Has Payment, for AMI, to above National Average Hospitals, Increased? Farrokh Alemi, Ph.D.

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Ignore Tables with Same Time Periods Only 3 unique time periods in 9 tables: 2010-2013 in HQI_HOSP_AMI_Payment 2011-2014 in HQI_HOSP_Payment 2012-2015 in HQI_HOSP_PaymentAndValueOfCare4

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Select above Average Hospitals

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Restrict to AMI 30 Day Measure Select Measure Payment_30_AMI

Average Payment across Hospitals Average = Total Payment / Number of Cases Total Payment is Sum of Hospital Averages times Number of Cases Paid2010-2013: CCur(Sum(CCur(CStr([HQI_HOSP_AMI_Payment]![payment])) * Int(CStr([HQI_HOSP_AMI_Payment]![denominator]))) / Sum(Int(CStr([HQI_HOSP_AMI_Payment]![denominator])))) Divide by Sum of Cases across Hospitals Ccur converts to currency from text CStr converts to string from memo Int converts to integer

Calculation for 2011-2014

Calculation for 2011-2014 SELECT Count(([HQI_HOSP_Payment]![Provider ID])) AS [Hospitals2011-2014] , StDev(CCur(CStr([HQI_HOSP_Payment]![Payment]))) AS [StDev2011-2014] , CCur(Sum(CCur(CStr([HQI_HOSP_Payment]![Payment]))* Int(CStr([HQI_HOSP_Payment]![denominator]))) / Sum(Int(CStr([HQI_HOSP_Payment]![denominator])))) AS [Paid2011-2014] FROM HQI_HOSP_AMI_Payment INNER JOIN HQI_HOSP_Payment ON (HQI_HOSP_AMI_Payment.[Measure ID] = HQI_HOSP_Payment.[Measure ID]) AND (HQI_HOSP_AMI_Payment.[Provider ID] = HQI_HOSP_Payment.[Provider ID]) WHERE (((HQI_HOSP_AMI_Payment.[Compared to National]) Like "*Greater*") AND ((HQI_HOSP_AMI_Payment.Denominator)<>"Not Available") AND ((HQI_HOSP_AMI_Payment.[Measure ID])="PAYM_30_AMI"));

Three Query Results Time Period Number of Hospitals Average Payment Standard Deviation 2010-2013 382 $23,827.56 1052.52 2011-2014 $24,168.80 1228.38 2012-2015 381 $24,511.89 1353.20

Calculate Control Limits Time period 2010-2013 2011-2014 2012-2015 Number of Hospitals 382 381 Observed Average $23,827.56 $24,168.80 $24,511.89 Standard Deviation $1,052.52 $1,228.38 $1,353.20 Grand Average $24,169.42 Upper Limit $26,232.36 $26,577.05 $26,821.70 Lower Limit $22,106.48 $21,761.79 $21,517.14 Standard Deviation calculated in SQL Upper Limit =Grand Average + 1.96 * Standard Deviation Lower Limit =Grand Average – 1.96 * Standard Deviation

Plot Control Chart

Payment to 381 hospitals that received above average hospital payments in 2010-2013 period did not change in subsequent time periods No change in AMI payments for hospitals that had initially received above national average payments