Common use of At-Risk DSRIP Funding Clause in Contracts

At-Risk DSRIP Funding. A portion of the State’s DSRIP expenditure authority will be at-risk. If MassHealth’s DSRIP expenditure authority is reduced based on an Accountability Score that is less than 100%, then MassHealth will reduce DSRIP payments in proportion to the reduced expenditure authority to ensure sufficient state funding to support the program. This mechanism ensures that all recipients of MassHealth DSRIP funding are accountable to the State achieving its performance commitments. The portion of the State’s DSRIP expenditure authority that is at-risk will follow the same at-risk Budget Period structure as for the ACOs. The Budget Period is January 1 through December 31. The 6-month Preparation Budget Period funds will be equal to half of the State’s allocated DSRIP Year 1 funds. Budget Period 1 funds will be equal to the sum of half of the State’s allocated DSRIP Year 1 funds, and half of DSRIP Year 2 funds. Budget Periods 2 through 4 will be sourced by the same funding pattern as Budget Period 1. Budget Period 5 funds will be equal to half of the State’s allocated DSRIP Year 5 funds. In the Preparation Budget Period and Budget Period 1, 0% of funds will be at-risk. However, in Budget Periods 2 through 5, the portion of at-risk expenditure authority follows the table below: DSRIP Budget Period Prep BP and BP 1 July 1, 2017 – December 31, 2018 BP 2 January 1, 2019- December 31, 2019 BP 3 January 1, 2020- December 2020 BP 4 January 1, 2021- December 31, 2021 BP 5 January 1, 2022- December 31, 2022 DSRIP Expenditure Authority $637.5M $412.5M $362.5M $275M $112.5M % of Expenditure Authority At- Risk 0% 5% 10% 15% 20% Actual Expenditure Authority At- Risk $0M $20.625M $36.25M $41.25M $22.5M State DSRIP Accountability Score: The State will calculate the State’s DSRIP Accountability Score. See DSRIP Protocol Section 5.2. The State DSRIP Accountability will be based on performance in the following domains: MassHealth ACO/APM Adoption Rate Reduction in State Spending Growth ACO Quality and Utilization Performance Each domain will be assigned a domain weight for each performance year, such that the sum of the domain weights is 100% each year. State performance in each domain will be multiplied by the associated weight, and then summed together to create an aggregate score, namely the State’s DSRIP Accountability Score. The State will report its Accountability Score to CMS once it is available, and the score will then be used by the State and CMS to determine whether the State’s DSRIP expenditure authority might be reduced.