Hospital Public Reporting

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• Hospital Public Reporting
• Background . . .Lessons Learned . . . Response

Presented by Michael T. Lundberg Executive
Director May 25, 2005
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What VHI Does Our Mission

• To create and disseminate health care information
• To promote informed decision making by Virginia
  consumers, business and
• To enhance the quality of health care delivery

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VHIs Organization

• Public/private partnership formed in 1993
• VHI is state-recognized source to collect,
  analyze and disseminate Virginia health care data
• Works through contracts with state health
  commissioner, private contracts, sales and
  services

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2 Nursing Facility Members
3 Consumer Members
5 Business Members
2 Hospital Members
VHI Board Of Directors
2 Health Insurance Members
2 Physician Members
2 State Members
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Health Data from Many Sources for Many Needs

• Hospital Discharge Data 860,000 discharges per
  year, 90 hospitals
• EPICS financial and operational information from
  370 ambulatory surgical centers, hospitals,
  nursing homes
• Outpatient Surgical Data for 7 procedure groups
  from ambulatory surgery centers, hospitals and
  physician offices
• HMO data from State Corporation Commission and
  National Committee on Quality Assurance
• Long-term care data
• Hospital and other facility licensure data

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VHI Revenues FY2006
2.85 HMO Fees
15.3 General Appropriations
P
48.2 Product Sales and Services
33.8 EPICS Provider Fees
SF
Nationwide, 2004 General Appropriations were 59
of State Data Organization Revenues
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VHI Consumer Publications
Cardiac Care Reports
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VHI Performance Measurements/Information
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www.vhi.org Hosts 150,000 Annual Visitors
Seeking Health Care Information

• Wide range of Virginia health care information
• Ambulatory surgical centers, hospitals, HMOs,
  nursing homes, physicians, long term care
• Who does what, where, costs, charges, outcomes,
  rankings

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Public Reporting StrategyLessons Learned

• Involve hospitals in design of measures and
  listen
• Design severity adjustment carefully . . . test
  and retest
• Allow hospitals a pre-release review and chance
  to tell their story
• Follow-up on challenges to reporting model
• Test public/provider response
• Make needed changes

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Hospital-Reported Actions in Response toVHI
Public Reporting

• Some hospitals began monitoring all high or low
  risk of mortality cases upon admission to improve
  care management
• Changed hospital policies to improve reporting of
  secondary diagnoses
• Hospitals present reports to medical staff to
  review results and identify reasons for
  variation some to improve documentation of
  morbidity
• Revised process of coding to better represent
  patients risk of mortality/severity of illness

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Next Steps in Public Reporting

• Expand cardiac care information to include 14-day
  related readmissions
• Allow drill down to subcategories such as AMI
  and heart failure within the medical cardiology
  service line and others
• Look to include 30-day post hospitalization
  mortality rates
• Evaluate certain AHRQ Quality Indicators for
  public reporting
• Use AHRQ Prevention Quality Indicators for local
  health department chronic disease prevention
  programs

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Supporting Pay for Performance and Consumer
Initiatives

• Anthem Blue Cross and Blue Shield, Virginia
  Quality-In-Sights Hospital Incentive Program
• VHI provides health information, website
  development and hosting to support this program
• Anthem Blue Cross and Blue Shield, Virginia
  Hospital Comparison Tool
• Length of stay efficiency information on 41
  procedures/conditions for Anthem subscriber use
• Anthem Northeast Quality-In-Sights Hospital
  Incentive Program (Maine, Connecticut, New
  Hampshire)
• VHI provides website development and hosting to
  support this program

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• Without health there is no happiness. An
  attention to health, then should take place of
  every other object.
• Thomas Jefferson, 1787