Midas Risk Model v3.0 Features and Capabilities · Midas Risk Model v3.0 Features and Capabilities...

Midas Annual Symposium September 17 – 19, 2019 Tucson, Arizona 1

Midas Annual Symposium | September 17 – 19, 2019

Loews Ventana Canyon Resort Tucson, Arizona

Midas Health Analytics Solutions

Midas Risk Model v3.0

Features and CapabilitiesWelcome Changes and New Enhancements

Carla Kinder

CPMS/DV/Live Functional Product Manager

Ellen Hamel

DataVision Product Specialist

Steven Philips

DataVision Product Specialist


After completing this session, you will be able to

• discuss the history of the Midas Risk Adjusted model (MRA) and how the

model is used in quality improvement initiatives,

• explain how to navigate and use the MRA tools to quickly access relevant

information, and

• demonstrate how the new MRA v3.0 model and enhancements impact

current initiatives and processes.

Objectives


Evolution of Midas Risk Adjustment

2015

Version 1.0 (ICD-9 only)

2016

Version 1.1 (ICD-9 and ICD-10)

2017

Version 2.0 (ICD-10 only)

2019

Version 3.0


More timely

More specific

More robust

More relevant

Why Midas

Risk

Adjustment?


Using the MRA

• Individual Relative Weight (CMI)

• Mortality

• Length of Stay

• Readmissions

• Charges

• Complications


Quick Navigation to the Risk Focus


Clinical and Complication Cluster Changes

Improved Accuracy

Use of CMS Data and Comparative Data

ICD-10 code updates

Revealing

MRA 3.0


Clinical Cluster Changes

New Clinical Clusters Added:

• 275 Septic shock• 283 Severe Sepsis Related Conditions, without Shock

• 276 Diseases of Ears, Mouth and Throat• 277 Heart Valve and Structural Disorders• 278 Injury-related Fractures Other Than Spine• 279 Injury-related Joint Disorders, Dislocations, Sprains and Strains• 280 Meningitis, Encephalitis and other CNS Infections• 281 Mycoses and Tuberculosis• 282 Other Cancers and Benign Neoplasms• 284 Skin Ulcers, Nonmalignant Breast and Subcutaneous Conditions• 285 Thrombosis, Phlebitis and Embolis• 286 Genitourinary Cancer• 541 Colostomy, Ileostomy and Enterostomy Procedures• 542 Musculoskeletal - Other Procedures on Joints and Ligaments• 543 Procedures of Ears, Nose, Mouth and Throat• 544 Spinal Fusion and Vertebral Procedures• 545 Musculoskeletal - Procedures of Head, Facial Bones• 546 Musculoskeletal - Other Procedures on Bone

Additional Changes:

• (85) Clinical Clusters being retired, and the associated

codes moved to other clinical clusters

• (6) Clinical Clusters renamed


Complication Cluster Changes

New Complication Clusters Added:

• 650 Myocardial Infarction

• 651 Venous embolism and thrombosis upper extremity

• 652 Phlebitis and thrombosis lower extremity

• 653 Intra and post-op procedure

endocrine and lymphatic system complication

• 654 Foreign Body Left during Procedure

• 655 Gastrointestinal hemorrhage and/or perforation

• 656 Intra and post-op procedure integumentary

system complication

• 657 Pericardial effusion and tamponade

Additional Changes:

• (11) Complication Clusters are being removed, and the clusters retired

• (9) Complication Clusters are being renamed


Versioning the MRA v2.0 and v3.0

• Why?

• Client’s choice*

• Allow for comparisons and goal

setting/tracking

• Default will be newest version

• Additional Indicators in the

navigation tree

* Dependent on hardware capabilities


Multiple Versioning Hardware Requirements

WHY? WHAT? HOW?


Requesting

Versioning

Contact Customer Support - Ticket

Support will evaluate client system to determine hardware capabilities

Based on evaluation, Support Team may advise upgrades


Midas Risk Model Future

Risk Model 3.0 Release - November 2019

Future Release Schedule

Transparency Report

Ambulatory Risk Model


New Reference Documents

Midas Risk Adjustment Model Reports and Indicators Quick Start Guide

Midas Risk Adjustment Methodology Quick Start Guide

Midas Risk Adjustment Model Clinical Clusters

Midas Risk Adjustment Model Complication Clusters

Midas Risk Adjustment Model Clinical Cluster ICD Code Reference


Questions and Answers


Midas Annual Symposium | September 17 – 19, 2019

Loews Ventana Canyon Resort Tucson, Arizona

Midas Health Analytics Solutions

Thanks for attending!

Any Questions?

© 2019 Conduent Business Service, LLC. All rights reserved. Conduent and Conduent Agile Star are trademarks of Conduent Business Services, LLC in the United States and/or other countries.

Carla Kinder

[email protected]

Ellen Hamel

[email protected]

Steven Philips

[email protected]

mailto:[email protected]



Midas Risk Model v3.0 Features and Capabilities · Midas Risk Model v3.0 Features and Capabilities...

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