KHA is investigating, as part of our strategic plan, developing an all-payer, all-Kentucky-hospital readmission tracking system. Current reporting is limited, through QI programs, to readmissions within your hospital. While CMS data does cover all hospitals, it is limited to Medicare patients. The value of creating a state-based system for collection will be to provide a true picture of readmissions and barriers as well as to replace manual, resource-intensive reporting in the future. KHA needs your input on the feasibility of developing a successful program.
KHA would offer aggregated reports to member facilities containing metrics for inpatient readmission. The reports would include all payer classifications within the database (Medicare, Medicaid Fee for Service, Medicaid Managed Care, Commercial, Self-Pay and Charity and Other Payers). The reports would be produced on a quarterly basis, and updated as new quarters of data are submitted.
KHA would use the existing data submission as a basis for the reports. But this process will require the building of a separate, voluntary data submission that contains the name and street address of the patient, as well as other fields from the billing record that will be used to link the records. This additional data would be submitted through a secure data submission process and would be segregated for use specifically for the readmission analysis program. This additional data would be treated as protected health information (PHI) and stored according to HIPAA standards. KHA would continue to build the Master Patient Index as new quarters of data are received. Statistical models and software are available to produce matches with a high confidence level.
A reasonable fee for producing periodic reports would be assessed by KHA for member participants. KHA would produce hospital-level readmission information for each participating hospital. Aggregated statistics would be provided for readmissions to the same hospital and to other hospitals. Aggregated statistics may be used by KHA for advocacy purposes, but will not identify specific hospitals or systems.
Downstream hospitals other than those owned or operated by an entity would not be identified within the reports. The data will be stratified to produce information based on clinical characteristics. Stratification by attending physician and operating physician would be considered as part of the reports.
In order to be successful, a high level of participation will be necessary to produce accurate data.