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Medicaid Transformation metrics

Under the Delivery System Reform Incentive Payment (DSRIP) program, Washington State, Accountable Communities of Health, and Medicaid managed care organizations are all accountable for demonstrating improvement toward and attainment of transformation targets. Earning the maximum funding available requires that performance expectations, including reporting activities, are met. 

DSRIP Measurement Guide

The measurement guide describes how performance is measured for all accountable entities participating in the Medicaid Transformation effort through DSRIP. 

In this guide, you will find:

  • Change log
  • Chapter 1: DSRIP program requirements and accountability
  • Chapter 2: statewide accountability
  • Chapter 3: managed care organization accountability
  • Chapter 4: ACH incentives for value-based care
  • Chapter 5: ACH project incentives overall
  • Chapter 6: ACH project incentives - pay-for-reporting
  • Chapter 7: ACH project incentives - pay-for-performance
  • Chapter 8: ACH high-performance incentives
  • Appendix A: glossary of terms
  • Appendix B: resources for monitoring DSRIP progress
  • Appendix C: DSRIP measurement and payment timing
  • Appendix D: ACH VBP incentive calculation examples
  • Appendix E: sample calculation of ACH high-performance incentives
  • Appendix F: DSRIP metric selection and alignment
  • Appendix G: DSRIP quality and outcome metrics
  • Appendix H: ACH project P4P improvement target and AV methodology
  • Appendix I: ACH project P4P metrics - sample AV calculations
  • Appendix J: technical specifications (DSRIP quality and outcome metrics)
  • Appendix K: technical specifications (ACH project P4R metrics)

    Measurement updates and resources

    DSRIP quality and outcome metrics

    Metrics listed in the state's Medicaid Transformation protocols were approved by the Centers for Medicare and Medicaid Services (CMS). These metrics use standard national and/or state specifications. Each technical specification sheet notes the utility of each metric within the DSRIP program.

    ACH pay for reporting metrics

    P4R metrics can help ACHs, partnering providers and the state gain greater insight of how Project 2A and Project 3A are progressing through a short list of site-level indicators.