Quality Based Reimbursement (QBR)
Reports built for users to understand hospital performance under the HSCRC’s Quality Based Reimbursement (QBR) Program
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The Health Services Cost Review Commission (HSCRC) Quality-Based Reimbursement (QBR) program is a payment model implemented in Maryland, USA, aimed at improving the quality and efficiency of healthcare services provided by hospitals. The program is part of Maryland’s unique all-payer hospital payment system.
Here’s an overview of how the program typically operates:
Overall, the HSCRC QBR program is intended to align financial incentives with the delivery of high-quality, cost-effective healthcare services, ultimately improving patient outcomes and reducing healthcare costs. For more information on the QBR policy, please visit the following HSCRC website page.
The CRISP Reporting Services Portal hosts a few types of reports built for users to understand hospital performance under the HSCRC’s Quality Based Reimbursement (QBR) Program.
The Sections below is a brief description of each type.
The QBR Scoring Report is a document that provides hospitals with detailed information about their performance in the QBR program. This report typically includes
Inpatient Mortality Reports are documents that provide detailed information on mortality rates for patients admitted to hospital. Here’s what is included in an HSCRC Inpatient Mortality Report:
These reports are similar to the Inpatient Mortality Reports, however, the purpose is to capture mortality which occurs after a hospital discharge. The HSCRC staff Staff believes that expansion to a 30-day measure in the payment program better captures and incentivizes the quality of care delivered by a hospital, expanding beyond the wall of the hospital.
PSI-90 (Patient Safety Indicator-90) Reports provide detailed information on patient safety outcomes in Maryland hospitals. These reports focus specifically on the PSI-90 metric, which is a composite measure of patient safety developed by the Agency for Healthcare Research and Quality (AHRQ).
The PSI-90 is a composite measure that combines several patient safety indicators, such as postoperative sepsis, accidental puncture or laceration, and bloodstream infections acquired in the hospital. It provides a comprehensive overview of patient safety outcomes within a hospital.
Using data from MD Medicare and Medicaid, the Follow-Up After Discharge Reports provide detailed information on patient outcomes and follow-up care after discharge from hospitals in Maryland. These reports are part of the broader QBR program aimed at improving healthcare quality and patient outcomes. The reports contain data on the extent to which hospitals conduct follow-up care with patients with specific conditions after they have been discharged. This may include scheduled appointments, phone calls, home visits, or other forms of follow-up care aimed at ensuring patients’ well-being and preventing readmissions. he reports may assess how effectively hospitals coordinate transitions of care between inpatient and outpatient settings. This includes communication with primary care providers, medication reconciliation, and continuity of care to ensure a smooth transition for patients after discharge.
TFU (Total Facility Utilization) – Patient Adversity Index and Disparity Gap Report provides detailed information on patient outcomes, facility utilization, and healthcare disparities in Maryland hospitals. This report focuses on assessing and addressing disparities in healthcare access, quality, and outcomes among different patient populations.
Patient Adversity Index is a composite measure that incorporates various socioeconomic, demographic, and clinical factors to assess the level of adversity or vulnerability experienced by patients. Factors may include income level, education, insurance status, race/ethnicity, housing stability, and comorbidities. The index helps identify patients who may face barriers to accessing healthcare or achieving optimal health outcomes.
The report analyzes disparities in healthcare utilization, quality, and outcomes among different patient populations, as measured by the Patient Adversity Index. It examines differences in hospital admissions, readmission rates, mortality rates, length of stay, resource utilization, and other metrics between advantaged and disadvantaged patient groups.
Similar to other quality metrics, the data in the Disparity Gap Report may be risk-adjusted to account for differences in patient populations and hospital characteristics. This ensures that hospitals are evaluated fairly and accurately based on their performance in addressing healthcare disparities.