1. RARE PPR for Mental Health Mark Sonneborne Vice President, Information Services Minnesota Hospital Association September 22, 2014 Participants:1-866-639-0744, access code 3808695

2. Place picture here Potentially Preventable Readmissions RARE Mental Health Collab. Mark Sonneborn February 2014

3. Review of PPRs  3M software 30-day readmissions clinically related to index admission Upgraded to v31 (from v27) in summer 2014  Based on MHA administrative data  Measures readmissions to the same facility only ~ 22% go to different facilities, per literature

4. Review: How to interpret PPR results PPRs At Risk Cases Actual Rate Expected Rate Expected PPRs Target PPRs Difference from TargetA/E Ratio 1723,8204.55.0**192.3153.918.10.90 PPRs is the actual number of PPRs detected during the time period

5. How to interpret PPR results “At Risk Cases” is the denominator – it’s all behavioral health cases, minus the exclusions PPRs At Risk Cases Actual Rate Expected Rate Expected PPRs Target PPRs Difference from TargetA/E Ratio 1723,8204.55.0**192.3153.918.10.90

6. How to interpret PPR results Actual Rate is PPRs divided by At Risk Cases PPRs At Risk Cases Actual Rate Expected Rate Expected PPRs Target PPRs Difference from TargetA/E Ratio 1723,8204.55.0**192.3153.918.10.90

7. How to interpret PPR results Expected Rate – this is a unique number for every hospital based on their patient population. Generally, hospitals with more severely ill patients will have higher expected rates. PPRs At Risk Cases Actual Rate Expected Rate Expected PPRs Target PPRs Difference from TargetA/E Ratio 1723,8204.55.0**192.3153.918.10.90

8. How to interpret PPR results One star is statistically “worse than expected” (or higher); Two stars is “no different than expected”; Three stars is “better than expected” (or lower) PPRs At Risk Cases Actual Rate Expected Rate Expected PPRs Target PPRs Difference from TargetA/E Ratio 1723,8204.55.0**192.3153.918.10.90

9. How to interpret PPR results Expected PPRs is the Expected Rate times the At Risk Cases PPRs At Risk Cases Actual Rate Expected Rate Expected PPRs Target PPRs Difference from TargetA/E Ratio 1723,8204.55.0**192.3153.918.10.90

10. How to interpret PPR results Target PPRs is 20% less than Expected PPRs PPRs At Risk Cases Actual Rate Expected Rate Expected PPRs Target PPRs Difference from TargetA/E Ratio 1723,8204.55.0**192.3153.918.10.90

11. How to interpret PPR results Difference from Target is your actual PPRs (first column) minus the Target PPRs. The goal for this hospital is to reduce by 18 PPRs per year. PPRs At Risk Cases Actual Rate Expected Rate Expected PPRs Target PPRs Difference from TargetA/E Ratio 1723,8204.55.0**192.3153.918.10.90

12. Actual to Expected Ratio Actual Rate Expected RateA/E Ratio 4.55.00.90 An A/E Ratio above 1.0 is more than expected; below is less than expected. The goal for the RARE campaign is to get the A/E ratio down to 0.80

13. Effects of upgrading to v31  Norms now based on 2011-13 statewide performance Therefore, “Expected rate” changed o Previously, it was based 2009-10 A/E ratio effectively set to 1.0 o Target is 0.8 (20% reduction from the 2011-13 performance)  Statewide A/E under v27 2011-13 was 0.88 To trend previous data, multiply current A/E by 0.88 o Note: did not calculate v27 behavioral-only A/E from 2011-13

14.  Questions?  Mark Sonneborn, msonneborn@mnhospitals.org msonneborn@mnhospitals.org

15. Upcoming RARE Mental Health Events…. October 15, 2014 Face-to- face Session 9:30am-1:30pm Eagan Community Center November 3, 2014 Effective Patient and Family Advisory Committees for Mental Health Melissa Hensley and Wendy Waddell

16. Future webinars… To suggest future topics for this series, Reducing Avoidable Readmissions Effectively “RARE” Networking Webinars, contact: Kathy Cummings, kcummings@icsi.orgkcummings@icsi.org Jill Kemper, jkemper@icsi.orgjkemper@icsi.org