Maryland Readmission Reduction Incentive Program for RY 2014-2015

$199 / year

This dataset comprises Maryland Readmissions Reduction Incentive Program (RRIP) incentivizes hospitals to reduce avoidable readmissions by linking rewards and penalties to improvements in readmissions rates. The RRIP began to impact hospital revenue starting in Rate Year 2016, with the first performance year of Calendar Year 2014.

Complexity

Most hospitals in the nation are subject to penalties based on their performance on certain diagnosis-specific Medicare readmissions as part of the federal Medicare Hospital Readmissions Reduction Program (HRRP). The Commission previously encouraged reductions in unnecessary readmissions under the Admission-Readmission Revenue (ARR) program. The current episode-based payment model encourages hospitals to reduce readmissions, and enables hospitals to keep the savings from such reductions. To ensure savings are passed on the public, the Commission passes some savings to payers via the Potentially Avoidable Utilization (PAU) Savings Program.

Readmissions occur when a patient is discharged from a hospital and is admitted to any hospital within 30 days of the discharge. Preventable hospitals readmissions may result from complications from previous hospitalization and/or inadequate care coordination, and generate substandard care quality for patients and unnecessary costs. The Readmissions Reduction Incentive Program (RRIP) compares all-payer readmission rates adjusted for the severity of illness (casemix) for all types of inpatient visits for the calendar year with the rates in the base year to calculate improvement, and reviews the all-payer readmission rates adjusted for casemix and out-of-state ratios to calculate attainment.

On January 1, 2014 the State of Maryland entered into a new All-Payer Model demonstration contract with the Center for Medicare and Medicaid Innovation (CMMI). Among other provisions of this contract, the State is required to reduce the statewide Medicare fee-for-service readmission rate to the national Medicare readmission rate level over the five-year contract term and make yearly progress towards reducing this gap.

In order to meet the new Model requirements, the Commission approved the Readmissions Reduction Incentive Program (RRIP) in April 2014 to increase the incentives to reduce unnecessary readmissions. The RRIP began to impact hospital revenue starting in Rate Year 2016, with the first performance year of Calendar Year 2014. The initial program focused on providing a set amount of rewards for strong reductions in readmission rates. As the program evolved, penalties were added, along with sliding scale payment adjustments that recognized the variation in performance. For the Calendar Year 2016 performance year, the Commission altered the methodology to measure hospital performance as the better of attainment (rewarding high-performing hospitals) or improvement to determine payment adjustments. This adjustment to the methodology strengthens incentives for low-performing hospitals to improve and avoids penalizing high-performing hospitals.

Date Created

2015-12-23

Last Modified

2015-12-23

Version

2015-12-23

Update Frequency

Annual

Temporal Coverage

2013-2015

Spatial Coverage

Maryland

Source

John Snow Labs => The Maryland Health Services Cost Review Comission

Source License URL

John Snow Labs Standard License

Source License Requirements

N/A

Source Citation

N/A

Keywords

Readmission Rates, Hospital Readmissions, Care Quality, Hospital Survey, Hospital Performance, Base Year, Performance Period, Healthcare Associated Infections, Readmission Reduction Incentive Program (RRIP)

Other Titles

The Maryland Readmission Reduction Incentive Program for Performace Periods 2014-2015, Maryland RRIP with Base Year 2013 and Performance Years 2014-2015

Name Description Type Constraints
Hospital_IDA Unique Identification Number assigned to the Hospital.integerrequired : 1 level : Nominal
Hospital_NameIt identifies the name of the hospital referred to as the provider.stringrequired : 1
Total_Number_Of_Hospital_Inpatient_Discharges_2013The number of patients discharges in the total number of hospitals.integerlevel : Ratio
Total_Number_Of_Readmissions_2013It indicates the total number of readmissions during period 2013.integerlevel : Ratio
Percent_Readmissions_2013Indicates the patients percent readmission rate during period 2013.numberlevel : Ratio
Total_Number_Of_Expected_Readmissions_2013Indicates the total number of patients expected readmissions rate during period 2013.numberlevel : Ratio
Readmissions_Ratio_2013Readmission Ratio is the ratio of Predicted Readmission Rate to the Expected Readmission Rate based on similar hospitals during period 2013.numberlevel : Ratio
Risk_Adjusted_Rate_2013It identifies the risk adjusted rate of the readmission reduction program during period 2013.numberlevel : Ratio
Performance_Period_Risk_Adj_Readmission_Goal_for_Incentive_2013It identifies the performance period of the risk adjusted readmissions goal for incentive reduction program.numberlevel : Ratio
Performance_YearIndicates the year during which the performance for several hospitals are measured.daterequired : 1
Total_Number_Of_Hospital_Inpatient_DischargesIt identifies the number of patients discharges in the total number of hospitals.integerrequired : 1 level : Ratio
Total_Number_Of_ReadmissionsIt indicates the total number of readmissions during the period.integerrequired : 1 level : Ratio
Percent_ReadmissionsIndicates the patients percent readmission rate.numberrequired : 1 level : Ratio
Total_Number_Of_Expected_ReadmissionsIndicates the total number of patients expected readmissions.numberrequired : 1 level : Ratio
Readmissions_RatioReadmission Ratio is the ratio of Predicted Readmission Rate to the Expected Readmission Rate based on similar hospitals.numberrequired : 1 level : Ratio
Risk_Adjusted_RateIt identifies the risk adjusted rate of the readmission reduction program.numberlevel : Ratio
Difference_Between_Current_Rate_And_GoalIt identifies the difference between the current rate and goal rate of the readmission reduction program.numberlevel : Ratio
Improvement_In_Risk_Adjusted_RateIt identifies the improvement in risk adjusted rate of the readmission reduction program.numberlevel : Ratio
Hospital_IDHospital_NameTotal_Number_Of_Hospital_Inpatient_Discharges_2013Total_Number_Of_Readmissions_2013Percent_Readmissions_2013Total_Number_Of_Expected_Readmissions_2013Readmissions_Ratio_2013Risk_Adjusted_Rate_2013Performance_Period_Risk_Adj_Readmission_Goal_for_Incentive_2013Performance_YearTotal_Number_Of_Hospital_Inpatient_DischargesTotal_Number_Of_ReadmissionsPercent_ReadmissionsTotal_Number_Of_Expected_ReadmissionsReadmissions_RatioRisk_Adjusted_RateDifference_Between_Current_Rate_And_GoalImprovement_In_Risk_Adjusted_Rate
210065HOLY CROSS GERMANTOWN20146738712.9382.3511.06
210037EASTON83127909.5943.40.8410.479.762014821387910.7920.910.9511.932.1713.95
210045MCCREADY2834917.3151.840.9511.8211.0220143143912.4252.4250.749.3-1.72-21.3
210058REHAB & ORTHO460245.2234.380.6989.78.792015465194.0927.820.6839.490.69-2.16
210039CALVERT69056369.21825.530.779.638.98201460404858.03743.210.658.16-0.82-15.28
210045MCCREADY2834917.3152.140.9413.0511.8420152372811.8136.50.76710.66-1.18-18.31
210034HARBOR8941103411.5610091.0212.8111.952014826590510.95921.380.9812.280.33-4.15
210006HARFORD441966214.98749.670.8811.0410.292014407259414.59678.10.8810.950.66-0.81
210037EASTON688674710.85889.760.8411.6610.582015677178711.62878.570.89612.441.876.69
210034HARBOR751699413.23988.161.00613.9712.672015651988513.58876.551.0114.021.350.36