Nevada Takes Flight with MONAHRQ (Text Version)

On September 27, 2010, Joseph Greenway made this presentation at the 2010 Annual Conference. Select to access the PowerPoint® presentation (1.7 MB).  

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Slide 1

Nevada takes flight with MONAHRQ

Center for Health Information Analysis (CHIA)

Joseph A. Greenway

Slide 2

Overview

• Introduction
• Nevada's political and budgetary status
• Averted failure—MONAHRQ saves the day
• Where does Nevada stand today
• Our wish list
• Summary and conclusion

Slide 3

Introduction

• The million dollar space pen.
• Innovation comes at a cost.
• Shared efforts stretch limited resources.

Slide 4

Introduction

• The million dollar space pen.
• Innovation comes at a cost.
• Shared efforts stretch limited resources.

Slide 5

Nevada's status

• Assemblywoman Sheila Leslie is a visionary:
  • The battle for transparency.
  • The endoscopy scandal (the leverage).
• The passage of Assembly Bill 146 (AB146):
  • Data collection begins.
  • The need to post to the public is looming.
  • A big project with a little budget.

Slide 6

Nevada's status

• Assemblywoman Sheila Leslie is a visionary:
  • The battle for transparency.
  • The endoscopy scandal (the leverage).
• The passage of Assembly Bill 146 (AB146):
  • Data collection begins.
  • The need to post to the public is looming.
  • A big project with a little budget.

Slide 7

Nevada's status

• Assemblywoman Sheila Leslie is a visionary:
  • The battle for transparency.
  • The endoscopy scandal (the leverage).
• The passage of Assembly Bill 146 (AB146):
  • Data collection begins.
  • The need to post to the public is looming.
  • A big project with a little budget.

Slide 8

MONAHRQ Saves the Day

• Beta testers of MONAHRQ:
  • A ton of bricks lifted from our shoulders.
  • DRGs, Diagnoses, Procedures, Quality Indicators.
  • The difficulties and delays, and the budgetary pressures.

Slide 9

MONAHRQ Saves the Day

• Beta testers of MONAHRQ:
  • A ton of bricks lifted from our shoulders.
  • DRGs, Diagnoses, Procedures, Quality Indicators.
  • The difficulties and delays, and the budgetary pressures.

Slide 10

Where does NV Stand Today?

A screen shot of the Nevada Compare Care Website is shown.

Slide 11

Where does NV Stand Today?

An image of the summary page from the Nevada Compare Care website on the Death rate for heart attack patients is shown.

Slide 12

Where does NV Stand Today?

Image of the top of a table entitled "Statistics for Clark Hospitals for 2 Septicemia (Except in Labor) (DXCCS2)"

Slide 13

An image of a table entitled "Statistics for University Medical Center of Southern Nevada for Septicemia Except in Labor) (DXCCS2)" is shown.

Slide 14

An image of a map of Nevada that shows adult asthma admission rates by county is shown.

Slide 15

Adult asthma admission rate (2009, PQI15)

County FIPS Code	Name	Numerator	Denominator	Rates per 100,000
				Observed Rate	Risk Adjusted Rate	S.E. of Risk Adjusted Rate
32001	NV- Churchill	40	19276	207.51	193.58	21.30
32003	NV- Clark	1658	1402539	118.21	120.39	2.61
32005	NV- Douglas	16	39879	40.12	35.37	14.40
32007	NV- Elko	18	35719	50.39	53.22	16.65
32009	NV- Esmeralda	3	683	439.24	367.78	107.20
32011	NV- Eureka	0	1210	.00	.00	84.80
32013	NV- Humboldt	2	13332	15.00	15.03	26.54
32015	NV- Lander	0	4011	.00	.00	47.81
32017	NV- Lincoln	1	3883	25.75	22.13	45.55
32019	NV- Lyon	45	41850	107.53	105.56	14.83
32021	NV- Mineral	2	4080	49.02	41.76	44.24
32023	NV- Nye	18	36391	49.46	43.87	15.12
32027	NV- Pershing	0	5264	.00	.00	45.34
32029	NV- Storey	2	3600	55.56	55.07	50.81
32031	NV- Washoe	228	319926	71.27	70.37	5.38
32033	NV- White Pine	5	7770	64.35	64.51	34.78
32510	NV- Carson City	32	45458	70.39	65.18	13.82
Total	Nevada	2070	1984871	104.29	104.62	2.18

Slide 16

Statistics for Discharges for Patients in County, NV— Washoe for 5 Diseases & Disorders of the Circulatory System (MDC5) in Nevada, 2009

	Number of discharges	Rate** of discharges
Total U.S. in 2007 (standard error)*	5,887,619 (152,849)	19.5
West U.S. in 2007 (standard error)*	946,462 (46,989)	13.5
All Hospitals in Nevada	41,292	15.6
Total	4,358	10.3
Age group
<18	36	0.4
18-44	374	2.4
45-65	1,486	12.9
65+	2,462	49.3
Gender
Male	2,397	11.2
Female	1,961	9.4
Race
White	3,487	11.9
Black	167	18.8
Hispanic	239	2.8
Asian or Pacific Island	86	3.9
Native American	52	8.0
Other	327	40.4

Slide 17

Our Wish List

• I would like MONAHRQ to be able to post hospital outpatient (OP) data:
  • HCPCS
  • Rate Codes
  • Outpatient DRGS (EAPGs ???)
• I'd like it to treat the OP types uniquely>
  • Emergency Department
  • Outpatient Surgery
  • Other OP

Slide 18

Our Wish List

• I'd like (where appropriate) MONAHRQ to compare Inpatient with Outpatient data (inter and intra hospital).
• I wish that a future version of MONAHRQ would incorporate Ambulatory Surgical Center data:
  • Treat each ASC type uniquely.
  • Compare to hospital OP data (where appropriate).

Slide 19

Summary and Conclusion

• MONAHRQ has been a godsend in Nevada. When budgetary constraints and political pressures put the need for public results into the forefront, MONAHRQ saved the day.
• I strongly recommend that MONAHRQ be used by all those that need to post health billing data.

Slide 20

Questions???