RARE PPR for Mental Health
Mark SonneborneVice President, Information Services
Minnesota Hospital Association
September 22, 2014
Participants:1-866-639-0744, access code 3808695
Place picture here
Potentially Preventable ReadmissionsRARE Mental Health Collab.
Mark Sonneborn
February 2014
Review of PPRs
3M software• 30-day readmissions clinically related to index
admission• Upgraded to v31 (from v27) in summer 2014
Based on MHA administrative data Measures readmissions to the same facility
only• ~ 22% go to different facilities, per literature
Review:How to interpret PPR results
PPRsAt Risk Cases
Actual Rate
Expected Rate
Expected PPRs
Target PPRs
Difference from Target A/E Ratio
172 3,820 4.5 5.0 ** 192.3 153.9 18.1 0.90
PPRs is the actual number of PPRs detected during the time period
How to interpret PPR results
“At Risk Cases” is the denominator – it’s all behavioral health cases, minus the exclusions
PPRsAt Risk Cases
Actual Rate
Expected Rate
Expected PPRs
Target PPRs
Difference from Target A/E Ratio
172 3,820 4.5 5.0 ** 192.3 153.9 18.1 0.90
How to interpret PPR results
Actual Rate is PPRs divided by At Risk Cases
PPRsAt Risk Cases
Actual Rate
Expected Rate
Expected PPRs
Target PPRs
Difference from Target A/E Ratio
172 3,820 4.5 5.0 ** 192.3 153.9 18.1 0.90
How to interpret PPR results
Expected Rate – this is a unique number for every hospital based on their patient population. Generally, hospitals with more severely ill patients will have higher expected rates.
PPRsAt Risk Cases
Actual Rate
Expected Rate
Expected PPRs
Target PPRs
Difference from Target A/E Ratio
172 3,820 4.5 5.0 ** 192.3 153.9 18.1 0.90
How to interpret PPR results
One star is statistically “worse than expected” (or higher); Two stars is “no different than expected”; Three stars is “better than expected” (or lower)
PPRsAt Risk Cases
Actual Rate
Expected Rate
Expected PPRs
Target PPRs
Difference from Target A/E Ratio
172 3,820 4.5 5.0 ** 192.3 153.9 18.1 0.90
How to interpret PPR results
Expected PPRs is the Expected Rate times the At Risk Cases
PPRsAt Risk Cases
Actual Rate
Expected Rate
Expected PPRs
Target PPRs
Difference from Target A/E Ratio
172 3,820 4.5 5.0 ** 192.3 153.9 18.1 0.90
How to interpret PPR results
Target PPRs is 20% less than Expected PPRs
PPRsAt Risk Cases
Actual Rate
Expected Rate
Expected PPRs
Target PPRs
Difference from Target A/E Ratio
172 3,820 4.5 5.0 ** 192.3 153.9 18.1 0.90
How to interpret PPR results
Difference from Target is your actual PPRs (first column) minus the Target PPRs.
The goal for this hospital is to reduce by 18 PPRs per year.
PPRsAt Risk Cases
Actual Rate
Expected Rate
Expected PPRs
Target PPRs
Difference from Target A/E Ratio
172 3,820 4.5 5.0 ** 192.3 153.9 18.1 0.90
Actual to Expected Ratio
Actual Rate
Expected Rate A/E Ratio
4.5 5.0 0.90
An A/E Ratio above 1.0 is more than expected; below is less than expected.
The goal for the RARE campaign is to get the A/E ratio down to 0.80
Effects of upgrading to v31
Norms now based on 2011-13 statewide performance• Therefore, “Expected rate” changed
o Previously, it was based 2009-10
• A/E ratio effectively set to 1.0 o Target is 0.8 (20% reduction from the 2011-13 performance)
Statewide A/E under v27 2011-13 was 0.88• To trend previous data, multiply current A/E by 0.88
o Note: did not calculate v27 behavioral-only A/E from 2011-13
Upcoming RARE Mental Health Events….
October 15, 2014Face-to- face Session9:30am-1:30pmEagan Community Center
November 3, 2014 Effective Patient and Family Advisory Committees for Mental HealthMelissa Hensley and Wendy Waddell
Future webinars…
To suggest future topics for this series, Reducing Avoidable Readmissions Effectively “RARE” Networking Webinars, contact:
Kathy Cummings, [email protected]
Jill Kemper, [email protected]