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MA DSRIP ACO/CP Semi-Annual Report Form

Thank you for completing your MA DSRIP TA Project bi-annual report form. Please note that TA Project progress is assessed according to the Scope of Work (SOW) and budget approved by Abt Associates (the Managing Vendor) and MassHealth prior to the start of project work. Copies of these documents are on file with Abt/MassHealth; we will reference them as we review your report.

1. ACO/CP Name: *This question is required.

2. TA Project Title *This question is required.

3. TA Application ID: *This question is required.

4. Please identify the person in your ACO or CP who is directly accountable for the progress and successful completion of the requested TA. *This question is required.

Name
Title
Organization
Email
Phone Number

5. TA Vendor who is providing this TA: *This question is required.

6. Please provide the start and end dates of this TA Project. *This question is required.

7. Has this TA Project ended? *This question is required.

8. Please identify the time period to which this report applies. *This question is required.

9. Have you acheived the TA Project milestones outlined for this reporting period? *This question is required.

10. If not, why have you not met the TA Project milestones for this reporting period? Please answer in as little or as much detail as you deem necessary. *This question is required.

10. Are you on budget for this reporting period? *This question is required.

11. If not, what is the reason for the variance from the anticipated budget? Please answer in as little or as much detail as you deem necessary. *This question is required.

11. Are you on track to achieve the TA Project milestones outlined for the next reporting period? *This question is required.

12. If not, why do you anticipate not achieving the project milestones outlined for the remainder of the project? Please answer in as little or as much detail as you deem necessary. *This question is required.

12. Do you anticipate being on budget for the next reporting period? *This question is required.

13. If not, why do you anticipate that you will not be on budget for the remainder of the reporting period? Please answer in as little or as much detail as you deem necessary. *This question is required.

13. How would you rate your experience with your TA Vendor during this reporting period? *This question is required.

14. Optional: please provide any additional information to explain your response to question 13.

15. Optional: please provide any recommendations that you have to improve the TA Program.

16. Would a conversation with MassHealth and Abt be helpful at this time? *This question is required.

Thank you!

The following questions apply only to those TA Projects that were completed during the current reporting period.

17. What was the impact of this project? What is your ACO or CP able to do now that it couldn’t do before? Please be sure to quantify impacts, as appropriate and to the extent possible, and/or to share anecdotes that illustrate the effect this project has had on your organization and the members you serve.

18. What are the identified competency areas that this project was intended to strengthen? In what ways did the project succeed in strengthening these competency areas? If one or more of the competency areas were not strengthened, please explain.

19. Please identify any resources developed via this project – e.g. training, curricula, databases/datasets, screening tools, etc. – that could benefit ACOs and CPs more broadly.

20. Please identify any “lessons learned” from this project work that could benefit ACOs or CPs more broadly.

21. Were there any unexpected benefits associated with pursuing this project? Did the experience of working on this project shift your thinking related to your broader ACO or CP efforts? If so, please explain.