Medicaid and CHIP Directed Payment Programs

Directed Payment Programs (DPPs) are designed to help Medicaid managed care programs achieve delivery system and payment reform and performance improvement. Texas Medicaid and CHIP currently administers five DPPs.  The programs must be approved annually by CMS.

• DPP 101: Introduction to CHIRP, TIPPS, RAPPS & DPP BHS Quality Reporting (PDF)
• Annual Evaluations 

Comprehensive Hospital Increase Reimbursement Program (CHIRP)

CHIRP is a directed payment program for hospitals providing healthcare services to adults and children enrolled in STAR and STAR+PLUS. Eligible hospitals include children's hospitals, rural hospitals, mental health hospitals, state-owned hospitals, and urban hospitals.

CMS approved CHIRP on March 25, 2022.

• CHIRP Quality Requirements

Directed Payment Program for Behavioral Health Services (DPP BHS)

The DPP BHS is a directed payment program for community mental health centers to promote and improve access to behavioral health services, care coordination, and successful care transitions. It also incentivizes continuation of care for STAR, STAR+PLUS and STAR Kids members using the Certified Community Behavioral Health Clinic model of care.

CMS approved DPP BHS on Nov. 15, 2021.

• DPP BHS Quality Requirements

Quality Improvement Payment Program (QIPP)

QIPP is an incentive payment program for Texas nursing facilities serving residents enrolled in the STAR+PLUS Medicaid managed care program.

QIPP was first implemented on Sept. 1, 2017.

• QIPP Quality Requirements
• QIPP Scorecards & Payment Information

Rural Access to Primary and Preventive Services Program (RAPPS)

RAPPS is a directed payment program for rural health clinics that provide primary care and long-term care services to STAR, STAR+PLUS, and STAR Kids members.

CMS approved RAPPS on March 25, 2022.

• RAPPS Quality Requirements

Texas Incentives for Physicians and Professional Services (TIPPS)

TIPPS is a directed payment program for certain physician groups providing health care services to children and adults enrolled in the STAR, STAR+PLUS and STAR Kids Medicaid programs. Eligible physician groups include health-related institutions, indirect medical education physician groups affiliated with hospitals and other physician groups.

CMS approved TIPPS on March 25, 2022.

• TIPPS Quality Requirements