Administrative Memos

200501

FROM: Theodore O. Will, Chief Executive Officer
DATE: Jan 13, 2005
SUBJECT: IPRO EDUCATIONAL SESSION: "PEPPER IN DETAIL, DRG 416 (SEPTICEMIA) IN DEPTH"
IPRO CONTACTS:

Kathy Terry, Ph.D., Senior Director, Medicare/Federal Health Care Assessment, Extension 226

IPRO is pleased to announce that we will be offering a Hospital Payment Monitoring Program (HPMP) educational session entitled, "PEPPER IN DETAIL, DRG 416 (SEPTICEMIA) IN DEPTH" on January 27, 2005. As you are aware, the overall goal of HPMP is to reduce the Medicare payment error rate within each state as well as nationally. The purpose of this session is to enable hospitals to maximize the use of the "Program for Evaluating Payment Patterns Electronic Report" (PEPPER) data in reducing their payment error rate and attaining the program goal.

The "Program for Evaluating Payment Patterns Electronic Report" (PEPPER) is an electronic data report containing hospital-specific data for the Centers for Medicare and Medicaid Services (CMS) target areas. These include specific Diagnosis Related Groups (DRGs) and discharges that have been identified as high-risk areas for payment errors. More information on PEPPER may be found at www.ipro.org/hpmp or by referencing IPRO Administrative Memorandum #2004-02: QualityNet HPMP Data Distribution.

IPRO disseminated PEPPER data to all New York State (NYS) acute care hospitals beginning in January 2004. Quarterly updates are transmitted through QualityNet Exchange with email hospital notification of data uploads sent to QualityNet Exchange Administrators, IPRO liaisons, and HPMP liaisons. In general, PEPPER data is intended to assist hospitals in their HPMP efforts by identifying potential problem areas so that more focused hospital-specific efforts may be taken by the hospital.

IPRO recently requested hospital feedback about their use of the PEPPER data. Based on your responses, we learned that some hospitals are unclear about the purpose of the PEPPER, how to interpret the reports and how the data may be used to facilitate improvement in their payment error rate. We greatly appreciate your responses and wish to address your questions through a focused PEPPER DRG 416 educational session.

Within the upcoming week, IPRO will release the next quarterly PEPPER update through QualityNet Exchange. With this release, we will include both the full data release as well as a separate data release for only target area DRG 416 (Septicemia). DRG 416 represents the DRG with the greatest number of payment errors for New York State. In follow-up to this data dissemination, IPRO will offer our focused educational session through QualityNet web-training. Hospital participants will need access to both the Internet and a phone line for participation in this training. The training will be offered on January 27, 2005 at 12:00 p.m Hospitals must register to participate in this training. Registration is available at https://ifmcevents.webex.com. Detailed registration instructions are provided on Attachment I. We request your assistance in keeping slots open for all hospitals wishing to participate by encouraging staff within your facility to share the computer/phone line used for the training event. In addition, IPRO will make an on-line recording of the training available at http://www.ipro.org/hpmp.

It is strongly recommended that hospitals access their PEPPER data and review both the PEPPER Users Guide and the data prior to training. The PEPPER Users Guide will be provided with the upcoming data dissemination and may also be downloaded at www.ipro.org/hpmp under PEPPER. The training will consist of an overview of PEPPER and its purpose, how to interpret PEPPER data, and how to apply this data to your institution. Examples of the DRG 416 PEPPER report will be displayed and explored. Specifically, DRG 416 will be discussed, including the way in which PEPPER can be utilized for improvements for this particular Target Area. Coding tips and auditing methodology will also be shared.

Should you have any questions or comments about this memorandum and/or the data, please contact Dr. Kathy Terry, Sr. Director, Medicare/Federal Health Care Assessment at 516-326-7767, extension 226.