Coordination of Care Community Scorecard

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Jemimah Matthews
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1 Coordination of Care Community Scorecard July 01, 2014 through June 30, 2018 West Metro Community Report Date: 01/10/2019 This material was prepared by the Lake Superior Quality Innovation Network - Quality Improvement Organization (QIN-QIO) under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. 11SOW

2 Table of Contents Section Introduction West Metro Community Map Page 1 2 Quarterly admissions and readmissions Figure 1.1: Observed admissions per 1,000 3 Figure 1.2: Observed readmissions per 1,000 4 Table 1.1: Quarterly Admissions and Readmissions for West Metro 5 Table 1.2: Quarterly Admissions and Readmissions for State 6 Table 1.3: Quarterly Admissions and Readmissions for Nation 7 Quarterly Emergency Department, Observation Stays, and Inpatient Admissions Figure 2.1: Emergency Department visits per 1,000 8 Figure 2.2: Observation stays per 1,000 9 Figure 2.3: Combined ED visits, observation stays, and inpatient visits for West Metro 10 Table 2.1: Quarterly Emergency Department, Observation Stays, and Inpatient Admissions for West Metro 11 Table 2.2: Quarterly Emergency Department, Observation Stays, and Inpatient Admissions for State 12 Table 2.3: Quarterly Emergency Department, Observation Stays, and Inpatient Admissions for Nation 13 Other Community Measures Figure 3.1: Days Spent by Fee For Service (FFS) Beneficiaries in Institutional Settings 14

3 Readmission Rate Page 1 Introduction The Coordination of Care Community Scorecard is a report designed to help communities monitor and evaluate their progress in reducing admissions and readmissions, and improving quality of care. The Scorecard is based on the most recent available community data from CMS and quality measures data from communities. This report has been prepared by the Lake Superior Quality Innovation Network's analytical team. Metrics in the Scorecard The Scorecard is divided into different sections displaying trends in admissions and readmissions metrics. It also includes emergency department visit and observation stay metrics, and admission and readmission metrics pertaining to post-acute care settings. All metrics are reported for quarterly time periods from the most recent available data from CMS. Graphs The graphs in the Scorecard display observed metrics and trends (unless otherwise noted) for the following cohort designations: National: All Medicare fee-for-service (FFS) residing in any valid zip code in the 50 states, District of Columbia, Puerto Rico, and the United States (U.S.) Virgin Islands State: All Medicare FFS residing in any valid zip code in Minnesota Community: All Medicare FFS residing in the zip codes associated with the West Metro Community Community Readmission Rate Comparison (year ending 6/30/2017 vs 6/30/2018) 25.0% 20.0% 15.0% 10.0% 7/1/2016-6/30/2017 7/1/2017-6/30/ % 0.0% Central MN Cuyuna/ Riverwood/ Mille Lacs Area East Metro Fargo/ NW MN Area Mora Area North Central MN North East MN Ridgeview Area South Central MN West Metro State Nation

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5 Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Page 3 Figure 1.1: Observed admissions per 1,000 Number of hospitalizations among eligible Medicare FFS per 1,000 eligible Medicare FFS residing in the zip codes associated with the designated cohort. Figure 1.1 displays a graph of admissions per 1,000, by quarter, for the Medicare FFS residing in the zip codes associated with the designated cohort. The time periods are denoted by quarter number and year (e.g., Q1 2010) Quarterly observed admissions per 1,000 Medicare FFS Community admissions per 1,000 National admissions per 1,000 State admissions per 1,000 Linear (Community admissions per 1,000 )

6 Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Page 4 Figure 1.2: Observed readmissions per 1,000 Number of readmissions within 30 days of hospital discharge among eligible Medicare FFS per 1,000 eligible Medicare FFS residing in the zip codes associated with the designated cohort. Figure 1.2 displays a graph of readmissions per 1,000, by quarter, for the Medicare FFS residing in the zip codes associated with the designated cohort. The time periods are denoted by quarter number and year (e.g., Q1 2010) Quarterly observed readmissions per 1,000 Medicare FFS Community readmissions per 1,000 National readmissions per 1,000 State readmissions per 1,000 Linear (Community readmissions per 1,000 )

7 Page 5 Coordination of Care Table 1.1: Quarterly Admissions and Readmissions for West Metro Number of hospitalizations and readmissions among eligible Medicare FFS per 1,000 eligible Medicare FFS residing in the zip codes associated with the designated community. Overall timeframe included: Q Q Quarter Admissions Readmissions Eligible Community admissions per 1,000 Observed Community readmissions per 1,000 Observed Readmission percent (Observed readmissions / Discharges) Q ,883 1, , % Q ,818 1, , % Q ,992 1, , % Q ,822 1, , % Q ,554 1, , % Q ,626 1, , % Q ,871 1, , % Q ,631 1, , % Q ,485 1, , % Q ,731 1, , % Q ,964 1, , % Q ,518 1, , % Q ,359 1, , % Q ,433 1, , % Q ,714 1, , % Q ,477 1, , %

8 Page 6 Coordination of Care Table 1.2: Quarterly Admissions and Readmissions for State Number of hospitalizations and readmissions among eligible Medicare FFS per 1,000 eligible Medicare FFS residing in the state. Overall timeframe included: Q Q Quarter Admissions Readmissions Eligible State admissions per 1,000 Observed State readmissions per 1,000 Observed Readmission percent (Observed readmissions / Discharges) Q ,363 4, , % Q ,705 4, , % Q ,257 4, , % Q ,153 4, , % Q ,341 4, , % Q ,503 4, , % Q ,922 4, , % Q ,383 4, , % Q ,570 4, , % Q ,479 4, , % Q ,672 4, , % Q ,186 4, , % Q ,471 4, , % Q ,098 4, , % Q ,538 4, , % Q ,734 4, , %

9 Page 7 Coordination of Care Table 1.3: Quarterly Admissions and Readmissions for Nation Number of hospitalizations and readmissions among eligible Medicare FFS per 1,000 eligible Medicare FFS nationwide. Overall timeframe included: Q Q Quarter Admissions Readmissions Eligible National admissions per 1,000 Observed National readmissions per 1,000 Observed Readmission percent (Observed readmissions / Discharges) Q ,532, ,753 37,315, % Q ,593, ,559 37,483, % Q ,701, ,125 37,223, % Q ,594, ,920 37,374, % Q ,508, ,294 37,564, % Q ,533, ,528 37,775, % Q ,653, ,040 37,767, % Q ,565, ,880 37,980, % Q ,504, ,720 38,196, % Q ,550, ,113 38,400, % Q ,695, ,460 37,867, % Q ,550, ,223 38,034, % Q ,468, ,083 38,249, % Q ,529, ,432 38,441, % Q ,628, ,818 37,823, % Q ,434, ,025 37,901, %

10 Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Page 8 Figure 2.1: Emergency Department visits per 1,000 Number of ED visits among eligible Medicare FFS residing in the zip codes associated with the designated cohort Figure 2.1 displays a graph of Emergency Department (ED), by quarter, for the Medicare FFS residing in the zip codes associated with the designated cohort. The time periods are denoted by quarter number and year (e.g., Q1 2010) Quarterly emergency department visits per 1,000 Medicare FFS Community State National Linear (Community)

11 Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Page 9 Figure 2.2: Observation stays per 1,000 Number of observation stays among eligible Medicare FFS residing in the zip codes associated with the designated cohort. Figure 2.2 displays a graph of Emergency Department (ED), by quarter, for the Medicare FFS residing in the zip codes associated with the designated cohort. The time periods are denoted by quarter number and year (e.g., Q1 2010) Quarterly observation stays per 1,000 Medicare FFS Community State National Linear (Community)

12 Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Encounters per 1,000 Page 10 Figure 2.3: Combined ED visits, observation stays, and inpatient visits for West Metro Number of Emergency Department (ED) visits, observation stays, and inpatient visits among eligible Medicare FFS residing in the zip codes associated with the community. Figure 2.3 displays a graph of ED, Observation stays, and Inpatient visits, by quarter, for the Medicare FFS residing in the zip codes associated with the designated community. The time periods are denoted by quarter number and year (e.g., Q1 2010) Quarterly Emergency Department, Observation Stays, and Inpatient Admissions for community Emergency Department Observation Inpatient Linear (Emergency Department)

13 Page 11 Coordination of Care Table 2.1: Quarterly Emergency Department, Observation Stays, and Inpatient Admissions for West Metro Number of ED visits, observation stays, and inpatient visits among eligible Medicare FFS residing in the zip codes associated with the designated community. Overall timeframe: Q Q Emergency Department Observation Inpatient Quarter Eligible Q ,477 12, , , Q ,982 11, , , Q ,431 10, , , Q ,881 11, , , Q ,388 12, , , Q ,791 11, , , Q ,226 11, , , Q ,904 11, , , Q ,468 12, , , Q ,827 11, , , Q ,086 11, , , Q ,363 11, , , Q ,917 11, , , Q ,528 10, , , Q ,200 10, , , Q ,924 10, , , Community

14 Page 12 Coordination of Care Table 2.2: Quarterly Emergency Department, Observation Stays, and Inpatient Admissions for State Number of ED visits, observation stays, and inpatient visits among eligible Medicare FFS residing in the state. Overall timeframe: Q Q Emergency Department Observation Inpatient Quarter Eligible Q ,852 47, , , Q ,769 44, , , Q ,746 42, , , Q ,661 45, , , Q ,804 47, , , Q ,505 43, , , Q ,961 43, , , Q ,950 45, , , Q ,019 47, , , Q ,784 43, , , Q ,585 43, , , Q ,981 44, , , Q ,409 45, , , Q ,777 42, , , Q ,870 42, , , Q ,373 42, , , State

15 Page 13 Coordination of Care Table 2.3: Quarterly Emergency Department, Observation Stays, and Inpatient Admissions for Nation Number of ED visits, observation stays, and inpatient visits among all eligible Medicare FFS nationwide. Overall timeframe: Q Q Emergency Department Observation Inpatient Quarter Eligible Q ,315,969 3,786, , ,532, Q ,483,659 3,652, , ,593, Q ,223,128 3,594, , ,701, Q ,374,982 3,777, , ,594, Q ,564,649 3,865, , ,508, Q ,775,085 3,684, , ,533, Q ,767,574 3,704, , ,653, Q ,980,288 3,818, , ,565, Q ,196,258 3,898, , ,504, Q ,400,933 3,743, , ,550, Q ,867,500 3,731, , ,695, Q ,034,986 3,788, , ,550, Q ,249,423 3,856, , ,468, Q ,441,428 3,716, , ,529, Q ,823,677 3,614, , ,628, Q ,901,103 3,573, , ,434, National

16 Average Days per Beneficiary Days Spent by Fee For Service (FFS) Beneficiaries in Institutional Settings (07/01/17-06/30/18) Community Tenure (higher is better): Nation: 93.35% MN: 94.05% West Metro: 94.18% Short-Term Hospital LTACHs Psych Units & Hospitals Rehab Units & Hospitals SNFs & Swing Beds Total Institutional Days Nation State West Metro

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