MHAC Hospital Performance By PPC FY2016

$179 / year

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.

Complexity

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.

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

NameDescriptionTypeConstraints
Hospital_IdRefers to the identity of the hospital (also referred to as the provider)integerrequired : 1 level : Nominal
Hospital_NameIt identifies the name of the hospital referred to as the provider.stringrequired : 1
PPC_NumberIt identifies the Potentially Preventable Complication (PPC) number in the hospital.integerrequired : 1 level : Ratio
PPC_DescriptionIt includes descriptions for different Potentially Preventable Complications (PPCs).stringrequired : 1
PPC_TierIndicates the Potentially Preventable Complication (PPC) condition.integerrequired : 1 level : Nominal
BenchmarkIt 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.numberlevel : Ratio
At_Risk_FY_2016It identifies the risk adjusted rate of the maryland hospital during fiscal year 2016.integerlevel : Ratio
Observed_PPC_FY_2016It includes the observed Potentially Preventable Complication (PPC) during fiscal year 2016.integerlevel : Ratio
Expected_PPC_FY_2016It identifies the Expected Potentially Preventable Complication (PPC) during fiscal year 2016.numberlevel : Ratio
OE_Ratio_FY_2016It indicates the Ratio for Observed and Expected values for PPC during fiscal year 2016.numberlevel : Nominal
At_Risk_PerformanceIt identifies the risk performance of the maryland hospital during fiscal year 2016.integerlevel : Nominal
Observed_PPC_PerformanceIt includes the observed Potentially Preventable Complication (PPC) Performance during fiscal year 2016.integerlevel : Nominal
Expected_PPC_PerformanceIt identifies the Expected Potentially Preventable Complication (PPC) Performance during fiscal year 2016.numberlevel : Nominal
OE_Ratio_PerformanceIt indicates the Ratio for Observed and Expected values for PPC performance during fiscal year 2016.numberlevel : Ratio
Unweighted_Achievement_PointIt identifies the unweighted achievement point for Potentially Preventable Complication (PPC) during fiscal year 2016.integerlevel : Ratio
Unweighted_Improvement_PointsIt identifies the unweighted improvement points for Potentially Preventable Complication (PPC) during fiscal year 2016.integerlevel : Ratio
Unweighted_Final_PointsIt identifies the unweighted final points for Potentially Preventable Complication (PPC) during fiscal year 2016.integerlevel : Ratio
Hospital_IdHospital_NamePPC_NumberPPC_DescriptionPPC_TierBenchmarkAt_Risk_FY_2016Observed_PPC_FY_2016Expected_PPC_FY_2016OE_Ratio_FY_2016At_Risk_PerformanceObserved_PPC_PerformanceExpected_PPC_PerformanceOE_Ratio_PerformanceUnweighted_Achievement_PointUnweighted_Improvement_PointsUnweighted_Final_Points
210064LEVINDALE9Shock1
210064LEVINDALE47Encephalopathy2
210064LEVINDALE7Pulmonary Embolism1
210064LEVINDALE6Aspiration Pneumonia1
210064LEVINDALE34Moderate Infectious2
210045MCCREADY MEMORIAL HOSPITAL9Shock1
210064LEVINDALE49Iatrogenic Pneumothrax1
210064LEVINDALE39Reopening Surgical Site2
210038UMMC MIDTOWN CAMPUS47Encephalopathy2
210013BON SECOURS HOSPITAL47Encephalopathy2