Provider Profiling. Substance Abuse Non- Hospital Short Term Rehabilitation. 01/01/12 to 12/31/12
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1 Provider Profiling Substance Abuse Non- Hospital Short Term Rehabilitation 01/01/12 to 12/31/12 1
2 Substance Abuse Non-Hospital Short Term Rehabilitation CBHNP utilizes a provider profiling process that is an important provider-level quality improvement activity, as well as an opportunity to internally track and trend data over a set period of time to identify possible areas of improvement. It is also a tool to make meaningful comparisons based on a varied data set including claims data, authorization data, quality reports and demographic information. Provider profiling results have been compiled using data from January 1, 2012 to December 31, Substance Abuse Non-Hospital Short Term Rehabilitation Services include twenty-four hour professionally directed, medically monitored, evaluation, care and treatment for addicted Members in acute distress. All SA NH Short Term Rehab providers across the Network with Members in service were profiled during this period. The profiled providers are as follows alphabetically: Bedford/Somerset Profiled Providers Bowling Green Brandywine, Inc. Fairmount Behavioral Health Systems Gateway Rehabilitation Center Gaudenzia, Inc. Greenbriar Treatment Center Outside In School of Experiential Education, Inc. Pyramid Healthcare, Inc. Roxbury Treatment Center Twin Lakes Center Valley Forge Medical Center and Hospital, Inc. White Deer Run/Cove Forge, Inc. Blair Profiled Providers Bowling Green Brandywine, Inc. BPC Management Group, Inc. Eagleville Hospital Greenbriar Treatment Center Pyramid Healthcare, Inc. Roxbury Treatment Center Twin Lakes Center Valley Forge Medical Center and Hospital, Inc. White Deer Run/Cove Forge, Inc. Franklin/Fulton Profiled Providers Bowling Green Brandywine, Inc. Clearbrook, Inc. Firetree, LTD. 2
3 Pyramid Healthcare, Inc. Roxbury Treatment Center White Deer Run/Cove Forge, Inc. Lycoming/Clinton Profiled Providers Bowling Green Brandywine, Inc. Clearbrook, Inc. Eagleville Hospital Fairmount Behavioral Health Systems Firetree, LTD. Gateway Rehabilitation Center Gaudenzia, Inc. Outside In School of Experiential Education, Inc. Pyramid Healthcare, Inc. Roxbury Treatment Center Twin Lakes Center Universal Health Services Recovery Keystone, Inc. White Deer Run/Cove Forge, Inc. Capital Profiled Providers Bowling Green Brandywine, Inc. BPC Management Group, Inc. Clearbrook, Inc. Colonial House, Inc. Eagleville Hospital Fairmount Behavioral Health Systems Firetree, LTD. Gaudenzia, Inc. Nuestra Clinica of SACA, Inc. Penn Foundation, Inc. Pyramid Healthcare, Inc. Roxbury Treatment Center Twin Lakes Center Universal Health Services Recovery Keystone, Inc. Valley Forge Medical Center and Hospital, Inc. White Deer Run/Cove Forge, Inc. Profiled indicators include demographics, utilization, quality, compliance, competency and satisfaction. Demographics 3
4 Demographic information available for Members receiving SA NH Short Term Rehab services includes age, gender, race and diagnostic data. Demographic mix is consistent with previous years with no developing change in trend. Overall, eight percent of the Members who received SA NH Short Term Rehab services were between the ages of thirteen and twenty, thirty-four percent were between twentyone and thirty, thirty-four percent were between thirty-one and forty-four, twenty-three percent were between forty-five and sixty-four and one percent of the population was sixty-five years of age or older. Forty percent of Members receiving this service were female and sixty percent were male. 4
5 Seventy-five percent of these Members were Caucasian, sixteen percent were African American and nine percent were categorized as Other. The most common diagnoses of Members receiving SA NH Short Term Rehab services were Opioid Dependence at forty-one percent, Alcohol Dependence at twenty-four percent, Polysubstance Dependence at eight percent, Cocaine Dependence at seven percent and Cannabis Dependence at three percent. 5
6 Utilization Utilization information available for Members receiving SA NH Short Term Rehab services includes the total number of discharges, the average length of stay, the number of recidivism episodes and the thirty day readmission rate. The total number of discharges across the Network was 2,292. There were seventy-one discharges in the zero to seventeen age group and 2,221 in the eighteen and over age group. 6
7 The total average length of stay across the Network was days for both age groups combined. The average length of stay for the zero to seventeen age group was days and days for the eighteen and over age group. The Blair and Lycoming/Clinton Contracts had an average length of stay less than the Network. Providers that had a total average length of stay below the Network average met one of the three target criteria for performance. Across the Network there were 110 episodes of recidivism, which is the number of readmissions for unduplicated Members, one from the zero to seventeen age group and 109 from the eighteen and over age group. 7
8 The average thirty day readmission rate, which is readmissions for duplicated Members, for the Network for the combined age groups was 4.80%. The average thirty day readmission rate for the zero to seventeen age group was 1.41% and 4.91% for the eighteen and over age group. Providers that had a total readmission rate below the Network average met the second target criteria for performance. Multi-Year Utilization Comparison The total number of discharges from SA NH 3B Rehab services has been increasing since The 30 day readmission rate has shown in increase since 2011, but has not exceeded 6% in previous years. The average length of stay for the combined age groups 8
9 has shown a slight increase since 2011, but the average length of stay for the 0-17 age group has shown an overall decrease. The number of IP admissions during treatment has trended downward since Quality The quality indicators for SA NH Short Term Rehab services were measured by the total number of Mental Health Inpatient admissions during treatment, the number of complaints, the number of quality of care issues and the number of critical incident reports submitted by the provider. There were a total of nine Mental Health Inpatient admissions during SA NH Short Term Rehab services during the profiled period, which was an average of admissions per 1000 Members. There were zero admissions in the Blair, Franklin/Fulton and Lycoming/Clinton Contracts. 9
10 Across the Network there was one complaint and two quality of care issues during the profiled period. The Network number of complaints and quality of care issues per 1000 Members was Both the complaint and quality of care issues came from the Capital Contract, which had an average of per 1000 Members. There were forty-seven Critical Incident Reports (CIR s) filed for SA NH Short Term Rehab services during the profiled period. Three of the CIR s resulted in a quality of care or safety issue. The Network number of CIR s resulting in quality of care or safety issues per 1000 Members was Compliance 10
11 Compliance indicators were measured using the number of denied administrative appeals and the number of provider performance issues reported for each provider. There were forty-four denied administrative appeals across the Network, with an average of denied appeals per 1000 Members. The Bedford/Somerset, Blair and Franklin/Fulton Contracts scored below the Network average. Across the Network there were ninety-one documented provider performance issues, with an average of provider performance issues per 1000 Members. The Bedford/Somerset Contract had zero provider performance issues. 11
12 Competency Competency was measured using the percentage of provider trainings that were attended. Providers have the opportunity to attend provider trainings offered by CBHNP throughout the year. Although these meetings are not mandatory, they include valuable information for providers, and all providers are encouraged to attend. However, during 2012 there were zero trainings offered to SA NH Short Term Rehab providers. Satisfaction Member satisfaction was measured by the percentage of Members satisfied with the outcomes of complaints that were filed. The overall Members satisfaction related to complaints for the Network was 100%. Target Criteria Although all aspects of performance are important, the specific targets of an average length of stay less than the Network average, a thirty day readmission rate less than the Network average, and zero Credentialing Corrective Actions since 01/01/12 are goals that all providers should strive to achieve. The following providers in each Contract met all three target criteria. Bedford/Somerset Profiled Providers Bowling Green Brandywine, Inc. Fairmount Behavioral Health Systems Gateway Rehabilitation Center Gaudenzia, Inc. Greenbriar Treatment Center Roxbury Treatment Center Valley Forge Medical Center and Hospital, Inc. Blair Profiled Providers Bowling Green Brandywine, Inc. Eagleville Hospital Pyramid Healthcare, Inc. Roxbury Treatment Center Valley Forge Medical Center and Hospital, Inc. White Deer Run/Cove Forge, Inc. Franklin/Fulton Profiled Providers Clearbrook, Inc. Firetree, LTD. 12
13 Roxbury Treatment Center White Deer Run/Cove Forge, Inc. Lycoming/Clinton Profiled Providers Eagleville Hospital Gateway Rehabilitation Center Gaudenzia, Inc. Pyramid Healthcare, Inc. Twin Lakes Center Capital Profiled Providers BPC Management Group, Inc. Colonial House, Inc. Fairmount Behavioral Health Systems Firetree, LTD. Nuestra Clinica of SACA, Inc. Penn Foundation, Inc. Roxbury Treatment Center Twin Lakes Center White Deer Run/Cove Forge, Inc. Network Recommendations When summarizing the information contained above, several strategies for impacting SA NH Rehab provider performance can be identified. Establish an active treatment culture that incorporates evidence based treatment packages. Continue with developing co-occurring competency. Encourage all SA NH Rehab staff to actively focus on appropriate and meaningful discharge planning with full family involvement. Distribute CBHNP resource guide to all internal staff in order to fully develop natural and community supports. Develop a consortium of SA NH Rehab providers in order to share information and collectively address difficulties. Develop procedures that will assist SA NH Rehab staff with meeting CBHNP expectations. Develop internal policies and procedures to facilitate more effective collaboration with other mental health providers and community agencies (e.g., Probation; CYS). Utilize Best Practice Guidelines to inform all treatment efforts. 13
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