Case Mix Comparative Data Program

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Case Mix Comparative Data Program

• Presenter
• Dukhbhanjan Kaur (D.K.)
• Program Operations Analyst

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Webinar Logistics
Webinar will last approximately one hour - 45
minute presentation and 15 minutes for
questions Sessions will be recorded and posted
to NACHRI website within 48 hours We will be
muting everyones line until it is time for
questions. Please do not put your phone on
hold Please save your Adobe Connect password -
you may register for additional webinars with the
same username and password If you have
difficulty during the webinar, please call
703/684-1355 and ask for Charles Murray or Kahari
McCall
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NACHRI Analytics Discover the Value of Our
Research and Analysis
September Webinar Series
A month-long series of educational programs
exploring how NACHRI Analytics - a suite of data,
benchmarking, and quality improvement programs -
can make a difference for your hospital
and childrens health care. The webinars are
free and open to NACHRI members, but require
registration. 
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NACHRI Analytics Discover the Value of Our
Research and Analysis
September Webinar Series
Remaining Schedule Pediatric Quality Indicators
(PDIs) Webinar Focus on Potentially Preventable
Complications for Pediatric Patients, Thursday,
Sept. 25 NACHRI Analytics Webinar The
Definition of Value from the Hospital
Perspective, Tuesday, Sept. 30
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Webinar Objectives
Introduction to the tools and databases available
to members Enhance and increase member
participation in data programs
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What is the Case Mix Comparative Data Program?

• The Case Mix program is a tool by which
  childrens hospitals can compare their inpatient
  population to truly comparable peer groups. It is
  a community of 89 childrens hospitals
  contributing their data to be used for many
  reasons, among them
• 1. Benchmarking
• 2. Research
• 3. Advocacy
• for the greater good

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Benchmarking

• Clinical, Operations, Financial, Strategic
  Planning
• Examples Clinical Redesign Cardinal Glennon
  Malcolm Baldridge Award

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Research

• Data from the Case Mix program is used in
  numerous studies
• Examples PSI, PDI, ROM, CA-BSI

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Advocacy

• Data from Case Mix program is often used for
  advocacy on behalf of childrens hospitals
• Examples CHGME, Medicaid Matters Campaign

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Case Mix Comparative Data Program-- Details --

• 89 NACHRI members currently contributing
• Freestanding (n44)
• Hospital within hospital (n39)
• Specialty (n6)
• Stores over 5 million records from 2000-2008 1Q
• Data warehouse vendor Thomson Reuters
• Data comes from UB-92 billing elements
• ICD-9-CM Dx and Px Codes, LOS, Charges, etc.
• Access to indicators such as (over 125 data
  elements)
• Case Volume
• Average Length of Stay (ALOS)
• Case Mix Index (CMI) APR-DRG
• CMI and Wage Adj Charges per Case or Day
• Estimated Costs
• Mortality
• Payor (e.g. Medicaid)

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How does it work?
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Case Mix Comparative Data Program
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Case Mix Data Stream Submission and Resultant
Services
NACHRI Case Mix

• Case Mix Services
• Departmental Costs
• Annual Report
• CHGME Application
• Unlimited Web-Based Ad-hoc Reporting
• Collaboratives
• -- (e.g., PSI, BSI, PDI, FOCUS Groups)

Thomson
With applied NACHRI-specific edits for CMI
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Who sees what in the dataset?

• Unblinded vs. Blinded
• Blinded Peer group consists of a minimum of 5
  hospitals. Data is aggregate.
• Unblinded 38 out of 89 (43) of hospitals in
  Case Mix. Even if unblinded, financial and
  mortality indicators are not available.

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What makes the Case Mix program valuable to
childrens hospitals?
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What makes the Case Mix program valuable?

• Access to the NACHRI developed Relative Cost
  Weights (RCWs)
• APR-DRG affiliation
• Analyst support
• Contains the largest number of members

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Custom Relative Cost Weights (RCW)

• Access to custom relative cost weights and
  outlier trim points
• Through Case Mix program participation, you get
  access to NACHRIs three (3) sets of relative
  cost weights

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The Three NACHRI Custom RCW Types

• All Age Weights
• Pediatric Weights
• Childrens Hospital Weights

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What makes the Case Mix program unique?

• APR-DRG affiliation through Classification
  Research
• If you have any questions on APR-DRGs, youve
  come to the right place

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• Why APR-DRGs?
• Most pediatric sensitive grouping methodology and
  relative weight / acuity assignment
• CMS DRGs CMI usually 30 lower than APR-DRG CMI

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Case Mix Comparative Data Program Benefits

• Annual Report
• Analyst support/Ad-hocs
• Website
• Informational webinars
• User Meetings
• On the horizon
• -Listserv
• -Newsletter

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Annual Reports

• Annual Report
• Detail Report
• APR-DRG Report
• APR-DRG SOI Report
• Service Line (1 2) Reports
• PDI Report
• CMI Ranking

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Annual Report
Inpatient Profile
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Average Length of Stay Trend
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APR-DRG v24 Case Mix Index Analysis
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2007 Average Wage Adjusted Charges Per Case Trend
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Top 5 MDCs by Discharge Volume
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Top Ten APR-DRGs by Discharge Volume
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Service Line Reports
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NACHRI Case Mix Database AHRQ PDI Report
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Case Mix v24 CMI Ranking
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IS that all, folks?!!
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Case Mix Sub-Program
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Case Mix Program-- Departmental Costs
(Sub-Program) --

• Provides drill-down to Case Mix data elements
  with estimated costs assigned to 16 key
  departmental buckets including

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Case Mix ProgramDepartmental Costs -- Benefits --

• Facilitates critical pathway design, benchmark
  development, and changes in hospital service
  delivery through identification of practice
  costs.

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Case Mix Comparative Data ProgramBe a Member!!!

• To become a member of the Case Mix Comparative
  Data Program
• Sign end user agreement form
• Cost of participation is 14,500
• Receive program application training

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QUESTIONS???Stay tuned
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For Further Information

• Contact us at casemix_at_nachri.org
• or
• Dukhbhanjan Kaur (D.K.)
• dkaur_at_nachri.org
• 703-797-6071

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To Access the Database

• Please log on to
• https//benchmark.childrenshospitals.net
• For site access, please contact
• casemix_at_nachri.org

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Case Mix Homepage

• Training Videos

• Program Updates!!

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Access to Educational Material
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Accessing Reports
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Ad-hoc Reports
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Create a New Report
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Case Mix Comparative Benchmark Access