Hospital Metrics TAG September 13, 2016 PLEASE DO NOT PUT YOUR PHONE ON HOLD: IT IS BETTER TO HANG UP AND CALL BACK IN IF NEEDED
Welcome and Introductions 2
Agenda Overview • Updates • SBIRT • Opioid Measure Update • Year 4 Draft Specifications • Learning Series 3
Updates 4
CCO Metrics / Metrics and Scoring Committee Updates • CCO Metrics & Scoring Committee met on August 19 th and: • Finalized 2017 benchmarks • Reviewed 2018 measure selection work plan • Reviewed 2015 metrics by race and ethnicity • CCO Metrics & Scoring Committee next meet Friday, September 16 th . Agenda items include: • Selecting 2017 challenge pool • Presentations on kindergarten readiness and medication therapy management measures 5
Health Plan Quality Metrics Committee • Purpose: to identify health outcome and quality measures that may be applied to services provided by CCOs or paid for by health benefit plans sold though the HIE or offered by the OEBB or the PEBB. • Will not oversee hospital metrics, but there will be a hospital representative on the Committee • The deadline to apply is 8:00 am Wednesday, October 19th. 6
Committee Meeting Debrief • No meeting was held in August • The next meeting is scheduled for September 21 with new committee membership. Agenda items include: – Discussing Year 4 benchmarks & options – The Perinatal Collaborative will deliver a presentation – Discussing challenge pool metric(s) 7
HTPP 4 Update: CMS Discussion • Years 4+ (2017 on) are part of OHA’s Medicaid waiver renewal proposal; OHA continues working with CMS 8
HTPP 4: EDIE Report • OHA surveyed hospitals on what and who to include in a report to help hospitals track patients approaching their sixth visit in 12 months at the same facility. • Working with CMT on the following: – Frequency : Hospitals would like the report to be updated on a weekly basis – Population (i.e., at what point should a patient to appear in the report to allow time to coordinate with partners): • Hospitals were evenly split between the third and fourth visit. CMT investigating production of two reports (one showing those at their third visit and one at their fourth) 9
HTPP 4: EDIE Report • Wish list of fields (some likely not available in EDIE – CMT investigating): – Patient name – Admit date – Admit time – Primary care provider (name and any other info available – contact info, etc.) – MR number – Encounter ID – Whether patient has a care guideline – Payer source (if available) – Chief complaint – Diagnosis (primary diagnosis code) • If possible, list for each visit up to threshold – Discharge prescriptions • If possible, list for each visit up to threshold 10
Questions? 11
SBIRT 12
SBIRT: Long-Term Vision • Where we are – Hospitals report and are held accountable for benchmarks on either the brief or the full screen AND – Report on the brief intervention (no benchmark) – Creates problems as hospitals fully implement SBIRT, change and improve processes, etc. • Where we’re going (HTPP Years 5+) – Process where all hospitals will be required to report on full SBIRT process – This would begin with a requirement to report on both screening rates (brief and full) using OHA-approved tools for both screens – Benchmark likely to move to a composite which incorporates performance on both rates – Reporting on the brief intervention would continue (and potentially would have benchmark in future years [possibly Year 6+/2019]) 13
SBIRT: Long-Term Vision • How Get There – Working closely with OAHHS and H-TAG – Updating our documentation to make sure it is appropriate / applicable for use in emergency department settings – Creating SBIRT ED Toolkit (updated, ED specific metric documentation) – Working with OAHHS on additional education / technical assistance (SBIRT education session on November 15 th , etc.) 14
Augmented version of CRAFFT Jim Winkle, MPH, Project Director of the SBIRT Oregon Residency Initiative, OHSU 15
Proposed Opioid Metric • Since last H-TAG meeting, OHA heard more from WA state regarding the specifics of their methodology • To remain comparable to WA state and address some of concerns from ED physicians, the current proposal is in three parts (versus two) ( subject to Committee approval / portion to be incentivized also subject to Committee review): 1) Average number of pills per opioid Rx in the ED 2) Average morphine equivalent strength per prescription written in the ED. This would be report-only, with results shared publicly, but not incentivized 3) Percent of ED visits that result in an opioid Rx . This would be report-only, with results shared publicly, but not incentivized. 16
Opioid Reporting Test Group • Met on August 25 th • Clarifications requested on: o Types of opioids for inclusion. o Tablets, capsules, and lozenges regardless of administration (now noted in specifications) o Inclusion of pre-packs? o Yes, pre-packs should be included in all counts (now noted in specifications) o Role of ‘master’ versus ‘floor’ list of opioids. o OHA will provide a master list of opioids that all hospitals will be required to include in measure. All hospitals will need to use this list. • Next webinar is September 22 nd (check-in on progress, issues with specifications, etc.) 17
Opioid Metric – Baseline / reporting clarification 18
Review Specifications 19
Learning Series Barbara Wade, Apprise/OAHHS 20
Wrap-up • Future agenda items? • Next meeting: Tuesday, October 11, 10 am – noon • H-TAG webpage www.oregon.gov/oha/analytics/Pages/Hospital-Metrics- Technical-Advisory-Group.aspx • OHA contact for all HTPP related questions: metrics.questions@state.or.us 21
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