I. Preface 2 A. DSRIP Planning Protocol and Funding and Mechanics Protocol 2 B. High Level Organization of “Attachment H: Program Funding and Mechanics Protocol” 2 C. DSRIP Eligibility Criteria 2 Table I. Participating Hospitals Eligible for DSRIP Payments 3 II. Hospital DSRIP Plans Applicable for Demonstration Years 6-8 4 A. Hospital DSRIP Plans 4 B. NJ Pre-Determined Menu of Areas 4 Table II. Participating DSRIP Hospitals, Focus Areas, and Projects PPProjectsPProjectsProjects 5 III. Reporting Requirements 6 7 77 A. Participating Hospital Reporting for Payment in DY6-DY8 7 77 B. State Reporting and Communications with CMS 11 IV. Hospital’s Target Funding Amount 12 A. Demonstration Years 6-8 12 B. Table III. Participating Hospitals Funding Target 12 V. Allocation of a Hospital’s Adjusted DSRIP Target Funding Amount to Stages 13 IV. Total DSRIP Funding Distributable to Demonstration Years YeYerIs………………………….. 14 Table V. DSRIP Stage Funding Distribution 14 VI. DSRIP Payment Based on Achievement of Milestones and Metrics 15 A. General Requirements 15 B. Milestone and Measure Valuation 15 C. Experience Period 18 Table VI. DSRIP Experience Time Periods, By Demonstration Year 18 D. Reporting Completion of Measures/Milestones 19 VII. DSRIP Payment Calculations: DY6-DY8 19 A. Calculating Payments for Stages 1 and 2 21 B. Calculating Payments for Quality Improvement Stage Project-Specific Metrics 22 Table VII. DSRIP Pay for Performance Improvement Calculation 25 C. Calculating DSRIP Payments for Population Focused Improvement Stage: Performance Indicators (i.e. Universal Metrics) 27 D. Forfeiture of DSRIP Payments and Appeals 33 VIII. Mergers, Acquisitions, and Business Combinations 34 IX. Program Management and Modification 36
Line Description Example Calculation 1 DY6 Measure Value [baseline] 50.00 2 DY7 Required Rate of Improvement 1.02 3 DY7 Expected Improvement Target Goal [Line 1 multiplied by Line 2] 51.00 4 DY8 Required Rate of Improvement 1.02 5 DY8 Expected Improvement Target Goal [Line 4 multiplied by Line 3] 52.02 DSRIP Universal Performance Pool All participating will be eligible for the Universal Performance Pool (UPP). The UPP will be made of the following For DY6-DY8: Hospital DSRIP Target Funds from hospitals that elected to not participate. The percentage of the total DSRIP funds set aside for the UPP, known as the Carve Out Allocation amount set at 25% of each hospitals funding target as shown in able II. Target Funds that are forfeited from hospitals that do not achieve project activities/metrics Forfeited amounts from hospitals electing to discontinue participation in the Program. The total UPP amount determined above will be distributed to hospitals based on maintaining or improving on a specific set of twelve Population Focused Improvement metrics identified as a UPP metric. As some hospitals may not have service areas required to calculate one or more of the twelve UPP metrics, these hospitals must substitute those metrics for one or more of the four replacement UPP metrics, not to exceed twelve total metrics. See DSRIP Planning Protocol, Addendum 2 for a list of the twelve UPP metrics and the four UPP replacement metrics. The baseline performance periods from which the UPP will be calculated will be included in the Planning Protocol as it is updated with the atabook. All hospitals must have a total of twelve UPP measures and only those hospitals that lack obstetrical (OB) or pediatric departments must choose substitute measures from the substitution list. These (non-OB/non-pediatric)