Copyright 2006 Thomson Medstat and The Leapfrog Group 1 INFORMATION SOLUTIONS 12/01/2006Leapfrog Opportunity Rate - Overview The Leapfrog Opportunity Rate Metric (simplified): What percent of patients are NOT going to hospitals that are Leapfrog-compliant for patients’ conditions, aka “defect rate” Objectives/uses: –Track Leapfrog progress and impact on lives saved –Benchmark regions, Frog-members, and health plans to identify best practices –Health plan transparency, e.g., enrollee communication, eValuate RFI –Identify new regions for rollout, target high-volume hospitals Reported by Frogs (LFG members) and health plans (book-of- business) via Medstat for Leapfrog aggregation and analysis How to improve the rate, i.e., realize all opportunities – rate = 0% –Increase hospital compliance –Shift patients to compliant hospitals Hospital reporting: non-responders default to “not compliant” for any Leap

Copyright 2006 Thomson Medstat and The Leapfrog Group 2 INFORMATION SOLUTIONS 12/01/2006Leapfrog Opportunity Rate - Overview Opportunity Rate -- Steps 1.Tabulate counts of admissions (observations = denominators) a,b by Leap (CPOE, EBHR x6, IPS x2... not NQF) by hospital, but requires Leapfrog hospital ID (usually Medicare #) ! 2.Merge with LFG survey results to determine defects (numerator) b 3.Compute Opportunity Rate b % defects / observations, by Leap weighted by differential mortality rate 1 associated with Leap implementation – byproduct = # lives saved, # deaths avoidable 4.Report nationally to eValue8, etc. a,b a option Leapfrog/Medstat computes steps 2 & 3 b option Plan computes the rate, steps See Birkmeyer, et al “The Leapfrog Group’s Patient Safety Practices, 2003: The Potential Benefits of Universal Adoption” (Feb 2004)

Copyright 2006 Thomson Medstat and The Leapfrog Group 3 INFORMATION SOLUTIONS 12/01/2006Leapfrog Opportunity Rate - Overview Opportunity Rate – Data Policies / T&C No PHI – only case counts by Leap by hospital National data aggregation: Leapfrog publishes aggregated data 1 –Hospital-specific can be released –No member- or plan-specific detail released, except to contributor or with their permission –Leapfrog and regional rollout (RRO) leads see member- and plan-specific results Toolkit –available at no charge, free registration, subject to EULA –Leapfrog (Medstat) computes steps 2 & 3 at no charge for plan’s book of business; step 4 met a option –Plans self-sufficient using toolkit resources to compute and report, responsible for all steps 1-4 b option –Medstat will compute for plan’s key accounts (fee required) c option 1 See Data Policy and User Agreement:

Copyright 2006 Thomson Medstat and The Leapfrog Group 4 INFORMATION SOLUTIONS 12/01/2006Leapfrog Opportunity Rate - Overview Simple Option – Step 1 Plan tabulates admission counts, e.g., CY2006 –by Leap (9) … toolkit has Dx/Px coding and other criteria All admissions (CPOE) Each EBHR surgery procedure (5) Complicated newborns Admissions including ICU stay, adult and pediatric –by hospital LFG hospital ID Toolkit has national roster Use spreadsheet template (“long-form”) to submit data to Medstat –Complete header info and data: hospital/row, counts in Leap columns –User registered to submit for plan must spreadsheet –Medstat computes and returns report … typical 1- or 2-day turnaround –Plan can rely on report results to answer eValue8 RFI questions Leapfrog Help Desk/