The Texas Incentives for Physicians and Professional Services program is one of four directed payment programs (DPPs) HHSC submitted to the Centers for Medicare and Medicaid Services (CMS) for approval as part of the Delivery System Reform Incentive Payment Transition Plan. CMS approved TIPPS for state fiscal year (SFY) 2022 (Year [Y] 1) on March 25, 2022. CMS approved TIPPS for SFY 2023 (Y2) on August 1, 2022.
Background
TIPPS is a DPP for certain physician practice groups providing health care services to children and adults enrolled in the STAR, STAR+PLUS and STAR Kids Medicaid managed care programs. Eligible physician practice groups include health-related institutions (HRIs), indirect medical education (IME) physician practice groups affiliated with hospitals and other physician practice groups.
The program includes three components:
- Component 1: Uniform dollar increase paid monthly that includes structure measures on quality improvement activities. Physician practice groups affiliated with a HRI or a hospital receiving the IME add-on are eligible for Component 1.
- Component 2: Uniform rate enhancement paid semiannually that includes measures focused on primary care and chronic care. Physician practice groups affiliated with a HRI or hospital receiving the IME add-on are eligible for Component 2.
- Component 3: Uniform rate enhancement for certain outpatient services that includes measures focused on maternal health, chronic care, behavioral health, and Social Determinants of Health. All physician practice groups are eligible for Component 3.
Proposed SFY 2024 (Y3) Measures and Requirements
HHSC will conduct an online public hearing on Jan. 11, 2023, at 10:30 a.m. CST to receive public comment on proposed quality measures and reporting requirements for SFY 2024 (Y3) of TIPPS. Additional information on the hearing is available on the HHS Meetings & Events Page.
This hearing will be conducted online only and will not have a physical location. Please register for this hearing at this link.
Briefing Packet
- Proposed Y3 Requirements (PDF)(12/30/2022)
- Proposed Y3 Measure Specifications (Excel) (12/30/2022)
Written Public Comments
Written comments regarding the proposed quality measures and reporting requirements may be submitted until 11:59 p.m. on Jan. 27, 2023 at this link.
SFY 2023 (Y2) Measures, Requirements, and Evaluation
- Y2 Requirements (PDF) (8/09/2022)
- TIPPS Taxonomy Code Changes for Y2 (PDF) (1/10/2022)
- Y2 Measure Specifications (Excel) (9/23/2022)
- Y2 Measure Specifications FAQs (Excel)(9/23/2022)
- Stakeholder Feedback for Y2 (PDF)(3/1/2022)
- Y2 Evaluation Plan (PDF) (3/31/2022)
SFY 2022 (Y1) Measures, Requirements, and Evaluation
- Y1 Requirements (PDF) (4/8/2022)
- Y1 Measure Specifications (Excel) (8/09/2022)
- Y1 Measure Specifications FAQs (Excel) (8/09/2022)
- Stakeholder Feedback for Y1 (PDF) (3/8/2021)
- Y1 Provider-Reported Data (Excel) (10/27/2022)
- Y1 Evaluation Plan (PDF) (10/31/2021)
- Preliminary Y1 Evaluation Report (PDF) (3/31/2022)
Rules
Contact Information
- Visit the HHSC Provider Finance Department website for more enrollment, eligibility and payment information for TIPPS.
- For program eligibility and financial questions, email pfd_tipps@hhs.texas.gov
- For questions on TIPPS quality requirements and reporting, email DPPQuality@hhs.texas.gov.