1. EVALUATION OF THE QUALITY OF PRESENT-ON-ADMISSION CODING ScoreGradeHospitals (#) Hospitals (%) >95%A31 16.6% >90% to 95%B34 18.2% >80% to 90%C41 21.9% >70% to 80%D26 13.9% >70% or lowerF55 29.4% Total Scored187100%

2. POA Screening Results for Sample Hospital Scores for High-Risk Medical Conditions ScreenScoreRange* Chronic medical conditions11 to 6 Acute and chronic components11 to 2 High prevalence of hospital-acquired21 to 4 High mortality when hospital-acquired31 to 5 * 1 = Best Result

3. POA Screening Results for Sample Hospital Scores for Elective Surgical Procedures ScreenScoreRange* Chronic medical conditions11 to 6 Acute and chronic components11 to 2 Relative contraindications31 to 5 Routine cases with long postop LOS21 to 2 * 1 = Best Result

4. POA Screening Results for Sample Hospital Scores for Labor and Delivery ScreenScoreRange* Chronic medical conditions11 to 6 Pre-labor obstetrical conditions31 to 6 Inconsistent coding of delivery11 to 4 Inconsistent coding of complications11 to 5 * 1 = Best Result

5. POA Screening Results for Sample Hospital Scores for General Screens and Aggregate Performance ScreenScoreRange* Miscoded exempt codes11 to 5 Miscoded non-exempt codes21 to 6 Miscoded principal diagnoses31 to 6 * 1 = Best Result Overall PerformanceScoreGrade All 15 screens83.5%C

6. Distribution of Hospital Total Scores ScoreGradeHospitals (#) Hospitals (%) >95%A31 16.6% >90% to 95%B34 18.2% >80% to 90%C41 21.9% >70% to 80%D26 13.9% >70% or lowerF55 29.4% Total Scored187100%

7. COMPARISON OF RISK-ADJUSTED CLINICAL PERFORMANCE

8. Observed and Predicted Hospital Mortality Rates Congestive Heart Failure

9. Observed and Predicted Hospital Adverse Outcome Rates Congestive Heart Failure

10. Hospital Cost Congestive Heart Failure

11. Adverse Outcomes and Hospital Costs Congestive Heart Failure 13.82% $6,629 7.99% $5,596

12. Observed and Predicted 30-Day Readmission Rate Congestive Heart Failure

13. DISTRIBUTION OF ADVERSE OUTCOMES

14. Distribution of Adverse Outcomes Congestive Heart Failure Chi-square = 1.85 N.S.

15. Asymmetrical Relationships of Observed and Predicted Outcomes Provide Insights about Clinical Effectiveness Overall Results Less Success with High Risk Balanced Less Success with Low Risk Superior Average Suboptimal Effect of Risk on Performance Superior Practice with Low Risk Cases Superior Practice Across All Risk Groups Superior Practice with High Risk Cases Special Problems with High Risk Cases Suboptimal Practice Across All Risk Groups Special Problems with Low Risk Cases Potential Problems with High Risk Cases No Particular Strengths or Weaknesses Potential Problems with Low Risk Cases

16. DYNAMIC PERSPECTIVE USING CONTROL CHARTS

17. Mortality Rate Congestive Heart Failure

18. Adverse Outcome Rate Congestive Heart Failure

19. Routine Cost Congestive Heart Failure

20. ASSESSMENT OF COMPARATIVE COST-EFFECTIVENESS Outcome (Best Providers) Input (Not A or C) Input (B † only in high risk) Comparison Outcome (Worst Providers) Conclusion (Best Practice = A with B † only in high risk) Cost-Effective Ineffective Risk Stratification Comparative Effectiveness

21. Comparative Effectiveness Traditional Comparative Effectiveness Analyses Congestive Heart Failure (First Line Therapy) Input A (+ Diuretics) Input A † (++ Diuretics) Comparative Effectiveness Conclusion (Best Practice = A+B † +C) Input B † (+ Vasodilators) Input B (No Vasodilators) Comparative Effectiveness Input C (No Pressors) Input C † (+ Pressors) Superior Inferior

22. Patient-Centered Comparative Cost-Effectiveness Analysis Congestive Heart Failure (First Line Therapy) Outcome (Best Providers) Comparative Effectiveness Input (Not A † or C † ) Input (B † only in high risk) Comparison Outcome (Worst Providers) Conclusion (Best Practice = A with B † only in high risk) Cost-Effective Ineffective Risk Stratification