicaid Services (CMS).

Original RHP 4 Plan (2012)

To access the RHP 4 Plan originally submitted to HHSC/CMS in 2012, click Original RHP 4 Plan and to access the original Plan's associated data file, click Original RHP 4 Plan Data File. The Original RHP 4 Plan includes the RHP 4 Community Needs Assessment.

Process Used for Adding Three-Year DSRIP Projects to RHP 4 Plan

Three-Year projects are additional Texas 1115 Waiver DSRIP projects selected by Providers in 2013 from Categories 1, 2, or 3 that operate only in Demonstration Years 3, 4, and 5. Funding for the Three-Year Projects comes from unallocated Waiver funds available from those Demonstration Years.

To view the process used by RHP 4 for adding Three-Year DSRIP Projects, click 3-Year Project Selection. The final Three-Year Projects for RHP 4 are available at All RHP's 3-Year DSRIP Projects; sort the linked workbook for RHP 4.

Updated RHP 4 Plan (2015)

To access information about the RHP 4 Plan currently on file with HHSC/CMS, click the links below for the particular DSRIP project information desired:

Category 1 & 2 Projects:

Updated RHP 4 Project Workbooks (workbook);

Category 3 Outcome Selections:

Category 3 Outcome Selections (workbook);

Category 4 Measures (hospitals only):

Potentially Preventable Admissions (PPA) (workbook);
Potentially Preventable Readmissions (PPR) (workbook); and
Potentially Preventable Complications (PPC) (workbook).

Updated RHP 4 Plan Draft (March 2018)

The Anchor Entity is required to present draft changes to the RHP 4 Plan for public review and stakeholder comments. The purpose of the 2018 RHP 4 Plan Update Draft is two-fold. First, it is to reflect the Providers' planned evolution of Demonstration Years 2-6 (DY2-6) DSRIP projects to Demonstration Years 7-8 (DY7-8) Provider-level outcomes; the Draft provides a crosswalk of Provider's DY2-6 discrete projects to the Provider's system-wide activities intended to achieve Provider-level outcomes. Second, it is to show the outcome measure bundles tentatively selected by each Provider to achieve their particular outcomes in DY7-8.

The Draft 2018 RHP 4 Plan Update files are shown in the links list at the bottom of this webpage; click the link to access the file.

HHSC information about the RHP Plan Update is available at RHP Plan Update.

Updated RHP 4 Plan Final (April 2018)

The Anchor Entity is required to present the final version of the 2018 Updated RHP 4 Plan for public review. The purpose of the 2018 RHP 4 Plan Update is two-fold. First, it is to reflect the Providers' final evolution of Demonstration Years 2-6 (DY2-6) DSRIP projects to Demonstration Years 7-8 (DY7-8) Provider-level outcomes; the final version provides a crosswalk of Provider's DY2-6 discrete projects to the Provider's system-wide activities intended to achieve Provider-level outcomes. Second, it is to show the outcome measure bundles final selected by each Provider to achieve their particular outcomes in DY7-8.

The Final 2018 RHP 4 Plan Update files are shown in the links list at the bottom of this webpage; click the link to access the file.

The RHP 4 Plan is subject to change.

File Access

The files shown below are in Adobe PDF format and require Adobe Reader.

Last updated: 5/2/2018