FROM: Theodore O. Will, Chief Executive Officer
DATE: Jun 18, 2004
SUBJECT: PEPPER - Updated Data Release
IPRO CONTACTS:
Kathy Terry, Ph.D., Senior Director, Medicare/Federal Health Care Assessment, Extension 226
In January 2004 IPRO disseminated Administrative Memorandum 2004-02 QualityNet HPMP Data Distribution which announced a data release through QualityNet Exchange of the data tool called PEPPER (Program for Evaluating Payment Patterns Electronic Report).
This tool contained hospital-specific, statewide and hospital ranking data for the Centers for Medicare & Medicaid Services (CMS) target areas. As discussed, these target areas focus on discharges at risk for payment errors due to incorrect DRG coding and/or potential unnecessary admissions. Focus areas include one-day stays, readmissions, and clusters of DRGs including Pneumonia, Septicemia, Respiratory Distress, Fractures, Esophagitis, Nutritional and Metabolic Disorders, Chest Pain, Heart Failure, and Stroke.
At this time, IPRO is releasing an updated PEPPER data tool containing more recent data; data spanning fiscal year (FY) 2000 through quarter one, FY 2004. As detailed in our previous memo, this data is intended to assist each hospital in identifying their potential outlier status for each of the targeted areas and to assist in hospital payment error reduction and compliance/auditing efforts. A User's Guide has been disseminated through QualityNet Exchange along with the hospital-specific data.
As a reminder, QualityNet Exchange is a web portal that provides secure, interactive applications for the exchange and input of privacy data between healthcare providers and the Quality Improvement Organization (QIO) responsible for their state. The purpose of QualityNet Exchange is to improve the quality of care for Medicare beneficiaries through increased efficiencies in information exchange.
IPRO's website provides additional information which may be used to assist your hospital with these PEPPER data. Information available at www.ipro.org/hpmp includes: a recorded statewide training for PEPPER, frequently asked questions including demonstration data, the Users Guide, a powerpoint presentation on PEPPER, and more.
Your hospital QualityNet Administrator has the ability to download this PEPPER data. Alternatively, you may also register for QualityNet exchange to download this data. Attachment A provides a one page overview of PEPPER which may be disseminated within your hospital to assist in effectively deciding upon the best person(s) to make use of these data. Attachment B provides instructions and materials needed for registration for QualityNet exchange should you wish to register. As part of the instructions, you will find the name of your QualityNet Administrator(s).
As with the first PEPPER release, IPRO recognizes that there will be some effort needed on all of our parts to ensure that all hospitals have access to their data; we are ready to assist hospitals in this effort as needed. Should you have any questions or comments about this memorandum and/or the data please contact Dr. Kathy Terry, Sr. Director, Data Analysis and Evaluation, Medicare/Federal Health Care Assessment at 516-326-7767, extension 226. Questions related to QualityNet Exchange registration issues should be directed to Jonathan Miller, Assistant Director, Information Systems at 516-326-7767, extension 665.