Data Collection Support Webinar

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

3. AnnouncementsInvalid Record Selection Update • Good news! • Discussed on last month’s call in detail • Thanks to Candi bringing the increased volume of these errors to CMS attention • CMS is looking at it “very seriously” • Keep your fingers crossed

4. AnnouncementsQIO Clinical Warehouse Known Issues • Go to www.qualitynet.org home page • Click hospitals, then data submission, then notifications

5. AnnouncementsPublic Reporting Preview Period • For Qtr 4 2005 – Qtr 3 2006 • Preview period April 17 – May 16 • Download your report from QNet inbox • Review carefully! • Contact Pam if you have concerns • PPS hospitals – may not withhold any measures without penalty • CAH – new withhold form on QNet, submit to Pam

6. Announcements Mortality Measures Reporting • Contrary to previous information, there will NOT be a new pledge form required • Reporting to begin October 2007 • Contact mortalitymeasures@coqio.sdps.org with questions

7. AnnouncementsSubmitting Questions to Quest • Search Quest (on QNet web site, home page, lower right) thoroughly before asking a question • Contact QNet Help Desk to check on status of a question you asked • They received 2,964 questions in February!

8. Clarifications/UpdatesWho Does MetaStar Send Information To? • Following categories: • Data Collection Support webinar – sign-up • HQA contact – per pledge form • RHQDAPU contact – per pledge form • Hospital data contact • Quality director • CEO/Administrator – usually only if directed by CMS

9. Clarifications/UpdatesWho Does MetaStar Send Information To? • If you want changes: • Coordinate request internally, we suggest you work it out through the Quality Director • One person from a hospital send e-mail to jparisi@metastar.com • Title on e-mail: Contact changes • List any additions or deletions in a category • Person’s name, title, hospital name, e-mail address, category

10. Clarifications/UpdatesSCIP Sampling Changes for Qtr 4 2006 • SCIP cases selected by primary OR secondary diagnosis

11. Clarifications/UpdatesNext Data Due Date • Next data due to QIO Clinical Warehouse on May 15 • Checklist provided by MetaStar with today’s materials will help you organize • Don’t wait until last minute!

12. Most Common Abstraction ErrorsPneumonia (n = 378) • Initial Blood Culture Time – 17.2% • Not following abstraction instructions – 24 • Parent element mismatch - 6 • Abstractor answer not found in record – 4 • Abstractor missed information – 4 • Arrival Time – 11.1% • Not following abstraction instructions – 16 • Abstractor missed information – 12 • Abstractor answer not found in record – 8 • Parent element mismatch – 6

13. Most Common Abstraction ErrorsPneumonia (n = 378) • Working Diagnosis of Pneumonia – 4.2% • Not following abstraction instructions – 10 • Abstractor answer not found in record – 7 • Abstractor missed information – 3 • Healthcare Associated Pneumonia – 11.4% • Not following abstraction instructions – 18 • Abstractor answer not found in record – 13 • Abstractor missed information – 6 • Parent element mismatch – 6

14. Most Common Abstraction ErrorsPneumonia (n = 378) • Flu and Pneumococcal – 11.5% • Abstractor answer not found in record – 21 • Abstractor missed information – 17 • Not following abstraction instructions – 12 • Parent element mismatch – 9

15. Most Common Abstraction ErrorsAMI (n = 97) • Contraindications to beta blockers • Arrival – 25.2% • Not following abstraction instructions – 13 • Abstractor missed information – 8 • Discharge – 17.2% • Abstractor missed information – 8 • Not following abstraction instructions – 6

16. Most Common Abstraction ErrorsAMI (n = 97) • Contraindications to aspirin • Arrival – 13.2% • Not following abstraction instructions – 4 • Abstractor missed information – 5 • Discharge – 14.0% • Not following abstraction instructions – 8

17. Most Common Abstraction ErrorsAMI (n = 97) • Time to EKG • Not following abstraction instructions – 14%

18. CMS’s Value-Based PurchasingWhat is it? • New acronym – VBP • New name for “pay for performance” • Will replace current annual payment update criteria • Program will replace RHQDAPU • Proposed to start Oct 2008

19. CMS’s Value-Based PurchasingWhich hospitals are affected? • IPPS (inpatient hospitals paid by the prospective payment system) • Not CAH at this time

20. CMS’s Value-Based PurchasingImportant Features • Financial incentives for high performance or good improvement • System based on benchmarks calculated from national hospital performance • System will not expect 100% performance because CMS does not want to create unintended consequences

21. CMS’s Value-Based PurchasingInitial Proposal • 20 of the core measures, not: • HF – LVEF assessment • AMI – beta blocker on arrival • PN – oxygenation assessment • PN – initial antibiotic within 4 hours • SCIP – antibiotic selection • HCAHPS • Mortality measures - heart failure and AMI

22. CMS’s Value-Based PurchasingProposal for Future • Add measures for coordination of care among settings • Compress data submission limit to 60 days • Change to monthly submission

23. CMS’s Value-Based PurchasingProposal for Future • Increase sample sizes • Monitor for applying exclusion criteria too broadly • Strengthen validation • Some targeting • At measure level, not item level

24. CMS’s Value-Based PurchasingNot Yet Decided • CMS is considering different options for • Structuring incentive payments • Phasing the program in • Dealing with small numbers

25. CMS’s Value-Based PurchasingLearn More • http://www.cms.hhs.gov/center/hospital.asp • Slides for April 12 call are very informative • Options paper looks daunting but is good

26. Questions/Feedback

27. Contact Information: MetaStar, Inc. 2909 Landmark Place Madison, 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