Missouri Price and Quality Transparency Initiative · 2018-12-20 · 14. Step 3 – Strategic...

Missouri Price and Quality Transparency Initiative

December 13, 2018

Housekeeping

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Refine and Enhance —Critical Access Hospitals’ Measures

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Concerns — sample sizes, specific surgical procedures not performed

Meaningful approach on quality measures

Moving Forward

Carve out CAHs as a separate cohort from other hospitals Performance of hospital will be compared to Missouri

average for CAHs Utilize 13 existing measures All measures reported as rates Rolling 36-months Minimum threshold of 25 cases (“Not Enough Cases”

will be stated when below threshold) Source will be claims, NHSN and Quality Collections

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Applicable Measures and Data SourceReducing Harm Measure Source

Pressure Ulcers Claims DataDeath in Low Mortality DRGs Claims DataFalls with Injury Claims DataPost-Operative Deep Vein Thrombosis Claims Data

Infections Measure Source

Catheter-Associated Urinary Tract Infection NHSN and Quality Collections

Central Line-Associated Bloodstream Infection NHSN and Quality Collections

Methicillin-Resistant Staphylococcus Aureus NHSN and Quality Collections

Clostridium Difficile NHSN and Quality Collections

Post-Operative Sepsis Claims DataReadmissions Measure Source

Hospital-Wide Claims DataPneumonia Claims DataCongestive Heart Failure Claims Data

Chronic Obstructive Pulmonary Disease Claims Data

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Implementation Timeline

Extended Preview stage – January 2019 Go-live – February 4, 2019 Aligns with the regularly scheduled quarterly

updates

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How Do I Interpret My Data?

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Upcoming Changes

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What is Not Changing?

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Understanding Your Data

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Power at Your Fingertips — HIDI

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Access to HIDI Database?

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Step 1 – Advantage+

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Step 2 – Quality Tab

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Step 3 – Strategic Quality Initiatives

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Step 4 – Quality and Price Transparency Dashboard

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Step 5 – Finish

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Step 6 – OK

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Step 7 – Patient-Level Information

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Identify Potential Gaps

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Performance Improvement Journey Share data transparently Drill down your patient-level data to identify gaps

Documentation Billing and coding practices Other process issues Identify key process drivers

Who needs to be at the table? Present current results and gaps identified

Focus on the process, not people. Identify solutions and develop an action plan

Communicate potential changes to staff involved and develop a real-time audit process

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Performance Improvement Journey

Provide real-time feedback as issues are identified during the audit process Update action plan accordingly and share results

as needed during monthly meetings Continue using best practice CQI strategies Celebrate successes and learn from challenges!

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Stephen Njenga, MPH, MHA, CPHQ, CPPSDirector of Performance Measurement Compliance

snjenga@mhanet.com573/893-3700, ext. 1325

Peter Rao, MHA, CMPEVice President of Quality Evaluation

& Program Developmentprao@mhanet.com

573/893-3700, ext. 1407

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Contact Information