Illinois Hospital Association

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April 4, 2008

Update on Key Health Information Reporting Issues

TO: Chief Executive Officers
  Chief Financial Officers
  Chief Medical Officers
  Chief Nursing Officers
  Chief Information Officers
  Directors of Quality
  Directors of Infection Control and Prevention
  COMPdata Contacts


As we have been saying, the overlap and convergence of quality and financial issues is continuing with direct impact on many areas within a hospital setting. We continue to encourage hospitals to meet as teams to address these issues and to work together as consistency of reporting and internal documentation is critical.

Following are some updates on key developments as they pertain to state and national reporting:

Illinois

  • 4th Quarter 2007 Reporting – Hospital Report Card and Consumer Guide Data
  • Illinois Department of Public Health (IDPH) Hospital CEO Attestation Form For Hospital Discharge Data
  • Joint Educational Conference Calls on Data Quality for Hospital Discharge and Outpatient Data
  • Federal

  • NPI Taxonomy Code Problems and Medicare Work Around Solutions
  • Hospital Outpatient Reporting Started
  • Illinois Hospital Quality Leadership Conference May 15 and 16

    Illinois
    4th Quarter 2007 Reporting – Hospital Report Card and Consumer Guide Data
    Hospitals once again came through and honored their commitment and support to public reporting by all Illinois hospitals reporting their nurse staff vacancy and SCIP infection data by end of the day on March 31. For additional upcoming deadlines on Hospital Report Card Act, please refer to IHA’s 2008 schedule (click here).

    The hospital inpatient discharge and outpatient surgical data continue also to be reported on time by Illinois hospitals. 4th Quarter 2007 was sent to IDPH earlier this week and IHA released applicable 4th Quarter 2007 inpatient and outpatient data to its COMPdata customers on April 1.

    Illinois Department of Public Health (IDPH) Hospital CEO Attestation Form For Hospital Discharge and Outpatient Data
    As reported earlier, hospital CEOs will need to submit an attestation form to IDPH at the end of each quarter attesting to the completeness and accuracy of their data. If there are any known problems, the information must be documented on the form. The submission of this attestation form will begin with 1st Quarter 2008 information and continue for each quarterly submission of data. To view the form in PDF, click here and in Word, click here.

    While hospital CEOs can designate someone within their organization to complete and submit this form, the organization will be accountable for their information submitted and attestation on the accuracy and completeness of data.

    Joint Educational Conference Calls on Data Quality for Hospital Discharge and Outpatient Data
    Given that hospital discharge and outpatient data for 1st Quarter 2008 are utilizing a new reporting format with new data elements for public reporting, it is essential that hospitals ensure the data are accurately reported. IHA strongly encourages hospitals teams to meet and review the data including hospital data coordinators, medical records, information technology, financial, quality, infection control and prevention, and COMPdata customers. It is very easy to make an error with any new format conversion as well as with any internal hospital system changes and often times it is the end user, the COMPdata on-line customer that discovers the error.

    In an effort to help guide and facilitate hospital team reviews, IHA will be holding educational conference calls that are focused on the data submission feedback reports provided to each data coordinator with their submission of hospital data. Specifically, IHA will review and discuss the value of each of the feedback reports and why it is so critically important during conversions that several areas within a hospital are reviewing the Data Quality Summary Report, Data Submission Verification Report, and Edit/Error Reports. The "Hospital Quality Monitoring of Publicly Disclosed Data" are scheduled for:

    • April 9, 2008 - 10:00 to 11:00 Central Time
    • April 18, 2008 - 10:00 to 11:00 Central Time

    Federal
    NPI Taxonomy Code Problems and Medicare Work Around Solutions
    On April 3, CMS announced that the usage of NPIs with taxonomy codes for claims payment was not working and that CMS has abandoned the taxonomy codes and is now requesting providers to secure multiple NPIs for provider sub-part units. This is a major change in operations and direction for many providers and will require substantial changes at many organizations. Yet, as many of our providers have told us, their claims were failing because of the inability by health plans and FIs to successfully crosswalk NPIs and taxonomy codes to the right provider and make payment – as a result, many of our providers had significant amounts of claims reject. This was occurring nation-wide.

    Hospitals are encouraged to review the message provided by Medicare and to follow the necessary steps to secure additional NPIs if needed and to make necessary changes. A copy of the message along with links to the various NPI informational documents can be found by clicking here.

    As the deadline for usage solely of the NPI for claims transactions is May 23, IHA is joining with AHA and other state hospital associations asking for a relaxation of the deadline and for providers that wish to submit both NPIs and legacy codes to be allowed to continue until a new deadline is available. IHA will continue to keep you informed on this critical development.

    Hospital Outpatient Reporting Started
    Just a quick reminder, Hospital Outpatient Quality reporting for the Hospital Compare CMS initiative began with April 1, 2008 cases. Hospitals that are reimbursed under the Hospital Outpatient PPS system for Medicare, must participate in the second quarter reporting in order to secure their full market outpatient market basket increase for calendar year 2009.

    While IHA has conducted educational conference calls on this topic, IHA is planning to do additional conference calls to assist hospitals. Please remember that 2nd quarter 2008 reporting for hospital outpatient measurements is considered by many as a ‘Pilot’ as there will be no public reporting or validation applied. However, we encourage hospitals to use this opportunity to improve their internal processes and identify accuracy and completeness issues prior to the 3rd quarter 2008 data which will be made public and hospital information will be validated.

    Illinois Quality Leadership Conference – May 15 and 16
    The Illinois Quality Leadership Conference will be held on May 15 and 16 at the Hilton in Lisle. The focus of the program is the cross cutting requirements across multi-disciplinary areas within a hospital to meet performance reporting and excel in quality improvement.

    Discussion Topics will include:

  • Institute for Healthcare Improvement (IHI) 5 Million Lives Campaign – IHI Faculty will discuss the emerging role of CMOs and CMIOs within hospitals and successful strategies to reduce patient harm and improve health outcomes
  • Quality Improvement Organization 9th Statement of Work effective August 1, 2008 and hospital requirements and initiatives presented by the Illinois Foundation for Quality Health Care executive director
  • Dartmouth Atlas presentation on hospital specific performance and discussion about chronic care management and end-of-life care challenges and opportunities
  • Illinois Public Reporting Requirements - Hospital Report Card Act nurse staff reporting and infection measurements; Consumer Guide Reports; Infection MRSA and C-Diff reports; and Adverse Event reporting
  • Federal Reporting Requirements on Hospital Compare inpatient and outpatient public reporting requirements; validation processes; patient satisfaction; payment information; and physician quality reporting requirements; and Patient Safety Organization (PSO) rules
  • Recovery Audit Contractor focus and lessons learned from Florida demonstration program from Florida Hospital Association executive. Highlights will include the importance of documentation and alignment and integration of all hospital information internally
  • State and local perspectives from leading health care experts and researchers on PBS Series on "Unnatural Causes" and presentations on interventions underway to reduce breast cancer mortality among African American women and reduce and control diabetes in the Hispanic population. IHA staff will discuss the types of information and reports providers will be seeing with the state mandated reporting on race and ethnicity that became effective in Illinois on January 1, 2008.
  • Registration and Fees
    Registration Information will be sent by e-mail and regular mail. The fees for the program will cover all meeting material, lunches, refreshments, and a networking reception. Early bird registration fees will be $175 for the first registrant and $160 for each additional registrant.

    If you have additional questions, please contact Pat Merryweather. IHA will continue to keep you updated and informed on these developing issues.