Title of Outcome Measure (Improvement Target):IT-2.4: Behavioral Health/Substance Abuse (BH/SA) Admission Rate

Unique RHP outcome identification number(s): 094109802.3.4

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 behavioral health/substance abuse (BH/SA) admission rate by at least 2.5% over the baseline recorded in DY 3. In DY 5, LPDS intends to improve its BH/SA admission rate by at least 2.5% over the DY 4 measurement.

Process Milestones:

  • DY2:
  • P-1 – Project planning – engage stakeholders, identify current capacity and needed resources, determine timelines and document implementation plans
  • DY3:
  • P-2 – Establish baseline rates

Outcome Improvement Targets for each year:

  • DY4:
  • IT-2.4: Behavioral Health/Substance Abuse (BH/SA) admission rate—2.5% improvement over DY3
  • DY5:
  • IT-2.4: Behavioral Health/Substance Abuse (BH/SA) admission rate—2.5% improvement over DY4

Rationale:

Behavioral health consumers frequently wait hours or even days in crowded EDs before receiving psychiatric evaluation and placement. Hospital reports show that patients with behavioral health concerns typically experience longer inpatient stays than other patients. Avoidable hospitalizations for these patients can be reduced by providing more timely consults from psychiatric specialists via tele-psychiatry services. A measurable reduction in LPDS’s BH/SA admission 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:

$1,124,382. 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 tele-psychiatry to improve quality of care and thereby improve patient outcomes for BH/SA patients. The valuation of this outcome measure also takes into account the challenges that LPDS will face in realizing this technological infrastructure improvement in the hospital setting. The valuation of this outcome measure also takes into account the challenges that LPDS will face in realizing this improvement in the hospital setting.

094109802.3.4 / IT-2.4 / Behavioral Health/Substance Abuse (BH/SA) Admission Rate
HCA Las Palmas Del Sol / 094109802
Related Category 1 or 2 Projects:: / 094109802.1.4
Starting Point/Baseline: / TBD
Year 2
(10/1/2012 – 9/30/2013) / Year 3
(10/1/2013 – 9/30/2014) / Year 4
(10/1/2014 – 9/30/2015) / Year 5
(10/1/2015 – 9/30/2016)
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: $132,796 / Process Milestone 2 [P-2]: Establish baseline rates.
Data Source: EHR; claims.
Process Milestone 3 Estimated Incentive Payment: $153,928 / Outcome Improvement Target 1 [IT-2.4]: Behavioral Health/Substance Abuse (BH/SA) admission rate.
Improvement Target: 2.5% improvement over DY3.
Data Source: EHR; claims.
Outcome Improvement Target 1 Estimated Incentive Payment: $247,001 / Outcome Improvement Target 2 [IT-2.4]: Behavioral Health/Substance Abuse (BH/SA) admission rate.
Improvement Target: 2.5% improvement over DY4.
Data Source: EHR; claims.
Outcome Improvement Target 2 Estimated Incentive Payment: $590,656
Year 2 Estimated Outcome Amount: $132,796 / Year 3 Estimated Outcome Amount: $153,928 / Year 4 Estimated Outcome Amount: $247,001 / Year 5 Estimated Outcome Amount: $590,656
TOTAL ESTIMATED INCENTIVE PAYMENTS FOR 4-YEAR PERIOD: $1,124,382

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