The Nevada Partnership for Value Driven Healthcare

1. The Nevada Partnership for Value Driven Healthcare So, What About the Data? Emily Sim, MS Healthcare Analyst HealthInsight

2. Data Source • Center for Health Information Analysis (CHIA) at UNLV. • Inpatient data submitted by all Nevada Hospitals • Time Frame: June 1, 2009 – May 31, 2010

3. Data Inclusions • All-Payer • Acute Care and Critical Access Hospitals

4. Data Exclusions • Children (<18 years) • Rehab Admits (Billing MS-DRGs 945, 946) • Transfers – coded as a single visit

5. Readmission Rate Calculation Readmission Rate = Number of Readmissions Number of Index Admissions

6. Definitions • All hospital admissions are coded as one of the following: • Index Admission • Readmission • Not a Readmission

7. Definitions (cont.) • Index Admission • First admission for each patient • The next admission occurring greater than 30 days after the discharge date of the previous Index Admission • The following cannot be Index Admissions • An admission in which a patient dies • An admission in which the patient leaves Against Medical Advice (AMA)

8. Definitions (cont.) • Readmission • The first admission within 30 days of an Index Admission • Not a Readmission • An admission that is neither an Index Admission nor a Readmission • An admission that occurs after a Readmission, but before another Index Admission

9. Example

10. Baseline Readmission Rate Number of Readmissions Number of Index Admissions

11. Readmission Rates by Payer

12. Readmission Rates for Top Conditions

13. % of Total Readmissions

14. Perhaps… Interventions that focus on the patient, not on the condition, will be most effective.

15. Rate Reduction Goal • Reduce Readmissions by 10% • Current Rate is 10.6% • Goal is 9.5%