Payment for DSRIP project performance is based on achievement
of a milestone bundle, outcome, or domain.
(1) A milestone bundle is the compilation of milestones
and related metrics associated with a project in a given demonstration
(2) The amount of the DSRIP to the performer is determined
by the value assigned for the DSRIP project for that demonstration
year and the progress made within the milestone bundle.
(3) To calculate the payment for Categories 1 and 2:
(A) First, a performer must fully achieve a metric
to include that metric in the DSRIP payment calculation.
(B) Second, a milestone is assigned an achievement
(i) 1.0 if all metrics are met;
(ii) 0.75 if at least 75% of the metrics are met;
(iii) 0.5 if at least 50% of the metrics are met;
(iv) 0.25 if at least 25% of the metrics are met; and
(v) zero if less than 25% of the metrics are met.
(C) Third, the achievement values for each milestone
(D) Fourth, the result of subparagraph (C) of this
paragraph is divided by the total possible achievement value of the
(E) Fifth, the value of the DSRIP project for that
demonstration year, as determined under §354.1635(a) of this
division (relating to DSRIP Project Valuation), is multiplied by the
result of subparagraph (D) of this paragraph.
(4) Eligibility for payment for Category 4 performance
is based on the following:
(A) For a payment of up to 5% of its allocation for
the second demonstration year, a performer must submit a status report
to HHSC that describes system changes put in place to prepare for
Category 4 reporting for the duration of the waiver.
(B) For a payment for a domain in the third, fourth,
or fifth demonstration years, a performer must report on all Category
4 measures included in the domain as described in the RHP Planning
(5) A performer may assign different values to Category
3 outcome milestones for the second demonstration year, but for the
third through fifth demonstration year all milestones for an outcome
will be valued equally each year, including both process milestones
and achievement milestones.
(A) A performer must fully achieve metrics associated
with process milestones to receive DSRIP related to those milestones.
(B) To calculate a payment for an achievement milestone:
(i) First, an achievement milestone is assigned an
achievement value of:
(I) 1.0 if the achievement target is achieved;
(II) 0.75 if the achievement target is at least 75%
(III) 0.5 if the achievement target is at least 50%
(IV) 0.25 if the achievement target is at least 25%
(V) zero if achievement target is less than 25% achieved.
(ii) Second, the result in clause (i) of this subparagraph
is multiplied by the value listed in the RHP plan for that particular
(6) If a performer does not complete all milestones
as specified in its RHP plan for a particular demonstration year,
the performer may carry forward the available DSRIP funding associated
with that milestone bundle until the end of the following demonstration
(A) The performer must complete the remaining milestones
during the following demonstration year to receive full payment for
(B) A performer must provide a narrative description
on the status of the missed milestones and outcome improvement targets
and outline the performer's plan to achieve the missed milestones
or targets by the end of the following demonstration year.
(C) This provision does not apply to Category 4.
(7) If a performer does not complete the remaining
milestones as described in paragraph (6) of this section or the Category
4 reporting in its particular year, the associated DSRIP funding is
(8) At no point may a performer receive a DSRIP payment
for a milestone more than two years after the end of the demonstration
year in which the milestone is to be completed according to the RHP
(9) Once the action associated with a metric is reported
by the performer as complete that metric may not be counted again
toward DSRIP payment calculations.
(10) For any DSRIP payment cycle, an IGT entity change
request must be submitted to HHSC no later than the last day of the
associated DSRIP reporting period.