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Preview: . 2.0. ETA December 2010 Carol Sniegoski AHRQ Annual Conference September 27, 2010. Future MONAHRQs (Estimated). MONAHRQ 2.0 More AHRQ QIs More measures Updated user interface. MONAHRQ 1.0 47 AHRQ QIs Hospital rates and costs Area rates and costs. MONAHRQ 3.0 TBD.

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  1. Preview: 2.0 ETA December 2010 Carol SniegoskiAHRQ Annual ConferenceSeptember 27, 2010

  2. Future MONAHRQs (Estimated) • MONAHRQ 2.0 • More AHRQ QIs • More measures • Updated user interface • MONAHRQ 1.0 • 47 AHRQ QIs • Hospital rates and costs • Area rates and costs • MONAHRQ 3.0 • TBD • MONAHRQ 1.1 • FY10 coding updates • Additional AHRQ QIs • MONAHRQ 2.1 • FY11 coding updates • Even more AHRQ QIs Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep 2 0 1 0 2 0 1 1

  3. MONAHRQ 1.0 Hospital Utilization Path Hospital Quality Path • Many AHRQ Inpatient QIs (provider level) • Many AHRQ Patient Safety QIs (provider level) • Procedure and condition rates and costs by hospital Area Preventable Hospitalizations Path Area Rates Path • Procedure and condition rates and costs by area • AHRQ Inpatient QIs (area level) • AHRQ Patient Safety QIs (area level) • AHRQ Prevention QIs

  4. MONAHRQ 2.0 Hospital Utilization Path Hospital Quality Path • AllAHRQ Inpatient QIs (provider level) • AllAHRQ Patient Safety QIs (provider level) • Hospital Compare inpatient measures • Procedure and condition rates and costs by hospital Area Preventable Hospitalizations Path Area Rates Path • Procedure and condition rates and costs by area • AHRQ Inpatient QIs (area level) • AHRQ Patient Safety QIs (area level) • AHRQ Prevention QIs

  5. Quick Guide: AHRQ Quality Indicators in MONAHRQ 1.0 (2010) 2.0 (2010) 3.0 (2011) AHRQ Inpatient QIs    AHRQ Patient Safety QIs    AHRQ Neonatal QIs    AHRQ Pediatric QIs    AHRQ Prevention QIs    some included not included included   

  6. Quick Guide: Hospital Compare Measures in MONAHRQ 1.0 2.0 CMS Process Measures, Inpatient           Surgical care improvement Heart attack Heart failure Pneumonia Children’s asthma care CMS Outcome Measures (30-Day Mortality and Readmissions)       Heart attack Heart failure Pneumonia CMS Structural Measures             HCAHPS Measures CMS Outpatient Imaging Efficiency Measures CMS Process Measures, Outpatient CMS Hospital Acquired Conditions (Sep 2010) Medicare Payment and Volume Information some included not included included   

  7. Hospital Compare Measure Results and MONAHRQ MOHAHRQ 1.0 model: Calculate your own measure results Step 1 Step 2 Step 3 Step 4 You calculate measure results You download MONAHRQ You generate a Website You load your data

  8. Hospital Compare Measure Results and MONAHRQ MOHAHRQ 2.0 model: Calculate your own measure results and/or Load precalculated measure results Step 1 Step 2 Step 3 Step 4 You calculate measure results You download MONAHRQ You generate a Website You load your data You link hospitals You load CMS measure results You download CMS measure results

  9. Handling Hospital Compare Measure Results We download the publicly available Hospital Compare measure results file from CMS We clean, format, and test the file to make sure it works with MONAHRQ We post the cleaned file to the MONAHRQ site You go to the MONAHRQ site and download the cleaned CMS measure results file You load the CMS measure results file and/or your own administrative data into MONAHRQ and generate a website

  10. Update Cycles Annual refresh dates Mar Jun Sep Dec     CMS inpatient process measure results* CMS inpatient outcome measure results*     HCAHPS results*         • MONAHRQ software updates • FY coding updates • Updates to internal supplemental files * According to information in document “Hospital.pdf,” version dated 03/09/10, in the Hospital Compare downloadable database

  11. New Look and Feel: Home Page New hospital quality path

  12. New Search Page Tab between consumer and professional paths Select health topic Select hospitals

  13. New Hospital Search Search by ZIP code or by region Enter ZIP code Select radius in miles Find hospitals

  14. New Hospital Search Select Hospitals for Comparison Hospital list appears Select one or more hospitals

  15. New Health Topic Search Select health topic Topic description appears

  16. New Search Page Select Hospitals for Comparison Submit to go to classification table page

  17. New Classification Table Professional path: numbers with confidence intervals Two-way scrolling Consumer path: red / yellow / green icons

  18. New Classification Table Tab between subgroups Tab for process measures Tab for outcome measures

  19. New Classification Table Sortable column for each indicator New classification icons • Above average • Average • Below average • Top 10% • Above median • Below median Switch between benchmarks: input file and national

  20. New Classification Table Professional path: drill down to either bar charts or detailed statistics Consumer path: drill down to bar charts view

  21. MONAHRQ Learning Network Goals • Facilitate MONAHRQ adoption • Gather feedback Timeframe • Through June 2011 Participants • MONAHRQ adopters and serious potential adopters Progress • Recruitment complete: 32 committed participants • Kickoff meeting after NAHDO conference, October 14

  22. MONAHRQ Learning Network CVE HCUP Partner Individual Hospital Other University Other State Government Other

  23. MONAHRQ Learning Network MONAHRQ Learning Network Participant Locations CVE HCUP Partner Individual Hospital Other University Other State Government Other

  24. MONAHRQ Websitewww.monahrq.ahrq.gov

  25. MONAHRQ Websitewww.monahrq.ahrq.gov

  26. Websites Generated Using MONAHRQ

  27. Websites Generated Using MONAHRQ

  28. Websites Generated Using MONAHRQ

  29. Questions?monahrq.ahrq.gov

  30. Questions?

  31. Websites Generated Using MONAHRQ

  32. Data Refresh Cycles Refresh rate Data period Data lag Quarterly (Sep, Dec, Mar, Jun) 12 months 9 months CMS process measures* CMS mortality and readmissions measures* Annually (Jun) 36 months 12 months HCAHPS patient experience measures* Quarterly (Sep, Dec, Mar, Jun) 12 months 9 months Census data for population denominators in area rates and area-level AHRQ QIs Annually (?) 12 months ? months * According to information in document “Hospital.pdf,” version dated 03/09/10, in the Hospital Compare downloadable database

  33. MONAHRQ Learning Network CVE HCUP Partner Individual Hospital Other University Other State Government Other

  34. MONAHRQ Learning Network CVE HCUP Partner Individual Hospital Other University Other State Government Other

  35. MONAHRQ Learning Network CVE HCUP Partner CVE HCUP Partner Individual Hospital Individual Hospital Other University Other University Other State Government Other State Government Other Other

  36. some included not included included    Quick Guide: AHRQ Quality Indicators in MONAHRQ 1.0 (Jun 2010) 1.1 (Oct/Nov 2010) 2.0 (Dec 2010) 2.1 (April/May 2011)                                             AHRQ Inpatient QIs* IQI 2 IQI 5 IQI 9 IQI 12 IQI 13 IQI 18 IQI 19 IQI 20 IQI 21 IQI 33 IQI 34 AHRQ Patient Safety QIs*                     PSI 3 PSI 5 PSI 7 PSI 9 PSI 16 AHRQ Neonatal QIs All     AHRQ Pediatric QIs   All   AHRQ Prevention QIs    All  * Any individual AHRQ QIs not listed are already included in MONAHRQ 1.0

  37. Quick Guide: Hospital Compare Measures in MONAHRQ 1.x 2.0 (Dec 2010) 3.0 (Sep 2011) CMS Process Measures, Inpatient                Surgical care improvement Heart attack Heart failure Pneumonia Children’s asthma care CMS Outcome Measures (30-Day Mortality and Readmissions)          Heart attack Heart failure Pneumonia CMS Structural Measures Cardiac Surgery Registry Participation                   HCAHPS Measures CMS Outpatient Imaging Efficiency Measures Medicare Payment and Volume Information CMS Process Measures, Outpatient (Jun 2010) CMS Hospital Acquired Conditions (Sep 2010)

  38. Data Update Cycles Annual refresh dates Data period Data lag Mar Jun Sep Dec     12 months 9 months CMS inpatient process measure results* CMS inpatient outcome measure results*     36 months 12 months HCAHPS results*     12 months 9 months     ? months 12 months, including yearly historical data since 1996 • MONAHRQ software updates • FY coding updates • Census data • area rates • area-level AHRQ QIs • Risk-adjustment data • provider-level AHRQ QIs • FIPS data • areas and maps * According to information in document “Hospital.pdf,” version dated 03/09/10, in the Hospital Compare downloadable database

  39. Update Cycles Annual refresh dates Data period Data lag Mar Jun Sep Dec     12 months 9 months CMS inpatient process measure results* CMS inpatient outcome measure results*     36 months 12 months HCAHPS results*     12 months 9 months     ? months 12 months, including yearly historical data since 1996 • MONAHRQ software updates • FY coding updates • Updates to internal supplemental files * According to information in document “Hospital.pdf,” version dated 03/09/10, in the Hospital Compare downloadable database

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