Data Collection Support Webinar MetaStar, Inc. April 18, 2007 Carol Ferguson Pam Clemens

Data Collection Support Data Collection Support WebinarWebinar

MetaStar, Inc.April 18, 2007

Carol FergusonPam Clemens

AnnouncementsAnnouncementsInvalid Record Selection UpdateInvalid Record Selection Update

Good news!Good news!

Discussed on last month’s call in detailDiscussed on last month’s call in detail

Thanks to Candi bringing the increased Thanks to Candi bringing the increased volume of these errors to CMS attentionvolume of these errors to CMS attention

CMS is looking at it “very seriously”CMS is looking at it “very seriously”

Keep your fingers crossedKeep your fingers crossed

AnnouncementsAnnouncementsQIO Clinical Warehouse Known IssuesQIO Clinical Warehouse Known Issues

Go to www.qualitynet.org home pageGo to www.qualitynet.org home page

Click hospitals, then data submission, then Click hospitals, then data submission, then notificationsnotifications

AnnouncementsAnnouncementsPublic Reporting Preview PeriodPublic Reporting Preview Period

For Qtr 4 2005 – Qtr 3 2006For Qtr 4 2005 – Qtr 3 2006Preview period April 17 – May 16Preview period April 17 – May 16Download your report from QNet inboxDownload your report from QNet inboxReview carefully!Review carefully!Contact Pam if you have concerns Contact Pam if you have concerns PPS hospitals – may not withhold any measures PPS hospitals – may not withhold any measures without penaltywithout penaltyCAH – new withhold form on QNet, submit to CAH – new withhold form on QNet, submit to Pam Pam

AnnouncementsAnnouncements Mortality Measures Reporting Mortality Measures Reporting

Contrary to previous information, there will Contrary to previous information, there will NOT be a new pledge form requiredNOT be a new pledge form required

Reporting to begin October 2007Reporting to begin October 2007

Contact [email protected] Contact [email protected] with questionswith questions

AnnouncementsAnnouncementsSubmitting Questions to QuestSubmitting Questions to Quest

Search Quest (on QNet web site, home Search Quest (on QNet web site, home page, lower right) thoroughly before asking page, lower right) thoroughly before asking a questiona question

Contact QNet Help Desk to check on status Contact QNet Help Desk to check on status of a question you askedof a question you asked

They received 2,964 questions in February!They received 2,964 questions in February!

Clarifications/UpdatesClarifications/UpdatesWho Does MetaStar Send Information To?Who Does MetaStar Send Information To?

Following categories:Following categories:Data Collection Support webinar – sign-upData Collection Support webinar – sign-up

HQA contact – per pledge formHQA contact – per pledge form

RHQDAPU contact – per pledge formRHQDAPU contact – per pledge form

Hospital data contactHospital data contact

Quality directorQuality director

CEO/Administrator – usually only if directed CEO/Administrator – usually only if directed by CMSby CMS

Clarifications/UpdatesClarifications/UpdatesWho Does MetaStar Send Information To?Who Does MetaStar Send Information To?

If you want changes:If you want changes:Coordinate request internally, we suggest you Coordinate request internally, we suggest you work it out through the Quality Directorwork it out through the Quality DirectorOne person from a hospital send e-mail to One person from a hospital send e-mail to [email protected]@metastar.comTitle on e-mail: Contact changesTitle on e-mail: Contact changesList any additions or deletions in a categoryList any additions or deletions in a category

Person’s name, title, hospital name, e-mail address, Person’s name, title, hospital name, e-mail address, categorycategory

Clarifications/UpdatesClarifications/UpdatesSCIP Sampling Changes for Qtr 4 2006SCIP Sampling Changes for Qtr 4 2006

SCIP cases selected by primary OR SCIP cases selected by primary OR secondary diagnosissecondary diagnosis

Clarifications/UpdatesClarifications/UpdatesNext Data Due DateNext Data Due Date

Next data due to QIO Clinical Warehouse Next data due to QIO Clinical Warehouse on May 15on May 15

Checklist provided by MetaStar with Checklist provided by MetaStar with today’s materials will help you organizetoday’s materials will help you organize

Don’t wait until last minute!Don’t wait until last minute!

Most Common Abstraction ErrorsMost Common Abstraction ErrorsPneumonia (n = 378)Pneumonia (n = 378)

Initial Blood Culture Time – 17.2%Initial Blood Culture Time – 17.2%Not following abstraction instructions – 24Not following abstraction instructions – 24Parent element mismatch - 6Parent element mismatch - 6Abstractor answer not found in record – 4Abstractor answer not found in record – 4Abstractor missed information – 4Abstractor missed information – 4

Arrival Time – 11.1%Arrival Time – 11.1%Not following abstraction instructions – 16Not following abstraction instructions – 16Abstractor missed information – 12Abstractor missed information – 12Abstractor answer not found in record – 8 Abstractor answer not found in record – 8 Parent element mismatch – 6Parent element mismatch – 6


Working Diagnosis of Pneumonia – 4.2%Working Diagnosis of Pneumonia – 4.2%Not following abstraction instructions – 10Not following abstraction instructions – 10

Abstractor answer not found in record – 7Abstractor answer not found in record – 7

Abstractor missed information – 3Abstractor missed information – 3

Healthcare Associated Pneumonia – 11.4%Healthcare Associated Pneumonia – 11.4%Not following abstraction instructions – 18Not following abstraction instructions – 18

Abstractor answer not found in record – 13Abstractor answer not found in record – 13


Parent element mismatch – 6Parent element mismatch – 6


Flu and Pneumococcal – 11.5%Flu and Pneumococcal – 11.5%Abstractor answer not found in record – 21Abstractor answer not found in record – 21


Not following abstraction instructions – 12Not following abstraction instructions – 12

Parent element mismatch – 9Parent element mismatch – 9

Most Common Abstraction ErrorsMost Common Abstraction ErrorsAMI (n = 97)AMI (n = 97)

Contraindications to beta blockersContraindications to beta blockersArrival – 25.2%Arrival – 25.2%



Discharge – 17.2%Discharge – 17.2%Abstractor missed information – 8Abstractor missed information – 8



Contraindications to aspirinContraindications to aspirinArrival – 13.2%Arrival – 13.2%



Discharge – 14.0%Discharge – 14.0%Not following abstraction instructions – 8Not following abstraction instructions – 8


Time to EKGTime to EKGNot following abstraction instructions – 14%Not following abstraction instructions – 14%

CMS’s Value-Based PurchasingCMS’s Value-Based PurchasingWhat is it?What is it?

New acronym – VBPNew acronym – VBP

New name for “pay for performance”New name for “pay for performance”

Will replace current annual payment update Will replace current annual payment update criteriacriteria

Program will replace RHQDAPUProgram will replace RHQDAPU

Proposed to start Oct 2008Proposed to start Oct 2008

CMS’s Value-Based PurchasingCMS’s Value-Based PurchasingWhich hospitals are affected?Which hospitals are affected?

IPPS (inpatient hospitals paid by the IPPS (inpatient hospitals paid by the prospective payment system)prospective payment system)

Not CAH at this timeNot CAH at this time

CMS’s Value-Based PurchasingCMS’s Value-Based PurchasingImportant FeaturesImportant Features

Financial incentives for high performance Financial incentives for high performance or good improvementor good improvement

System based on benchmarks calculated System based on benchmarks calculated from national hospital performancefrom national hospital performance

System will not expect 100% performance System will not expect 100% performance because CMS does not want to create because CMS does not want to create unintended consequencesunintended consequences

CMS’s Value-Based PurchasingCMS’s Value-Based PurchasingInitial ProposalInitial Proposal

20 of the core measures, not:20 of the core measures, not:HF – LVEF assessment HF – LVEF assessment AMI – beta blocker on arrivalAMI – beta blocker on arrivalPN – oxygenation assessmentPN – oxygenation assessmentPN – initial antibiotic within 4 hoursPN – initial antibiotic within 4 hoursSCIP – antibiotic selectionSCIP – antibiotic selection

HCAHPSHCAHPSMortality measures - heart failure and AMI Mortality measures - heart failure and AMI

CMS’s Value-Based PurchasingCMS’s Value-Based PurchasingProposal for FutureProposal for Future

Add measures for coordination of care Add measures for coordination of care among settingsamong settings

Compress data submission limit to 60 daysCompress data submission limit to 60 days

Change to monthly submissionChange to monthly submission

CMS’s Value-Based PurchasingCMS’s Value-Based PurchasingProposal for FutureProposal for Future

Increase sample sizesIncrease sample sizes

Monitor for applying exclusion criteria too Monitor for applying exclusion criteria too broadlybroadly

Strengthen validationStrengthen validationSome targetingSome targeting

At measure level, not item levelAt measure level, not item level

CMS’s Value-Based PurchasingCMS’s Value-Based PurchasingNot Yet DecidedNot Yet Decided

CMS is considering different options forCMS is considering different options forStructuring incentive paymentsStructuring incentive payments

Phasing the program inPhasing the program in

Dealing with small numbersDealing with small numbers

CMS’s Value-Based PurchasingCMS’s Value-Based PurchasingLearn MoreLearn More

http://www.cms.hhs.gov/center/hospital.asphttp://www.cms.hhs.gov/center/hospital.asp

Slides for April 12 call are very informativeSlides for April 12 call are very informative

Options paper looks daunting but is goodOptions paper looks daunting but is good

Questions/Feedback

Contact InformationContact Information:

MetaStar, Inc.2909 Landmark PlaceMadison, WI 53713

(608) 274-1940 or (800) 362-2320

www.metastar.com

This material was prepared by MetaStar under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. 8SOW-WI-INP-07-64

Documents

Data Collection Support Webinar MetaStar, Inc. April 18, 2007 Carol Ferguson Pam Clemens