Others titles
- Maryland Hospital Acquired Conditions for Performace Period 2016
- MHAC with Base Year 2015 and Performance Year 2016
Keywords
- Hospital Acquired Conditions
- Inpatient Hospital Revenue
- Hospital Survey
- Hospital Performance
- Base Year
- Performance Period
- Potentially Preventable Complication (PPC)
- PPC Classification System
- PPC Costs
- Maryland Hospital Acquired Conditions (MHAC)
MHAC Hospital Performance By PPC FY2016
This dataset comprises Maryland Hospital Acquired Conditions (MHAC) program which was implemented in state fiscal year (FY) 2011 to link hospital payment with hospital performance using 3M’s Potentially Preventable Complication (PPC) classification system. PPCs are post-admission complications that may result from hospital care and treatment.
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Description
The initial methodology for the Maryland Hospital Acquired Conditions (MHAC) program estimated the number of Potentially Preventable Complication (PPC) above the statewide average, or “excess PPCs,” for each hospital and calculated the percentage of inpatient hospital revenue associated with these excess PPCs. Hospitals with higher PPC costs than the statewide average received penalties and hospitals with lower PPC costs than the statewide average collected rewards. Because the initial program was required to be revenue neutral, this process resulted in unpredictable payment adjustments as the amount of revenue available for rewards was determined by the penalties assessed within the program.
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. This new contract included a requirement that the State of Maryland reduces the rate of PPCs by 30% over the 5-year contract term.
The MHAC program was implemented in state fiscal year (FY) 2011 to link hospital payment with hospital performance using 3M’s Potentially Preventable Complication (PPC) classification system. PPCs are post-admission complications that may result from hospital care and treatment, such as accidental puncture/laceration during an invasive procedure or infections related to central venous catheters. In contrast to complications resulting from underlying disease progression, PPCs are considered potentially preventable. 3M identified 65 PPC measures through secondary diagnosis codes not present when patients are admitted to hospital.
– Key Program Components of Current MHAC Methodology
– Determine hospital scores based on observed-to-expected PPC ratios rather than excess PPC costs. The expected number of PPCs for each hospital is calculated by multiplying the base year statewide PPC rate by the number of discharges at each hospital, adjusted for diagnosis and severity of illness categories.
– Prioritize PPCs according to All-Payer Model priorities by grouping PPCs into tiers and weighting them according to their level of priority.
– Key Program Components of Current MHAC scoring
– Measure hospital performance as the better of attainment or improvement to determine payment adjustments.
– Determine payment rewards/penalties through a preset point scale developed with base year scores. This approach improves the financial predictability of the program and allows for statewide rewards to exceed penalties to adequately reward hospitals with better or improved performance.
– Focus payment adjustments on higher and lower performing hospitals by making adjustments only at the top and bottom end of the score distribution.
About this Dataset
Data Info
Date Created | 2017-03-08 |
---|---|
Last Modified | 2017-03-08 |
Version | 2017-03-08 |
Update Frequency |
Annual |
Temporal Coverage |
2016 |
Spatial Coverage |
Maryland |
Source | John Snow Labs; The Maryland Health Services Cost Review Commission; |
Source License URL | |
Source License Requirements |
N/A |
Source Citation |
N/A |
Keywords | Hospital Acquired Conditions, Inpatient Hospital Revenue, Hospital Survey, Hospital Performance, Base Year, Performance Period, Potentially Preventable Complication (PPC), PPC Classification System, PPC Costs, Maryland Hospital Acquired Conditions (MHAC) |
Other Titles | Maryland Hospital Acquired Conditions for Performace Period 2016, MHAC with Base Year 2015 and Performance Year 2016 |
Data Fields
Name | Description | Type | Constraints |
---|---|---|---|
Hospital_Id | Refers to the identity of the hospital (also referred to as the provider) | integer | level : Nominalrequired : 1 |
Hospital_Name | It identifies the name of the hospital referred to as the provider. | string | required : 1 |
PPC_Number | It identifies the Potentially Preventable Complication (PPC) number in the hospital. | integer | level : Ratiorequired : 1 |
PPC_Description | It includes descriptions for different Potentially Preventable Complications (PPCs). | string | required : 1 |
PPC_Tier | Indicates the Potentially Preventable Complication (PPC) condition. | integer | level : Nominalrequired : 1 |
Benchmark | It refers to the Benchmarks for each PPC based on FY 2015 base period data. It is used to assign attainment and improvement points comparing FY 2015 with CY 2016 performance. | number | level : Ratio |
At_Risk_FY_2016 | It identifies the risk adjusted rate of the maryland hospital during fiscal year 2016. | integer | level : Ratio |
Observed_PPC_FY_2016 | It includes the observed Potentially Preventable Complication (PPC) during fiscal year 2016. | integer | level : Ratio |
Expected_PPC_FY_2016 | It identifies the Expected Potentially Preventable Complication (PPC) during fiscal year 2016. | number | level : Ratio |
OE_Ratio_FY_2016 | It indicates the Ratio for Observed and Expected values for PPC during fiscal year 2016. | number | level : Nominal |
At_Risk_Performance | It identifies the risk performance of the maryland hospital during fiscal year 2016. | integer | level : Nominal |
Observed_PPC_Performance | It includes the observed Potentially Preventable Complication (PPC) Performance during fiscal year 2016. | integer | level : Nominal |
Expected_PPC_Performance | It identifies the Expected Potentially Preventable Complication (PPC) Performance during fiscal year 2016. | number | level : Nominal |
OE_Ratio_Performance | It indicates the Ratio for Observed and Expected values for PPC performance during fiscal year 2016. | number | level : Ratio |
Unweighted_Achievement_Point | It identifies the unweighted achievement point for Potentially Preventable Complication (PPC) during fiscal year 2016. | integer | level : Ratio |
Unweighted_Improvement_Points | It identifies the unweighted improvement points for Potentially Preventable Complication (PPC) during fiscal year 2016. | integer | level : Ratio |
Unweighted_Final_Points | It identifies the unweighted final points for Potentially Preventable Complication (PPC) during fiscal year 2016. | integer | level : Ratio |
Data Preview
Hospital Id | Hospital Name | PPC Number | PPC Description | PPC Tier | Benchmark | At Risk FY 2016 | Observed PPC FY 2016 | Expected PPC FY 2016 | OE Ratio FY 2016 | At Risk Performance | Observed PPC Performance | Expected PPC Performance | OE Ratio Performance | Unweighted Achievement Point | Unweighted Improvement Points | Unweighted Final Points |
210001 | MERITUS MEDICAL CENTER | 1 | Stroke & Intracranial Hemorrhage | 2 | 0.5707 | 14071 | 9 | 8.9818 | 1.002 | 12943 | 6 | 9.2333 | 0.6498 | 8.0 | 8.0 | 8.0 |
210001 | MERITUS MEDICAL CENTER | 3 | Acute Pulmonary Edema and Respiratory Failure without Ventilation | 1 | 0.5502 | 11898 | 35 | 21.0499 | 1.6627 | 10652 | 29 | 20.9266 | 1.3858 | 2.0 | 2.0 | |
210001 | MERITUS MEDICAL CENTER | 4 | Acute Pulmonary Edema and Respiratory Failure with Ventilation | 1 | 0.5994 | 11898 | 11 | 12.059000000000001 | 0.9122 | 10652 | 8 | 13.3235 | 0.6004 | 9.0 | 9.0 | 9.0 |
210001 | MERITUS MEDICAL CENTER | 5 | Pneumonia & Other Lung Infections | 1 | 0.544 | 9719 | 17 | 14.6862 | 1.1576 | 8775 | 23 | 13.3623 | 1.7213 | |||
210001 | MERITUS MEDICAL CENTER | 6 | Aspiration Pneumonia | 1 | 0.5021 | 13516 | 9 | 11.4671 | 0.7849 | 12433 | 5 | 12.6276 | 0.396 | 10.0 | 9.0 | 10.0 |
210001 | MERITUS MEDICAL CENTER | 7 | Pulmonary Embolism | 1 | 0.3555 | 14223 | 5 | 8.6529 | 0.5778 | 13093 | 2 | 8.5737 | 0.2333 | 10.0 | 9.0 | 10.0 |
210001 | MERITUS MEDICAL CENTER | 8 | Other Pulmonary Complications | 2 | 0.4387 | 7840 | 11 | 6.0729999999999995 | 1.8113 | 7085 | 7 | 5.4469 | 1.2851 | 3.0 | 3.0 | |
210001 | MERITUS MEDICAL CENTER | 9 | Shock | 1 | 0.5528 | 13635 | 14 | 10.1779 | 1.3755 | 12524 | 11 | 12.1169 | 0.9078 | 2.0 | 5.0 | 5.0 |
210001 | MERITUS MEDICAL CENTER | 10 | Congestive Heart Failure | 2 | 0.2236 | 12575 | 8 | 8.1964 | 0.976 | 11394 | 5 | 7.2073 | 0.6937 | 4.0 | 3.0 | 4.0 |
210001 | MERITUS MEDICAL CENTER | 11 | Acute Myocardial Infarction | 2 | 0.5728 | 13919 | 9 | 9.6873 | 0.929 | 12836 | 10 | 9.6454 | 1.0368 |