Three metrics of quality are used to create the IAC:
-
National Hospital Quality Metrics (NHQM) - as are required of hospitals for submission to Medicare and The Joint Commission (TJC). There are 34 metrics in 5 categories. Most acute care hospitals are required to submit these measures to Medicare. (Those hospitals that do not wish to submit them and participate in this Ohio initiative would not be eligible for additional Medicaid reimbursements. However, these hospitals would still be monitored using MedPar data.)
-
Reduction In Variation (RIV) – The 10 most resource intense DRGs are trended over a three year period to determine if physicians, other clinicians and administration are more consistent in their treatment patterns as measured by the statistically significant Reductions In Variation.
-
Severity-adjusted Morbidity rates – Excessive lengths of patients’ stays are excellent indicators of morbidities. The 10 most resource intense DRGs are recorded and their excessive LOSs are trended over three years.
-
Severity-adjusted Mortality statistics – Nine (9) risk-adjusted, inpatient mortality rates are trended.
-
Hospitals’ inflation rates of resource consumption (charges) - Total hospital charge inflations are trended over 4 years. The total numbers of charges utilized for all patients are assessed and the inflation or deflation rates are measured on an annual basis ‘excluding mental and rehabilitation patients’. (Resource consumption is a sensitive indicator of quality because every test and treatment that physicians use has a documented complication rate. Physicians who over-utilize resources cannot be the highest quality doctors because eventually they will experience complications to tests or treatments with marginal indications.5)
The Index of Accountable Care (IAC) displays the five metrics using a bar graph that compares each hospital’s performances to state norms. The graphs are easily interpreted by providers, purchasers and patients alike. Verras provides hospitals with technologies and techniques that clinicians can utilize for modifying their practice patterns and improving each of these metrics for their patients’ outcomes.
