Voluntary Hospital Public Reporting: PCI Readmission Collaboration between: The Centers for Medicare...
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Voluntary Hospital Public Reporting: PCI Readmission Collaboration between: The Centers for Medicare & Medicaid Services The American College of Cardiology Center for Outcomes Research and Evaluation 1
Voluntary Hospital Public Reporting: PCI Readmission Collaboration between: The Centers for Medicare & Medicaid Services The American College of Cardiology
Voluntary Hospital Public Reporting: PCI Readmission
Collaboration between: The Centers for Medicare & Medicaid
Services The American College of Cardiology Center for Outcomes
Research and Evaluation 1 Slide 2 Agenda Introduction and Roles
(next) Why Measure PCI Readmission? Voluntary Public Reporting
Overview Measure Overview Interpreting Your Results Hospital
Compare Display Conclusion and Questions 2 Slide 3 Introduction and
Roles The American College of Cardiology (ACC) Centers for Medicare
& Medicaid Services (CMS) Yale New Haven Health Services
Corporation Center for Outcomes Research and Evaluation
(YNHHSC/CORE) 3 Slide 4 Agenda Introduction and Roles Why Measure
PCI Readmission? (next) Voluntary Public Reporting Overview Measure
Overview Interpreting Your Results Hospital Compare Display
Conclusion and Questions 4 Slide 5 PCI Procedures Common cardiac
procedure More than 600,000 performed in US Improves patient
survival and quality of life 5 Slide 6 PCI Readmission Common,
potentially preventable event Major driver of cost in health care
system Variation across hospitals suggests opportunity for
improvement Evidence that hospitals can reduce readmission rates
Project RED BOOST 6 Slide 7 Opportunity for Improvement CathPCI
Registry readmission rate: 11.9% Risk-standardized readmission rate
ranges from 8.6% to 16.8% Distribution of CathPCI Registry Hospital
30-Day Risk- Standardized Readmission Rates following PCI
(2010-2011 ) 7 Slide 8 Agenda Introduction and Roles Why Measure
PCI Readmission? Voluntary Public Reporting Overview (next) Measure
Overview Interpreting Your Results Hospital Compare Display
Conclusion and Questions 8 Slide 9 Aims of Voluntary Public
Reporting Inform health care providers about opportunities to
improve care Provide public with information on readmissions after
PCI procedures without additional data collection burden to
hospitals Promote investment in QI initiatives 9 Slide 10
Overarching Goal of This Effort Shifting and Narrowing the Curve 10
Slide 11 Plans for Implementation ACC, YNHHSC/CORE, and CMS provide
measure results to CathPCI Registry hospitals in March Hospitals
can choose to voluntarily publicly report their measure results in
the July 2013 release on Hospital Compare 11 Slide 12 Timeline 12
Slide 13 Purpose of Preview Period Educate hospitals about measure
in advance of voluntary public reporting Provide hospitals with
results and data Help hospitals interpret results and data Explain
how they can participate in voluntary public reporting Allow
hospitals to ask questions 13 Slide 14 Preview Period Overview NCDR
website Hospitals have received: CathPCI Registry Results Summary
and Data File Instructions Hospital-Specific Data and Results Excel
File Publicly available resources: 2013 Measure Update Report, 2009
Technical Report, FAQs Data Release Consent Forms (to participate)
[email protected]@acc.org 14 Slide 15 Agenda Introduction and Roles
Why Measure PCI Readmission? Voluntary Public Reporting Overview
Measure Overview (next) Interpreting Your Results Hospital Compare
Display Conclusion and Questions 15 Slide 16 Measure Summary
Hospital risk-standardized 30-day readmission rate following PCI
Results for CathPCI Registry hospitals with at least one eligible
PCI 16 Slide 17 Measure Design Medicare claims linked to CathPCI
Registry data Risk model uses CathPCI Registry data Readmissions
identified using claims data Excludes planned readmissions
Estimates hospital-level risk-standardized readmission rate (RSRR)
17 Slide 18 Inclusion criteria Medicare FFS patients aged 65+
Received PCI at a CathPCI Registry hospital Discharged between
1/1/2010 and 11/30/2011 18 Slide 19 Exclusion Criteria Not enrolled
in Medicare FFS at the time of the PCI PCI performed >10 days
after admission In hospital deaths Transfers out Patient discharged
against medical advice. PCI without 30-day follow-up data PCI
performed within 30 days of a prior PCI 19 Slide 20 Risk adjustment
Accounts for differences in patient characteristics and
comorbidities across hospitals Risk adjustment variables from
CathPCI Registry data Age Gender 18 additional variables 20 Slide
21 Outcome All-cause unplanned readmission To any acute care
hospital Within 30 days of discharge Yes/No outcome Attributed to
hospital discharging the patient to a non-acute setting 21 Slide 22
Top 10 Reasons for Unplanned Readmission 22 Slide 23 Planned
Readmissions Not a signal of hospital quality Not counted in
measure outcome Measure identifies planned readmissions using
algorithm 23 Slide 24 Planned Readmission Definition 24 Slide 25
Top 10 Planned Readmissions (With stent) Top 10 Planned Procedures
among Planned Readmissions Following PCI Discharge In 2010 (without
stent) 25 Procedure CCS Procedure Description Number of Planned
Procedures 45Percutaneous transluminal coronary angioplasty
(PTCA)2161 48Insertion; revision; replacement; removal of cardiac
pacemaker or cardioverter/defibrillator477 44Coronary artery bypass
graft (CABG)300 49Other OR heart procedures126 62Other diagnostic
cardiovascular procedures120 59Other OR procedures on vessels of
head and neck102 51Endarterectomy; vessel of head and neck98
157Amputation of lower extremity55 52Aortic resection; replacement
or anastomosis55 43Heart valve procedures48 Slide 26 Top 10 Planned
Readmissions (Without stent) Top 10 Planned Procedures among
Planned Readmissions Following PCI Discharge In 2010 (without
stent) 26 Procedure CCS Procedure Description Number of Planned
Procedures 44Coronary artery bypass graft (CABG)221 45Percutaneous
transluminal coronary angioplasty (PTCA)169 48Insertion; revision;
replacement; removal of cardiac pacemaker or
cardioverter/defibrillator73 49Other OR heart procedures33
51Endarterectomy; vessel of head and neck15 99Other OR
gastrointestinal therapeutic procedures14 59Other OR procedures on
vessels of head and neck14 62Other diagnostic cardiovascular
procedures13 84Cholecystectomy and common duct exploration12
43Heart valve procedures12 Slide 27 Agenda Introduction and Roles
Why Measure PCI Readmission? Voluntary Public Reporting Overview
Measure Overview Interpreting Your Results (next) Hospital Compare
Display Conclusion and Questions 27 Slide 28 Categorizing Hospital
Performance No different than CathPCI Registry rate Worse than
CathPCI Registry rate Better than CathPCI Registry rate Number of
cases too small 28 Slide 29 Worksheet 1 PCI Readmission Results
CathPCI Registry and Your Hospitals Results on the 30-Day PCI
Readmission Measure for the 2010-2011 Reporting Period **DO NOT
TRANSMIT THIS FILE** This file contains personally identifiable
information. Note: This data is for demonstration only 29 Your
Hospital's Comparative Performance Your Hospital's Eligible Patient
Stays (#) Your Hospital's Unadjusted Readmission Rate Your
Hospital's RSRR (Lower 95% CI, Upper 95% CI) Unadjusted CathPCI
Registry Readmission Rate Number of Hospitals Better than CathPCI
Registry Readmission Rate Number of Hospitals No Different than
CathPCI Registry Readmission Rate Number of Hospitals Worse than
CathPCI Registry Readmission Rate Number of CathPCI Registry
Hospitals with too few cases (
