1. The Leapfrog Hospital Recognition Program A program of The Leapfrog Group

2. Overview of The Leapfrog Group

3. The Leapfrog Group: Mission  The Leapfrog Group was formed in 2000 by a passionate group of Fortune 500 companies following the release of the Institute of Medicine’s (IOM) report To Err is Human.  From the beginning, The Leapfrog Group as been committed to leveraging the purchasing power of its members to make giant leaps in the safety, quality, and affordability of health care in the U.S. by: Supporting informed healthcare decisions by those who use and pay for health care Promoting high-value health care through incentives and rewards

4. The Leapfrog Group: Core Principles  Transparency: Leapfrog publically reports results of The Leapfrog Hospital Survey and works with others to strengthen public reporting efforts at the state and national level.  Standard Measurement & Practices: Leapfrog advocates for the standardization of measurement because of its role in helping purchasers and consumers discern variation in performance and the standardization of practices because it improves safety and quality.  Incentives & Recognition: Leapfrog believes that the highest performing hospitals should be recognized and rewarded. Leapfrog’s Top Hospital award and Hospital Recognition Program puts this idea into practice.

5. Overview of The Leapfrog Hospital Survey

6. The Leapfrog Hospital Survey  The Leapfrog Hospital Survey measures and publicly reports hospital performance on national safety, quality, and efficiency standards.  Standards focus on processes, structures, and outcomes.  The Survey results are publically displayed at www.leapfroggroup.org/cp and used to inform the health care decisions of purchasers and consumers. www.leapfroggroup.org/cp  Leapfrog has harmonized many of its standards with The Joint Commission, CMS, and other state and national organizations to minimize the burden of reporting for hospitals.

7. 2011 Leapfrog Hospital Survey Database  1106 hospitals from 45 states* reporting on over 12 million admissions  Hospitals range in size from 1000 inpatient beds  220,000+ total inpatient beds in the database *As of August 31, 2011

8. Overview of The Leapfrog Hospital Recognition Program

9. Leapfrog Hospital Recognition Program Leapfrog Hospital Recognition Program (LHRP) utilizes the publicly reported results of The Leapfrog Hospital Survey to identify and reward hospitals that achieve quality and resource use goals derived from national benchmarks. LHRP scores hospitals in three areas of performance: Quality Resource Use Value

10. Quality Score  The Quality score represents 65% of the overall Efficiency Score.  The Quality score is based on a hospital’s performance on the following national quality standards: Common Acute Conditions (AMI, Pneumonia, and Normal Deliveries) Outcomes for High Risk Procedures (CABG, PCI, AVR, AAA, Pancreatectomy, Esophagectomy, Bariatric Surgery, and High-risk Deliveries Hospital Acquired Conditions (pressure ulcers, injuries, and central-line associated blood stream infections) Computerized Physician Order Entry (CPOE) ICU Physician Staffing (IPS) NQF Safe Practices Leapfrog’s Never Events Policy

11. Resource Use Score  The Resource Use score is 35% of the overall Efficiency Score.  The Resource Use score is based on a hospital’s average length of stay (risk adjusted and tempered by 14-day re-admission) for the following: Common Acute Conditions (AMI and Pneumonia) Outcomes on High Risk Procedures (CABG and PCI)  In addition, the Resource Use score includes the following measures which have been shown to significantly impact length of stay and/or cost of care: Hospital Acquired Conditions (pressure ulcers, injuries, and central-line associated blood stream infections) Normal Newborn Deliveries CPOE ICU Physician Staffing

12. Value Score  The Value score is a combination of Quality (65%) and Resource Use (35%).  Health plans and purchasers who license LHRP, use the Value score to determine whether a hospital is placed in the Attainment or Improvement category of rewards. Attainment is reserved for hospitals whose score represents “top performance” when compared to their peers in a market or nationwide. Improvement is for hospitals that have not attained “top performance” when compared to their peers, but demonstrate improvement in Quality and/or Resource Use.  Hospitals can use their value score to rank themselves among other Leapfrog hospitals.  The Value score is also used to determine Leapfrog Top Hospitals

13. LHRP Scoring Methodology

14. Measure Scores  A numerical score of 0-100 is calculated for each measure that applies to a hospital’s score. If a hospital does not perform a procedure, they receive a score of N/A for that measure.

15. Standard Weights  A measure weight is then applied to each numerical score. If a measure does not apply to a hospital, the weight for that measure is distributed across applicable measures.

16. Calculating Quality, Resource Use, & Value  The sum of each weighted score is then combined into three composite scores: Quality Resource Use (Quality x 65% = Resource Use x 35%)

17. Understanding Your LHRP Scores  The scatter plot illustrates how a hospital compares to others in the state and nation on Quality and Resource Use (in each category a higher score is better).

18. Understanding Your LHRP Scores  The Value Score comparison illustrates how a hospital compares to others in the nation. Each decile represents a range of value scores from 0-100 rounded to the nearest whole number.

19. How To Use Your LHRP Report  Use the color-coded measure scores to identify areas of excellence and opportunities for improvement  Use the color-coded measure scores to prioritize quality improvement initiatives  Use the color-coded measure scores and scatter plot to engage your board of directors in a dialogue around quality and resource use.  Use the state and national averages to set goals for improvement  Use the value comparison to set goals for improvement

20. For More Information  About LHRP and LHRP Reports visit www.leapfroggroup.org/lhrpreports www.leapfroggroup.org/lhrpreports  About The Leapfrog Hospital Survey visit www.leapfroghospitalsurvey.org www.leapfroghospitalsurvey.org  About Leapfrog visit www.leapfroggroup.org www.leapfroggroup.org