MHAC PPC Improvement by Hospital FY 2016

$179 / year

This dataset comprises Maryland Hospital Acquired Conditions (MHAC) program FY 2016, 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 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.

Date Created

2011

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 2015, MHAC Performance By Hospital With Period 2015

NameDescriptionTypeConstraints
Hospital_IdA Unique number assigned to the hospital.integerlevel : Nominal
Hospital_NameIt identifies the name of the hospital referred to as the provider.stringrequired : 1
Observed_Base_PeriodIt identifies the Observed Base Period for Potentially Preventable Complication (PPC) for fiscal year 2015.integerlevel : Number
Expected_Base_PeriodIt includes the Expected Base Period for Potentially Preventable Complication (PPC) for fiscal year 2015.numberrequired : 1 level : Ratio
Ratio_Base_PeriodIndicates the ratio Base Period for Potentially Preventable Complication (PPC) for fiscal year 2015.numberlevel : Ratio
Adjusted_Rate_Base_PeriodIndicates the adjusted rate Base Period for Potentially Preventable Complication (PPC) for fiscal year 2015.numberlevel : Ratio
Observed_Performance_PeriodIt includes the observed performance period of the maryland hospital during fiscal year 2015.integerlevel : Nominal
Expected_Performance_PeriodIt includes the expected performance period for Potentially Preventable Complication (PPC) for fiscal year 2015.numberrequired : 1 level : Ratio
Ratio_Performance_PeriodIt indicates the ratio performance period for Potentially Preventable Complication (PPC) during fiscal year 2015.numberlevel : Ratio
Adjusted_Rate_Performance_PeriodIt includes the Adjusted Rate Performance Period for Potentially Preventable Complication (PPC) during fiscal year 2015.numberlevel : Ratio
Percent_ChangeIt identifies the percent change of the maryland hospital during fiscal year 2015.numberlevel : Ratio
Hospital_IdHospital_NameObserved_Base_PeriodExpected_Base_PeriodRatio_Base_PeriodAdjusted_Rate_Base_PeriodObserved_Performance_PeriodExpected_Performance_PeriodRatio_Performance_PeriodAdjusted_Rate_Performance_PeriodPercent_Change
210045MCCREADY MEMORIAL HOSPITAL0.03480.0407
210064LEVINDALE13723.08195.93545.38056824.64342.75942.5014-54.00
210012SINAI HOSPITAL645776.81240.83030.7527631774.73320.81450.7383-1.90
210013BON SECOURS HOSPITAL5864.62560.89750.81365660.65390.92330.8372.90
210038UMMC MIDTOWN CAMPUS133105.50391.26061.14282393.50850.2460.223-80.00
210011ST. AGNES HOSPITAL420460.5830.91190.8266339515.23260.6580.5964-28.00
210022SUBURBAN HOSPITAL404374.22141.07960.9786274397.06020.69010.6256-36.00
210061ATLANTIC GENERAL HOSPITAL7772.40871.06340.9643873.28870.51850.47-51.00
210004HOLY CROSS HOSPITAL792843.92190.93850.85076251016.5740.61480.5573-34.00
210008MERCY MEDICAL CENTER448470.12290.95290.8639339509.44450.66540.6032-30.00