Case Review/HPMP

Title:	Quality Improvement Plans (QIPs) in Case Review – A Key QIO Method for Achieving Improvements in Health Care
Date:	3/12/2004
Presenter:	Mary Giammona, MD, Lumetra, Christine LaRocca, MD, Colorado Foundation for Medical Care, Connie Gilman, BSN, MHA, CPHQ, Michigan Peer Review Organization, and Andrea Goldstein, RN, MS, IPRO
Description:	PowerPoint presentation describing the key components of a QIP and identifying the types of cases needing to have quality improvement plans (QIPs) requested.
Keywords:	Quality Improvement Plans, Case Review, key components of a QIP
Title:	Substantial Violations in a Substantial Number of Cases: A Quality Sanction Horror Story
Date:	3/12/2004
Presenter:	Melody Petrul, RN, and Jeffrey Deitch, Michigan Peer Review Organization
Description:	PowerPoint presentation identifying weaknesses in the QIO sanction process, as well as strategies for strengthening the sanction process.
Keywords:	QIO sanction process, sanction violations
Title:	Paving the Way to New Frontiers in Hospice Care
Date:	3/12/2004
Presenters:	Mary Heldermann, Health Care Excel, and Joe Rotella, Hospice and Palliative Care of Louisville
Description:	PowerPoint presentation describing the proper utilization management of beneficiaries covered under the MHB. Includes overview of the criteria used in determining the relationship between the terminal diagnosis and the inpatient admission.
Keywords:	Hospice, Condition Code 07, Education
Title:	Applying Process Design Methodology to Improve Letter Writing
Date:	3/12/2004
Presenter:	Jennifer Bitterman, Ohio KePRO
Description:	PowerPoint presentation introducing to the community concrete ways to analyze and improve process flow.
Keywords:	review, letter writing, Case Review
Title:	Getting Hospital Buy-in: Ways to Identify Hospitals for Intensive HPMP Interventions
Date:	3/12/2004
Presenter:	Mary Ralston, BA, MS, PhD, Mary Giammona MD, MPH, Terry Ramirez RN, and Aurora Dagdagan, Lumetra
Description:	PowerPoint presentation discussing how to reduce the statewide payment error due to unnecessary one-day hospitalizations and to identify hospitals with high error rates unable to significantly reduce their error rates after a series of interventions.
Keywords:	Target identification, admission denials, hospital buy-in, self-audit, full case review
Title:	Addressing Variation in Hospital Coding Intensity
Date:	2/24/2005
Presenters:	Charles Schade, MD, MPH, Cathy Bowles, RN, and David Lomely BA, West Virginia Medical Institute
Description:	Present results from baseline data collection in hospitals that had high and low DRG coding error rates, which characterized cases with and without secondary diagnoses of fluid and electrolyte disorders (ICD 276.0-276.9). It will demonstrate relationships between the abstracted results, the claims-based surveillance, and long term error frequencies from the HPMP. We will present a logistic regression model that uses abstracted data to predict whether a chart has correctly entered (or inadvertently omitted) a secondary diagnosis of fluid and electrolyte disorder.
Keywords:	surgical quality; process measure; outcome measure; risk adjustment