Title of Outcome Measure (Improvement Target): IT-3.3: Diabetes 30-Day Readmission Rate
Unique RHP outcome identification number(s): 094109802.3.3
Outcome Measure Description:
To achieve improvement under this metric, LPDS will engage in project planning during DY 2. In
DY 3, LPDS will apply the planning developed in DY 2 in order to determine baseline rates for
future DYs. In DY 4, LPDS intends to improve its diabetes 30-day readmission rate by at least
2.5% over the baseline recorded in DY 3. In DY 5, LPDS intends to improve its diabetes 30-day
readmission rate by at least 2.5% over the DY 4 measurement.
Process Milestones:
 DY2:
o P-1 – Project planning – engage stakeholders, identify current capacity and
needed resources, determine timelines and document implementation plans
 DY3:
o P-2 – Establish baseline rates
Outcome Improvement Targets for each year:
 DY4:
o IT-3.3: Diabetes 30-day readmission rate—2.5% improvement over DY3
 DY5:
o IT-3.3: Diabetes 30-day readmission rate—2.5% improvement over DY4
Rationale:
According to the Medicare Payment Advisory Committee, 76 percent of re-hospitalizations
occurring within 30 days in the Medicare population are potentially avoidable. Other
populations affected include patients with chronic diseases, complex medical and social needs
and patients with little or no funding resources for post-acute care needs. Evidence suggests
that the rate of avoidable re-hospitalization for diabetes patients can be reduced when a
diabetes patient registry is successfully implemented to allow better management of patients’
diabetes-related conditions. A measurable reduction in LPDS’s diabetes 30-day readmission
rate will indicate that LPDS has made progress towards these goals. In order to record this
reduction, LPDS must first engage in planning and baseline measurement in DYs 2 and 3,
respectively.
Outcome Measure Valuation:
$1,799,011. In determining the value of this outcome measure, LPDS considered the extent to
which a reduction in the BH/SA admission rate will address the community’s needs, the
population which this improvement will serve, the resources and cost necessary to realize the
improvement, and the improvement’s conformity to the goals of the Waiver (including
supporting the development of a coordinated care delivery system, improving outcomes while
containing costs, and improving the healthcare infrastructure). Specifically, the valuation of this
outcome measure takes into account the potential of implementing a hospital-wide diabetes
registry to improve quality of care and thereby improve patient outcomes for diabetes patients.
The valuation of this outcome measure also takes into account the challenges that LPDS will
face in realizing this improvement in the hospital setting.
094109802.3.3
Related Category 1 or 2 Projects::
Starting Point/Baseline:
Year 2
(10/1/2012 – 9/30/2013)
Process Milestone 1 [P-1]: Project
planning—engage stakeholders,
identify current capacity and
needed resources, determine
timelines, and document
implementation plans.
Data Source: Documentation of
project planning
Process Milestone 1 Estimated
Incentive Payment: $212,474
IT-3.3
HCA Las Palmas Del Sol
Year 3
(10/1/2013 – 9/30/2014)
Process Milestone 2 [P-2]:
Establish baseline rates.
Data Source: EHR; claims.
Process Milestone 3 Estimated
Incentive Payment: $246,286
Diabetes 30-Day Readmission Rate
094109802
094109802.1.3
TBD
Year 4
Year 5
(10/1/2014 – 9/30/2015)
(10/1/2015 – 9/30/2016)
Outcome Improvement Target 1
Outcome Improvement Target 2
[IT-3.3]: Diabetes 30-day
[IT-3.3]: Diabetes 30-day
readmission rate.
readmission rate.
Improvement Target: 2.5%
Improvement Target: 2.5%
improvement over DY3.
improvement over DY4.
Data Source: EHR; claims.
Data Source: EHR; claims.
Outcome Improvement Target 1
Estimated Incentive Payment:
$395,202
Year 2 Estimated Outcome
Year 3 Estimated Outcome
Year 4 Estimated Outcome
Amount: $212,474
Amount: $246,286
Amount: $395,202
TOTAL ESTIMATED INCENTIVE PAYMENTS FOR 4-YEAR PERIOD: $1,799,011
94614.2
Outcome Improvement Target 2
Estimated Incentive Payment:
$945,049
Year 5 Estimated Outcome
Amount: $945,049