NN&I - January 2012

Renal Policy We nailed it Cybernius Medical Ltd Electronic Medical Records for Nephrology Electronic Medical Records for Nephrology web www cyberren com email info@ cyberren com ph 18002768128 January 2012 Nephrology News Issues 23 It is based on the Medicare Inpatient Hospital Value Based Purchasing methodology with individual measures clinical measures only being scored as the higher of an achievement score or improvement score with a scoring range for each measure of 0 10 Several terms become important for understanding the scoring system Achievement Score Performance period this will be for calendar year 2012 Baseline period This will be the period of time that the facilitys performance in 2012 is reviewed For the clinical measures the baseline period will be national performance from July 1 2010 to June 30 2011 Achievement threshold This is the minimum level of performance that must be surpassed to receive any points at all for a specific clinical measure It is designated as the fifteenth percentile of national performance in the baseline period For example it is estimated that the achievement threshold for the measure percentage of patients with URR 65 will be 91 If the facility has less than this percentage of patients with URR 65 then it would receive zero achievement points Benchmark The maximum number of achievement points for each measure is 10 and this is accomplished by performance at or above the benchmark level The benchmark is set at the ninetieth percentile of national performance during the baseline period As noted the structure of the ESRD QIP is very similar to the Hospital Value Based Purchasing Program see sidebar p 24 One of the problems however with the benchmark values is they often top out meaning the value is at or close to 100 For example achieving the maximum 10 achievement points for the percentage of patients with URR 65 measure www NephrologyNews com will likely require 100 of facility patients to have URR 65 Achievement Range This is the range between the achievement threshold and the benchmark yielding a score from zero to 10 points If the facility scores below the achievement threshold its score for the measure is zero at or above the benchmark and the achievement score is 10 In the examples above for URR 65 the achievement range is estimated to be 91 to 100 the exact values should be reported on Jan 31 2012 Achievement Score A linear scale laid parallel to the achievement range with values ranging from 0 10 would determine the facilitys score for the measure In the URR example if a facility had 96 of patients with URR 65 then its achievement web www cyberren com email info@ cyberren com ph 18002768128