82 FR 17998 - Medicare Program; Funding in Support of the Pennsylvania Rural Health Model-Cooperative Agreement
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services Federal Register Volume 82, Issue 71 (April 14, 2017)
Centers for Medicare & Medicaid Services
Federal Register Volume 82, Issue 71 (April 14, 2017)
| Page Range | 17998-18000 | |
| FR Document | 2017-07555 |
[Federal Register Volume 82, Number 71 (Friday, April 14, 2017)] [Notices] [Pages 17998-18000] From the Federal Register Online [www.thefederalregister.org] [FR Doc No: 2017-07555] ----------------------------------------------------------------------- DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-5523-N] Medicare Program; Funding in Support of the Pennsylvania Rural Health Model--Cooperative Agreement AGENCY: Centers for Medicare & Medicaid Services (CMS), Department of Health and Human Services (HHS). ACTION: Notice. ----------------------------------------------------------------------- SUMMARY: This notice announces the issuance of the January 12, 2017 single-source cooperative agreement funding opportunity announcement to begin the Pennsylvania Rural Health Model's implementation activities, titled ``Funding in Support of the Pennsylvania Rural Health Model Cooperative Agreement'' (the ``Funding Opportunity''). This Funding Opportunity is available solely to the Commonwealth of Pennsylvania acting through the Pennsylvania Department of Health (the ``Commonwealth''). This [[Page 17999]] Funding Opportunity provides the Commonwealth with necessary start-up funding for the Model and is open to the Pennsylvania Department of Health, and, once established, the Rural Health Redesign Center (RHRC) (or in the event that the RHRC is not established, the Pennsylvania Department of Health). DATES: The project period of the initial award, in the amount of $10 million, to the Pennsylvania Department of Health will be 12 months from the date of award. The project period of the second award, in the amount of $15 million, to the RHRC, or to the Pennsylvania Department of Health if the RHRC has not been established, will be 36 months from the date of award. The performance period of the Pennsylvania Rural Health Model began on January 13, 2017, and will conclude on December 31, 2023. FOR FURTHER INFORMATION CONTACT: Stephen Cha, (410) 786-1876. SUPPLEMENTARY INFORMATION: I. Background The Pennsylvania Rural Health Model (the ``Model'') is a new Centers for Medicare & Medicaid Services (CMS) alternative payment model designed to improve health and health care in rural Pennsylvania. Specifically, the Model seeks to increase rural Pennsylvanians' access to high-quality care and improve their health, while also reducing the growth of hospital expenditures across payers, including Medicare fee- for-service, and increasing the financial viability of the State's rural hospitals to ensure continued access to care facilities. The Model will test whether the deliberate care delivery transformation of participating rural hospitals, including critical access hospitals (CAHs), in conjunction with population-based payments to those hospitals (in the form of prospective hospital global budgets for participating payers) improves health outcomes and quality of care for the Commonwealth's rural residents, reduces the growth of hospital expenditures across payers, and improves the financial viability of participant rural hospitals to maintain access to care for the Commonwealth's rural residents. Participation in the model is voluntary for hospitals and payers; and CMS and the Commonwealth will collaborate to achieve participation sufficient to meet the hospital participation and payer participation scale targets in the Model. This Model is being tested by the Center for Medicare and Medicaid Innovation (the ``Innovation Center'') using the authority of the Secretary of the Department of Health and Human Services (the ``Secretary'') in section 1115A of the Social Security Act (the Act). CMS believes that states can be critical partners of the federal government and other health care payers to facilitate the design, implementation, and evaluation of community-centered health systems that can deliver significantly improved cost, quality, and population health performance results for all state residents, including Medicare, Medicaid, and Children's Health Insurance Program (CHIP) beneficiaries. States have policy and regulatory authorities, as well as ongoing relationships with commercial health care payers, health plans, and health care providers that can accelerate delivery system reform. CMS has previously partnered with states to accelerate delivery system reform through initiatives such as the State Innovation Models (SIM) initiative. SIM provides state-based health care transformation efforts with funding to test the ability of states to utilize policy and regulatory levers to advance multi-payer health care payment and delivery system reform models. On January 13, 2017, CMS and the Commonwealth entered into the Pennsylvania Rural Health Model Agreement (the ``State Agreement'') to implement the Pennsylvania Rural Health Model. The performance period of the Model began on January 13, 2017 and will end on December 31, 2023. As part of the Model, the Commonwealth commits to achieving population health outcomes, access and quality targets, financial targets, and rural hospital participation and payer participation scale targets, as defined in the State Agreement. The Commonwealth intends to legislatively authorize and, through the Pennsylvania Department of Health, establish the RHRC to operate certain aspects of the Model. The Funding Opportunity offers up to a total of $25 million in funding to the Commonwealth over a 4-year period, with an initial award to the Pennsylvania Department of Health, and a second award to the RHRC (or to the Pennsylvania Department of Health, if the RHRC is not established in time). The Pennsylvania Department of Health will have the opportunity to apply for the initial award with a project period of one year (one 12-month budget period) from the date of the award. Then the RHRC, if established in time, will have the opportunity to apply for the second award with a project period of 36 months from the date of the award, comprised of three 12-month budget periods. In the event that the RHRC is not established in time, the Pennsylvania Department of Health can apply again as the second award applicant. II. Provisions of the Notice The Funding Opportunity offers $10 million in start-up funding to the Pennsylvania Department of Health to begin the Model's implementation activities, including Model operations, global budget administration, data analytics, technical assistance, quality assurance, and to establish the RHRC (if authorized to do so by Pennsylvania's legislature), to which the Pennsylvania Department of Health may delegate the Model's implementation activities once the RHRC is established. The Funding Opportunity also provides the RHRC (or the Pennsylvania Department of Health, if the RHRC is not established in time) with the opportunity to apply for an additional $15 million to continue implementation activities under the Model. In the event that the RHRC is not established in time, the Pennsylvania Department of Health can apply as the second applicant for the additional $15 million to continue implementation activities under the Model. As set forth in the State Agreement, the Commonwealth commits to achieving population health outcomes, access and quality targets, financial targets, and rural hospital participation and payer participation scale targets. CMS and the Commonwealth aim to transform the rural hospital care delivery system to address community health needs, achieve financial sustainability for rural hospitals, and achieve savings or budget neutrality for payers participating in the Model. Payers and rural hospitals can choose to participate in the Model, and CMS and the Commonwealth expect to work closely together to achieve participation sufficient to meet the hospital participation and payer participation scale targets. Additionally, CMS and the Commonwealth aim for this Model to deliver meaningful improvements in the health of the Commonwealth's rural population by transforming the relationships between and among care delivery and public health systems across the Commonwealth. CMS and the Commonwealth believe the Model can help rural hospitals to succeed, in part by transitioning hospital payments from fee-for-service to, prospective hospital global budgets for participating payers. More information about the Pennsylvania Rural Health Model can be found at: https://innovation.cms.gov/initiatives/pa-rural-health-model/. The Funding Opportunity is open solely to the Pennsylvania Department [[Page 18000]] of Health and to the RHRC (once established). The Pennsylvania Department of Health is uniquely positioned as the initial applicant under the Funding Opportunity based on its existing knowledge of the Model; authority and role in administering the Model; and its existing partnerships and collaborations with Pennsylvania health care providers, payers, and community-based stakeholders. The RHRC (once established) will also be uniquely positioned to meet the goals of the Model (as outlined in the State Agreement), as it will be established specifically to provide implementation support for the Model. III. Collection of Information Requirements This document does not impose information collection requirements, that is, reporting, recordkeeping or third-party disclosure requirements. Consequently, there is no need for review by the Office of Management and Budget under the authority of the Paperwork Reduction Act of 1995 (44 U.S.C. 3501 et seq.). Dated: April 10, 2017. Seema Verma, Administrator, Centers for Medicare & Medicaid Services. [FR Doc. 2017-07555 Filed 4-11-17; 11:15 am] BILLING CODE 4120-01-P
![17998 Federal Register / Vol. 82, No. 71 / Friday, April 14, 2017 / Notices
is used by State agencies who conduct including 2014 psychometric testing meet professionally recognized
certification surveys on CMS’ behalf to and 2015 beta testing of the QHP standards of quality. The QIOs also
maintain information on the facility’s Enrollee Survey. The psychometric review health care services where the
characteristics that facilitate conducting testing helped determine psychometric beneficiary or a representative has
surveys, e.g., determining the size and properties and provided an initial complained about the quality of those
the composition of the survey team on measure of performance for services or is appealing alleged
the basis of the number of ORs/ Marketplaces and QHPs to use for premature discharge.
procedure rooms and the types of quality improvement. Based on Under the current 11th QIO Statement
surgical procedures performed in the psychometric test results, CMS further of Work (SOW), two organizations are
ASC. Form Numbers: CMS–370 and refined the questionnaire and sampling providing services as BFCC QIOs across
CMS–377 (OMB control number: 0938– design to conduct the 2015 beta test of all of the United States. The QIO
0266); Frequency: Occasionally; the QHP Enrollee Survey. CMS evaluation criteria have been revised to
Affected Public: Private Sector— previously obtained clearance for the reflect this national regionalization and
Business or other for-profit and Not-for- 2016 and 2017 administrations of the it is important for CMS to understand
profit institutions; Number of QHP Enrollee Survey. the impact on beneficiaries from this
Respondents: 5,694; Total Annual At this time, CMS is requesting to reorganization. The information will be
Responses: 1,898; Total Annual Hours: renew approval for the information used to evaluate the success of each QIO
627. (For policy questions regarding this collection related to the QHP Enrollee in meeting its contractual requirements
collection contact Erin McCoy at 410– Experience Survey in 2018–2020. These and to understand the experience of
786–2337.) activities are necessary to ensure that Medicare beneficiaries and/or their
3. Type of Information Collection CMS fulfills legislative mandates representative with QIO contract
Request: Revision of a currently established by section 1311(c)(4) of the mandated work. Form Number: CMS–
approved collection; Title of Affordable Care Act to develop an 10393 (OMB Control number: 0938–
Information Collection: Consumer ‘‘enrollee satisfaction survey system’’ 1177); Frequency: Once; Affected
Experience Survey Data Collection; Use: and provide such information on Public: Individuals or households;
Section 1311(c)(4) of the Affordable Marketplace Web sites. CMS is also Number of Respondents: 24,970;
Care Act requires the Department of seeking approval to remove eight survey Number of Responses: 24,970; Total
Health and Human Services (HHS) to questions beginning with the 2018 Annual Hours: 2,899. (For policy
develop an enrollee satisfaction survey survey administration. With the removal questions regarding this collection,
system that assesses consumer of these eight questions, the revised contact David Russo at 617–565–1310.)
experience with qualified health plans total estimated annual burden hours of Dated: April 11, 2017.
(QHPs) offered through an Exchange. It national implementation of the QHP William N. Parham, III,
also requires public display of enrollee Enrollee Survey is 22,523 hours with
Director, Paperwork Reduction Staff, Office
satisfaction information by the 90,015 responses. The revised total of Strategic Operations and Regulatory
Exchange to allow individuals to easily annualized burden over three years for Affairs.
compare enrollee satisfaction levels this requested information collection is
[FR Doc. 2017–07568 Filed 4–13–17; 8:45 am]
between comparable plans. HHS 67,569 hours and the total average
BILLING CODE 4120–01–P
established the QHP Enrollee annualized number of responses is
Experience Survey (QHP Enrollee 270,045 responses. Form Number:
Survey) to assess consumer experience CMS–10488 (OMB Control Number: DEPARTMENT OF HEALTH AND
with the QHPs offered through the 0938–1221); Frequency: Annually; HUMAN SERVICES
Marketplaces. The survey include topics Affected Public: Public sector
to assess consumer experience with the (Individuals and Households), Private Centers for Medicare & Medicaid
health care system such as sector (Business or other for-profits and Services
communication skills of providers and Not-for-profit institutions); Number of
ease of access to health care services. Respondents: 90,015; Total Annual [CMS–5523–N]
CMS developed the survey using the Responses: 90,015; Total Annual Hours:
Medicare Program; Funding in Support
Consumer Assessment of Health 22,523; (For policy questions regarding
of the Pennsylvania Rural Health
Providers and Systems (CAHPS®) this collection contact Nidhi Singh-
Model—Cooperative Agreement
principles (https://www.ahrq.gov/ Shah at 301–492–5110.)
cahps/about-cahps/principles/ 4. Type of Information Collection AGENCY: Centers for Medicare &
index.html) and established an Request: Revision of a previously Medicaid Services (CMS), Department
application and approval process for approved collection; Title of of Health and Human Services (HHS).
survey vendors who want to participate Information Collection: Beneficiary and ACTION: Notice.
in collecting QHP enrollee experience Family Centered Data Collection; Use:
data. The CMS Quality Improvement SUMMARY: This notice announces the
The QHP Enrollee Survey, which is Organization (QIO) Program includes issuance of the January 12, 2017 single-
based on the CAHPS® Health Plan Beneficiary and Family Centered Care source cooperative agreement funding
Survey, will be used to (1) help (BFCC) QIOs whose functions, as set opportunity announcement to begin the
consumers choose among competing forth in Section 1862(g) of the Social Pennsylvania Rural Health Model’s
health plans, (2) provide actionable Security Act, are to improve the implementation activities, titled
‘‘Funding in Support of the
sradovich on DSK3GMQ082PROD with NOTICES
information that the QHPs can use to effectiveness, efficiency, economy, and
improve performance, (3) provide quality of services delivered to Medicare Pennsylvania Rural Health Model
information that regulatory and beneficiaries. To accomplish these Cooperative Agreement’’ (the ‘‘Funding
accreditation organizations can use to goals, the QIOs review health care Opportunity’’). This Funding
regulate and accredit plans, and (4) services funded under Medicare to Opportunity is available solely to the
provide a longitudinal database for determine whether those services are Commonwealth of Pennsylvania acting
consumer research. CMS completed two reasonable, medically necessary, through the Pennsylvania Department of
rounds of developmental testing furnished in the appropriate setting, and Health (the ‘‘Commonwealth’’). This
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![18000 Federal Register / Vol. 82, No. 71 / Friday, April 14, 2017 / Notices
of Health and to the RHRC (once DEPARTMENT OF HEALTH AND for national level estimates of service
established). The Pennsylvania HUMAN SERVICES quality, nor inferences about children
Department of Health is uniquely who enter the program after 15 months
positioned as the initial applicant under Administration for Children and of age. To fill these knowledge gaps and
the Funding Opportunity based on its Families to answer additional questions about
existing knowledge of the Model; how programs function, the proposed
authority and role in administering the [OMB NO.: 0970–0354]
Baby FACES 2018 design will include a
Model; and its existing partnerships and cross-section of a nationally
collaborations with Pennsylvania health Proposed Information Collection
Activity; Comment Request; The Early representative sample of programs,
care providers, payers, and community-
Head Start Family and Child centers, home visitors, teachers,
based stakeholders. The RHRC (once
Experiences Survey 2018 (Baby classrooms, children and families. This
established) will also be uniquely
positioned to meet the goals of the FACES 2018) will allow nationally representative
Model (as outlined in the State estimates at all levels at a point in time
Description: The Administration for and will include the entire age span of
Agreement), as it will be established Children and Families (ACF) at the U.S.
specifically to provide implementation enrolled children.
Department of Health and Human
support for the Model. Services (HHS) seeks approval to collect The goal of this work is to obtain
III. Collection of Information descriptive information for the Early updated information on EHS programs
Requirements Head Start Family and Child and understand better how program
Experiences Survey 2018 (Baby FACES processes support relationships (e.g.,
This document does not impose between home visitors and parents,
2018). This information collection is to
information collection requirements,
provide nationally representative data between parents and children, and
that is, reporting, recordkeeping or
on Early Head Start (EHS) programs, between teachers and children) which
third-party disclosure requirements.
centers, classrooms, staff, and families are hypothesized to lead to improved
Consequently, there is no need for
to guide program planning, technical child and family outcomes.
review by the Office of Management and
assistance, and research. The proposed Respondents: Early Head Start
Budget under the authority of the
data collection builds upon a prior
Paperwork Reduction Act of 1995 (44 program directors, child care center
study (Baby FACES 2009; OMB 0970–
U.S.C. 3501 et seq.). directors, teachers and home visitors,
0354) that longitudinally followed two
Dated: April 10, 2017. and parents of enrolled children.
cohorts of children through their
Seema Verma, experience in the program. While that
Administrator, Centers for Medicare & study provided a great deal of
Medicaid Services. information about program participation
[FR Doc. 2017–07555 Filed 4–11–17; 11:15 am] over time and about services received by
BILLING CODE 4120–01–P children and families, it did not allow
ANNUAL BURDEN ESTIMATES
[2-Year clearance]
Total Annual Number of Average Annual burden
Instrument number of number of responses per burden hours hours
respondents respondents respondent per response
Classroom/home visitor sampling form from EHS staff ...... 563 282 1 .17 48
Child roster form from EHS staff ......................................... 563 282 1 .33 93
Parent consent form ............................................................ 2,475 1,238 1 .17 210
Parent survey ....................................................................... 2,475 1,238 1 .5 619
Parent Child Report (PCR) .................................................. 2,475 1,238 1 .25 309
Staff survey (Teacher survey and Home Visitor survey) .... 1,575 788 1 .5 394
Staff Child Report (SCR) ..................................................... 1,238 619 2 .25 310
Program director survey ...................................................... 150 75 1 .5 38
Center director survey ......................................................... 450 225 1 .33 74
Estimated Total Annual Burden Promenade SW., Washington, DC 20447, the quality, utility, and clarity of the
Hours: 2,095. Attn: OPRE Reports Clearance Officer. information to be collected; and (d)
In compliance with the requirements Email address: OPREinfocollection@ ways to minimize the burden of the
of Section 3506(c)(2)(A) of the acf.hhs.gov. All requests should be collection of information on
Paperwork Reduction Act of 1995, the identified by the title of the information respondents, including through the use
Administration for Children and collection. of automated collection techniques or
Families is soliciting public comment The Department specifically requests other forms of information technology.
on the specific aspects of the comments on (a) whether the proposed Consideration will be given to
sradovich on DSK3GMQ082PROD with NOTICES
information collection described above. collection of information is necessary comments and suggestions submitted
Copies of the proposed collection of for the proper performance of the within 60 days of this publication.
information can be obtained and functions of the agency, including
Mary Jones,
comments may be forwarded by writing whether the information shall have
to the Administration for Children and practical utility; (b) the accuracy of the ACF/OPRE Certifying Officer.
Families, Office of Planning, Research agency’s estimate of the burden of the [FR Doc. 2017–07602 Filed 4–13–17; 8:45 am]
and Evaluation, 370 L’Enfant proposed collection of information; (c) BILLING CODE 4184–22–P
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Document Created: 2017-04-14 00:56:28
Document Modified: 2017-04-14 00:56:28
| Category | Regulatory Information | |
| Collection | Federal Register | |
| sudoc Class | AE 2.7: GS 4.107: AE 2.106: | |
| Publisher | Office of the Federal Register, National Archives and Records Administration | |
| Section | Notices | |
| Action | Notice. | |
| Dates | The project period of the initial award, in the amount of $10 million, to the Pennsylvania Department of Health will be 12 months from the date of award. The project period of the second award, in the amount of $15 million, to the RHRC, or to the Pennsylvania Department of Health if the RHRC has not been established, will be 36 months from the date of award. The performance period of the Pennsylvania Rural Health Model began on January 13, 2017, and will conclude on December 31, 2023. | |
| Contact | Stephen Cha, (410) 786-1876. | |
| FR Citation | 82 FR 17998 |
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