RARE PPR for Mental Health

Mark SonneborneVice President, Information Services

Minnesota Hospital Association

September 22, 2014

Participants:1-866-639-0744, access code 3808695

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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

Questions?

Mark Sonneborn, msonneborn@mnhospitals.org

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, kcummings@icsi.org

Jill Kemper, jkemper@icsi.org