AHRQ Patient Safety Indicators Update: Minimizing Risk, Maximizing Payment

CMS profiles the performance of every short-term hospital, including VA facilities, using Agency for Healthcare Research Quality (AHRQ) Patient Safety Indicators on its Hospital Compare website. This affects a hospital’s fiscal integrity, notably through the CMS’s Hospital Acquired Condition Reduction Program that places 1% of its traditional Medicare reimbursement at risk. In addition, it contributes greatly to Leapfrog Hospital Safety Grade reputational scoring. Despite the importance of AHRQ PSIs, relatively few in healthcare fully understand how they work and how to prevent inaccurate (and often negative) ratings.

In this ICD10monitor webcast, physician and PSI expert Dr. James Kennedy pulls back the curtain on AHRQ PSIs, clearly explaining what they are and how to mitigate risk by adjusting your ICD-10-CM/PCS coding, documentation and traditional clinical documentation integrity (CDI) workflows.

Other key elements of Dr. Kennedy’s presentation include an update on AHRQ PSI amendments for 2021; reconciling CDI reporting errors and omissions; how the Do Not Resuscitate (DNR) metric affects PSI 02 (Death Rate in Low Mortality DRGs) and PSI 04 (Death Rate Among Surgical Inpatients with Serious Treatable Conditions); the impact of the Present on Admission indicator on PSI exclusions; the role of the Elixhauser risk-adjustment methodology in predicting PSI occurrences; and other lesser known strategies that correlate with AHRQ’s intent to measure patient safety.

Why This is Relevant:

Avoiding a 1% CMS Hospital Acquired Condition penalty for traditional Medicare payments is reason enough to make time for this important presentation by Dr. Kennedy. On the other hand, getting a better handle on AHRQ PSIs could lead to significant benefits, including a boost to your hospital’s reputation on the CMS Hospital Compare website, an increase in referrals due to positive publicity via U.S. News & World Report and the Leapfrog website and better patient care that avoids PSIs in the first place.

Learning Objectives:

• Embrace the fundamentals of AHRQ PSIs and how they are calculated solely from inpatient ICD-10-CM/PCS data
• Understand the Elixhauser PSI-specific risk-adjustment methodology and other factors that predict PSI occurrence
• Learn why PSI 08 (In-Hospital Fall with Hip Fracture Rate), PSI 11 (Postoperative Respiratory Failure) and PSI 14 (Postoperative Wound Dehiscence) rates will likely see increases in FY2021, even in facilities with high-functioning, PSI-specific CDI programs
• Grasp the importance of a preoperative assessment program that mitigates PSI risk and improves your facility’s performance with other risk-adjustment methodologies (e.g., MS-DRGs, HCCs, CMS mortality and readmission models)
• Be able to develop an action plan that can be initiated in the following week

Who Should Attend:

Clinical documentation integrity specialists (CDISs), Chief quality officers, CDI directors, inpatient coding directors, chief medical and nursing officers, compliance officers, chief marketing/branding personnel, surgery department leadership and practitioners involved with these departments.