Advancing Excellence in Health Care 2.0 ETA December 2010 Carol Sniegoski AHRQ Annual Conference...

Advancing Excellence in Health Care

2.0ETA December 2010

Carol SniegoskiAHRQ Annual Conference

September 27, 2010

Preview:


Future MONAHRQs (Estimated)

Jan Feb Mar Apr May Jun Jul Aug SepJun Jul Aug Sep Oct Nov Dec

2 0 1 0 2 0 1 1

MONAHRQ 1.0

• 47 AHRQ QIs• Hospital rates and

costs• Area rates and costs

MONAHRQ 2.0• More AHRQ QIs• More measures• Updated user interface

MONAHRQ 3.0• TBD

MONAHRQ 2.1• FY11 coding updates• Even more AHRQ

QIs

MONAHRQ 1.1• FY10 coding updates• Additional AHRQ QIs


MONAHRQ 1.0

Hospital Quality Path Hospital Utilization Path

Area Preventable Hospitalizations Path

Area Rates Path

• Many AHRQ Inpatient QIs (provider level)• Many AHRQ Patient Safety QIs (provider

level)

• AHRQ Inpatient QIs (area level) • AHRQ Patient Safety QIs (area level)• AHRQ Prevention QIs

• Procedure and condition rates and costs by area

• Procedure and condition rates and costs by hospital


MONAHRQ 2.0

Hospital Utilization Path

Area Preventable Hospitalizations Path

Area Rates Path

Hospital Quality Path

• All AHRQ Inpatient QIs (provider level)• All AHRQ Patient Safety QIs (provider level)• Hospital Compare inpatient measures

• AHRQ Inpatient QIs (area level) • AHRQ Patient Safety QIs (area level)• AHRQ Prevention QIs

• Procedure and condition rates and costs by area

• Procedure and condition rates and costs by hospital


Quick Guide: AHRQ Quality Indicators in MONAHRQ

AHRQ Inpatient QIs

AHRQ Patient Safety QIs

2.0(2010)

AHRQ Neonatal QIs

AHRQ Pediatric QIs

3.0(2011)

AHRQ Prevention QIs

1.0(2010)

included some included

not included


Quick Guide: Hospital Compare Measures in

MONAHRQ

CMS Process Measures, Inpatient

CMS Outcome Measures (30-Day Mortality and Readmissions)

CMS Hospital Acquired Conditions (Sep 2010)

Surgical care improvementHeart attackHeart failurePneumoniaChildren’s asthma care

Heart attackHeart failurePneumonia

CMS Structural Measures

CMS Outpatient Imaging Efficiency Measures

Medicare Payment and Volume Information

2.01.0

HCAHPS Measures

CMS Process Measures, Outpatient


not included


Hospital Compare Measure Results and MONAHRQ

MOHAHRQ 1.0 model:

Step 1

You download MONAHRQ

Step 2

You load your data

You calculate measure results

Step 3

You generate a

Website

Step 4

Calculate your own measure results


Hospital Compare Measure Results and MONAHRQ

MOHAHRQ 2.0 model:

Calculate your own measure results

You download CMS measure

results

You load CMS

measure results

You link hospitals

Load precalculated measure results

Step 1

You download MONAHRQ

Step 2

You load your data

You calculate measure results

Step 3

You generate a

Website

Step 4

and/or


Handling Hospital Compare Measure Results

We download the publicly available Hospital Compare measure results file from CMS

We clean, format, and test the file to make sure it works with MONAHRQ

We post the cleaned file to the MONAHRQ site

You go to the MONAHRQ site and download the cleaned CMS measure results file

You load the CMS measure results file and/or your own administrative data into MONAHRQ and generate a website


Update Cycles

CMS inpatient process measure results*

CMS inpatient outcome measure results*

HCAHPS results*

Annual refresh dates

MONAHRQ software updates• FY coding updates• Updates to internal

supplemental files

* According to information in document “Hospital.pdf,” version dated 03/09/10, in the Hospital Compare downloadable database

Mar Jun Sep Dec


New Look and Feel: Home Page

New hospital quality path


New Search Page

Select health topic

Tab between consumer and professional

paths

Select hospitals


New Hospital Search

Select radius in miles

Enter ZIP codeSearch by ZIP code or by region

Find hospitals


New Hospital Search

Select Hospitals for Comparison

Hospital list appears

Select one or more hospitals


New Health Topic Search

Select health topic

Topic description

appears


New Search Page

Select Hospitals for Comparison

Submit to go to classification table

page


New Classification Table

Consumer path: red / yellow / green

icons

Professional path: numbers with

confidence intervals

Two-way scrolling



Tab for outcome measures

Tab for process measures

Tab between subgroups



Sortable column for each indicator

New classification icons

• Above average• Average• Below average

• Top 10%• Above median• Below median

Switch between benchmarks: input

file and national



Professional path: drill down to either

bar charts or detailed statistics

Consumer path: drill down to bar

charts view


MONAHRQ Learning Network

Goals• Facilitate MONAHRQ adoption• Gather feedback

Timeframe• Through June 2011

Participants• MONAHRQ adopters and serious potential adopters

Progress• Recruitment complete: 32 committed participants• Kickoff meeting after NAHDO conference, October 14



Types of MONAHRQ Learning Network Participants

HCUP PartnerCVE

Other

Other State Government

Other University

Individual Hospital



HCUP PartnerCVE

Other


Other University

Individual Hospital

MONAHRQ Learning Network Participant Locations


MONAHRQ Website www.monahrq.ahrq.gov


Websites Generated Using MONAHRQ


Questions?monahrq.ahrq.gov


Questions?


Websites Generated Using MONAHRQ


Data Refresh Cycles

CMS process measures* Quarterly(Sep, Dec, Mar, Jun)

12 months

CMS mortality and readmissions measures*

Annually(Jun)

36 months

HCAHPS patient experience measures*

12 months

Refresh rate Data period Data lag

Quarterly(Sep, Dec, Mar, Jun)

9 months

9 months

12 months

Census data for population denominators in area rates and area-level AHRQ QIs

12 monthsAnnually(?)

? months





HCUP PartnerCVE

Other


Other University

Individual Hospital



HCUP PartnerCVE

Other


Other University

Individual Hospital


HCUP PartnerCVE

Other


Other University

Individual Hospital


Quick Guide: AHRQ Quality Indicators in MONAHRQ

AHRQ Inpatient QIs*

AHRQ Patient Safety QIs*

1.1 (Oct/Nov 2010)

2.0 (Dec 2010)

IQI 2IQI 5IQI 9IQI 12IQI 13IQI 18IQI 19IQI 20IQI 21IQI 33IQI 34

PSI 3PSI 5PSI 7PSI 9PSI 16

AHRQ Neonatal QIsAHRQ Pediatric QIs

All

All

2.1(April/May 2011)

AHRQ Prevention QIs All

1.0 (Jun 2010)

* Any individual AHRQ QIs not listed are already included in MONAHRQ 1.0


not included


Quick Guide: Hospital Compare Measures in MONAHRQ

CMS Process Measures, Inpatient

CMS Outcome Measures (30-Day Mortality and Readmissions)

CMS Hospital Acquired Conditions (Sep 2010)

Surgical care improvementHeart attackHeart failurePneumoniaChildren’s asthma care

Heart attackHeart failurePneumonia

CMS Structural MeasuresCardiac Surgery Registry Participation

CMS Outpatient Imaging Efficiency Measures

Medicare Payment and Volume Information

2.0(Dec 2010)

3.0(Sep 2011)

1.x

HCAHPS Measures

CMS Process Measures, Outpatient (Jun 2010)


Data Update Cycles

CMS inpatient process measure results* 12 months

CMS inpatient outcome measure results* 36 months

HCAHPS results* 12 months

Annual refresh dates Data period

Data lag

9 months

9 months

12 months

MONAHRQ software updates• FY coding updates• Census data

• area rates• area-level AHRQ QIs

• Risk-adjustment data• provider-level AHRQ QIs

• FIPS data• areas and maps

12 months, including

yearly historical

data since 1996

? months


Mar Jun Sep Dec


Update Cycles

CMS inpatient process measure results* 12 months

CMS inpatient outcome measure results* 36 months

HCAHPS results* 12 months

Annual refresh dates Data period

Data lag

9 months

9 months

12 months

MONAHRQ software updates• FY coding updates• Updates to internal

supplemental files

12 months, including

yearly historical

data since 1996

? months


Mar Jun Sep Dec

Advancing Excellence in Health Care 2.0 ETA December 2010 Carol Sniegoski AHRQ Annual Conference...

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