Overview of the Hospital Value-Based Purchasing (VBP) Fiscal Year (FY) 2017
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1 Overview of the Hospital Value-Based Purchasing (VBP) Fiscal Year (FY) 2017 Audio for this event is available via INTERNET STREAMING. No telephone line is required. Computer speakers or headphones are necessary to listen to streaming audio. 4/21/2015 1
2 Submitting Questions Type questions in the Chat with Presenter section, located in the bottomleft corner of your screen. 4/21/2015 2
3 Hospital Value-Based Purchasing (VBP) Program Claims-Based Measures Kayte Hennick, BA Hospital Reporting Reports and Analytics Contractor April 21, 2015
4 Purpose The purpose of today s webinar is to provide an overview of the AHRQ PSI-90 Composite and Mortality Measures Hospital Specific Report (HSR); including how to receive your HSR, how to comprehend the calculations of the AHRQ PSI-90 and Mortality Measure, how to read the HSR and identify the process of submitting a Review and Corrections Request. 4/21/2015 4
5 Objectives Participants will be able to: Identify how to receive your Agency for Healthcare Research and Quality (AHRQ) PSI- 90 Composite and Mortality Measures Hospital Specific Report (HSR) Comprehend the calculations of the AHRQ PSI-90 and Mortality Measures Understand how to read the HSR Identify the process of submitting a Review and Correction Request 4/21/2015 5
6 How to Receive Your HSR How do you know your HSR is available? A QualityNet Notification was sent via to those who are registered for the notifications regarding the Hospital Inpatient Quality Reporting Program. The notification indicated the reports are available. Who has access to your HSR? Hospital users with the Hospital Reporting Feedback- Inpatient role and the File Exchange and Search role will have access to the HSRs and User Guide. How can you access your HSR? For those with the correct access the HSRs and User Guide will be in their My QualityNet Secure File Transfer Inbox. 4/21/2015 6
7 HOSPITAL VBP AHRQ HSR 4/21/2015 7
8 Table 1: Hospital Results 4/21/2015 8
9 Table 2: AHRQ PSI Performance 4/21/2015 9
10 Table 3: AHRQ PSI Discharges The ID Number is provided for use if you need to reference records in this table in an or otherwise, so that you can avoid sharing personally identifiable information (PII) or personal health information (PHI). 4/21/
11 Understanding the AHRQ Calculations Through Replication The replication process for the AHRQ PSI-90 Composite includes calculation of the: Observed Rate per 1,000 Eligible Discharges Risk-Adjusted Rate per 1,000 Eligible Discharges Smoothed Rate per 1,000 Eligible Discharges PSI-90 Composite 4/21/
12 Calculate the Observed Rate per 1,000 Eligible Discharges 4/21/
13 Calculate the Risk-Adjusted Rate per 1,000 Eligible Discharges 4/21/
14 Calculate the Smoothed Rate per 1,000 Eligible Discharges 4/21/
15 Calculate the PSI 90 Composite 4/21/
16 AHRQ Differences Across Programs Differences in IQR and HVBP results are due to the following: Data period used for calculation - IQR - July 1, 2012 through June 30, 2014 HVBP - October 15, 2012 through June 30, 2014 Diagnosis and procedure codes FY16 HVBP uses nine diagnoses and six procedure codes in order to be consistent with the HVBP baseline period 2015 IQR uses 25. Software versions FY16 HVBP uses version 4.4 of the AHRQ software in order to be consistent with the HVBP baseline period 2015 IQR uses 4.5a. 3/11/
17 HOSPITAL VBP MORTALITY HSR 4/21/
18 Table 1: Hospital Results 4/21/
19 Table 2: Additional Information 4/21/
20 Tables 3, 4, and 5: Discharges The discharge tables contain discharge-level data for all Part A Medicare Fee-for-Service (FFS) patient stays with a primary qualifying diagnosis of Acute Myocardial Infarction (AMI), Heart Failure (HF), or Pneumonia accordingly, that had a discharge date in the reporting period, for patients who were age 65 and older at the time of admission. The ID Number is provided for use if needed to reference records in this table in an or otherwise, so that sharing of PII or PHI is avoided. 4/21/
21 Tables 3, 4, and 5: Discharges Row 8 in the HSR contains the model coefficients for each risk factor. These are estimates over data for all hospitals. 4/21/
22 Understanding the AHRQ Calculations Through Mortality The replication process for the Mortality Measures includes calculation of the: Predicted Deaths Expected Deaths Risk-Standardized Mortality Rate Performance Period Survival Rate 4/21/
23 Calculate Predicted Deaths: Step 1 Limit your Replication calculations to rows where "INDEX STAY" (column I) equals YES. In this example, "INDEX STAY" is represented by discharges in rows /21/
24 Calculate Predicted Deaths: Step 2 4/21/
25 Calculate Predicted Deaths: Step 3 4/21/
26 Calculate Predicted Deaths: Step 4 Predicted probability for each discharge =(1/(1+exp(-1 * Add HOSP_EFFECT results))) 4/21/
27 Calculate Predicted Deaths: Step 5 4/21/
28 Calculate Expected Deaths Expected probability for each discharge =(1/(1+exp(-1 * Add AVG_EFFECT results))) 4/21/
29 Calculate Expected Deaths Predicted Deaths 4/21/
30 Calculate the Risk-Standardized Mortality Rate Predicted Deaths 4/21/
31 Calculate the Performance Period Survival Rate Predicted Deaths 4/21/
32 HVBP HSR User Guide The FY16_HVBP_HSR_UserGuide.pdf accompanies your HSRs and contains additional information about the HSRs, including examples for the AHRQ and Mortality replication process. 4/21/
33 REVIEW AND CORRECTION PROCESS 4/21/
34 Review and Corrections Period Timeline The notification that was sent to indicate the reports were available also contained the timeline of the Review and Corrections period. Pay special attention to the deadline. Review and Correction requests sent after the deadline will not be considered. The Review and Correction period for FY 2016 is April 10 May 11, /21/
35 Submission of a Review and Corrections Request Requests can be submitted via: to [email protected] Include Hospital VBP in the subject line Phone at Teletypewriter (TTY) at /21/
36 Review and Corrections Process Inclusions and Exclusions Eligible for Review: Suspected calculation errors on your report can be submitted for consideration. Ineligible for Review: Requests for submission of new or corrected claims to the underlying data are not allowed. 4/21/
37 Resources HVBP Overview ge%2fqnettier4&c=page AHRQ Resources QualityNet: httsp:// > Hospitals Inpatient > Claims-Based Measures > Agency for Healthcare Research and Quality (AHRQ) Indicators > Resources ier4&cid= Quality Indicators Support PSI Resources Mortality Resources QualityNet: httsp:// > Hospitals Inpatient > Claims-Based Measures > Mortality Measures > Resources ier3&cid= Questions about the 30-day mortality measures may be sent to: 4/21/
38 Contact Us Q & A Tool Support [email protected] Phone Support or Inpatient Live Chat Monthly Web Conferences Secure Fax ListServes Sign up on Website 4/21/
39 Continuing Education Approval This program has been approved for 1.0 continuing education (CE) unit given by CE Provider # by the following professional boards: Florida Board of Nursing Florida Board of Clinical Social Work, Marriage and Family Therapy and Mental Health Counseling Florida Board of Nursing Home Administrators Florida Council of Dietetics Florida Board of Pharmacy Professionals licensed in other states will receive a Certificate of Completion to submit to their licensing Boards 4/21/
40 CE Credit Process: Survey Complete the WebEx survey you will receive by within the next 48 hours, or the one that will pop up after the webinar. The survey will ask you to log in or register to access your personal account in the Learning Management Center. A one-time registration process is required. 4/21/
41 CE Credit Process: Survey 4/21/
42 CE Credit Process: Accessing Certificate 4/21/
43 CE Credit Process: New User 4/21/
44 CE Credit Process: Existing User 4/21/
45 QUESTIONS? This material was prepared by the Inpatient Value, Incentives, and Quality Reporting Outreach and Education Support Contractor, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. HHSM I, FL-IQR-Ch /21/
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