2. Data Collection Support Webinar MetaStar, Inc. April 18, 2007 Carol Ferguson Pam Clemens

3. Announcements Invalid Record Selection Update Good news! Discussed on last month’s call in detail Thanks to Candi bringing the increased volume of these errors to CMS attention CMS is looking at it “very seriously” Keep your fingers crossed

4. Announcements QIO Clinical Warehouse Known Issues Go to www.qualitynet.org home page Click hospitals, then data submission, then notifications

5. Announcements Public Reporting Preview Period For Qtr 4 2005 – Qtr 3 2006 Preview period April 17 – May 16 Download your report from QNet inbox Review carefully! Contact Pam if you have concerns PPS hospitals – may not withhold any measures without penalty CAH – new withhold form on QNet, submit to Pam

6. Announcements Mortality Measures Reporting Contrary to previous information, there will NOT be a new pledge form required Reporting to begin October 2007 Contact mortalitymeasures@coqio.sdps.org with questions

7. Announcements Submitting Questions to Quest Search Quest (on QNet web site, home page, lower right) thoroughly before asking a question Contact QNet Help Desk to check on status of a question you asked They received 2,964 questions in February!

8. Clarifications/Updates Who Does MetaStar Send Information To? Following categories: Data Collection Support webinar – sign-up HQA contact – per pledge form RHQDAPU contact – per pledge form Hospital data contact Quality director CEO/Administrator – usually only if directed by CMS

9. Clarifications/Updates Who Does MetaStar Send Information To? If you want changes: Coordinate request internally, we suggest you work it out through the Quality Director One person from a hospital send e-mail to jparisi@metastar.com Title on e-mail: Contact changes List any additions or deletions in a category Person’s name, title, hospital name, e-mail address, category

10. Clarifications/Updates SCIP Sampling Changes for Qtr 4 2006 SCIP cases selected by primary OR secondary diagnosis

11. Clarifications/Updates Next Data Due Date Next data due to QIO Clinical Warehouse on May 15 Checklist provided by MetaStar with today’s materials will help you organize Don’t wait until last minute!

12. Most Common Abstraction Errors Pneumonia (n = 378) Initial Blood Culture Time – 17.2% Not following abstraction instructions – 24 Parent element mismatch - 6 Abstractor answer not found in record – 4 Abstractor missed information – 4 Arrival Time – 11.1% Not following abstraction instructions – 16 Abstractor missed information – 12 Abstractor answer not found in record – 8 Parent element mismatch – 6

13. Most Common Abstraction Errors Pneumonia (n = 378) Working Diagnosis of Pneumonia – 4.2% Not following abstraction instructions – 10 Abstractor answer not found in record – 7 Abstractor missed information – 3 Healthcare Associated Pneumonia – 11.4% Not following abstraction instructions – 18 Abstractor answer not found in record – 13 Abstractor missed information – 6 Parent element mismatch – 6

14. Most Common Abstraction Errors Pneumonia (n = 378) Flu and Pneumococcal – 11.5% Abstractor answer not found in record – 21 Abstractor missed information – 17 Not following abstraction instructions – 12 Parent element mismatch – 9

15. Most Common Abstraction Errors AMI (n = 97) Contraindications to beta blockers Arrival – 25.2% Not following abstraction instructions – 13 Abstractor missed information – 8 Discharge – 17.2% Abstractor missed information – 8 Not following abstraction instructions – 6

16. Most Common Abstraction Errors AMI (n = 97) Contraindications to aspirin Arrival – 13.2% Not following abstraction instructions – 4 Abstractor missed information – 5 Discharge – 14.0% Not following abstraction instructions – 8

17. Most Common Abstraction Errors AMI (n = 97) Time to EKG Not following abstraction instructions – 14%

18. CMS’s Value-Based Purchasing What is it? New acronym – VBP New name for “pay for performance” Will replace current annual payment update criteria Program will replace RHQDAPU Proposed to start Oct 2008

19. CMS’s Value-Based Purchasing Which hospitals are affected? IPPS (inpatient hospitals paid by the prospective payment system) Not CAH at this time

20. CMS’s Value-Based Purchasing Important Features Financial incentives for high performance or good improvement System based on benchmarks calculated from national hospital performance System will not expect 100% performance because CMS does not want to create unintended consequences

21. CMS’s Value-Based Purchasing Initial Proposal 20 of the core measures, not: HF – LVEF assessment AMI – beta blocker on arrival PN – oxygenation assessment PN – initial antibiotic within 4 hours SCIP – antibiotic selection HCAHPS Mortality measures - heart failure and AMI

22. CMS’s Value-Based Purchasing Proposal for Future Add measures for coordination of care among settings Compress data submission limit to 60 days Change to monthly submission

23. CMS’s Value-Based Purchasing Proposal for Future Increase sample sizes Monitor for applying exclusion criteria too broadly Strengthen validation Some targeting At measure level, not item level

24. CMS’s Value-Based Purchasing Not Yet Decided CMS is considering different options for Structuring incentive payments Phasing the program in Dealing with small numbers

25. CMS’s Value-Based Purchasing Learn More http://www.cms.hhs.gov/center/hospital.asp Slides for April 12 call are very informative Options paper looks daunting but is good

26. Questions/Feedback

27. Contact Information Contact Information: MetaStar, Inc. 2909 Landmark Place Madison, WI 53713 (608) 274-1940 or (800) 362-2320 www.metastar.com This material was prepared by MetaStar under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. 8SOW-WI-INP-07-64