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A Companion Guide to Understanding HealthChoices Behavioral Health 2014/2015 Performance and Improvement Charts 12/3/2015 1
A Companion Guide to
Understanding HealthChoices
Behavioral Health
2014/2015 Performance
and Improvement Charts
12/3/2015 1
An Improvement & Performance
Chart answers the questions:
“What was the result for the year?”
and
“Did the result increase or decrease
when compared from the result last
year?”
12/3/2015 2
The measures
12/3/2015 3
• 7-Day Follow Up after Hospitalization (FUH) Pa-Specific
Measure
• 30-Day Follow Up after Hospitalization (FUH) Pa-Specific
Measure
• 7-Day Follow Up after Hospitalization (FUH) HEDIS Measure
• 30-Day Follow Up after Hospitalization (FUH) HEDIS Measure
• 7-Day Follow Up after Hospitalization (FUH) ages 6-20 HEDIS
Measure
• 30-Day Follow Up after Hospitalization (FUH) ages 6-20
HEDIS Measure
• 7-Day Follow Up after Hospitalization (FUH) ages 6-64 HEDIS
Measure
• 30-Day Follow Up after Hospitalization (FUH) ages 6-64
HEDIS Measure
• 30-Day Readmission Measure
Understanding the Title
12/3/2015 4
7-Day FUH HEDIS Ages 6-20 Measure by HC BH Contractors
MY 2013 to MY 2014 Percentage Point Change
What is a 7-Day FUH? FUH = Follow-Up after Hospitalization
7-Day FUH = A follow up mental health appointment within 7 calendar days of discharge from in-patient
psychiatric setting.
30-Day FUH = A follow up mental health appointment within 30 calendar days of discharge from in-patient
psychiatric setting.
What does it mean by HEDIS? HEDIS © = Healthcare Effectiveness Data and Information Set
HEDIS is an informational tool consisting of a group of measures that 90 percent of America's health plans
use to measure performance on researched care and services. HEDIS makes it possible to compare the
performance of health plans across the United States.
Understanding the Title
12/3/2015 5
7-Day FUH PA-Specific Ages 6-20 Measure by HC BH
Contractors
MY 2013 to MY 2014 Percentage Point Change
Why is FUH important?
There is research indicating that individuals who follow-up with mental health care soon after an in-patient
hospitalization may reduce their need for another psychiatric hospitalization.
What is the difference between HEDIS and PA Specific?
FUH can either be measured by a national standard of data coding called the HEDIS or the Pennsylvania
standard appropriately named PA Specific. The difference is that PA Specific includes 19 additional service
codes not captured in HEDIS that better represent outpatient services of the PA Behavioral Health
HealthChoices system.
Understanding the Title
12/3/2015 6
7-Day FUH HEDIS Ages 6-20 Measure by HC BH Contractors
MY 2013 to MY 2014 Percentage Point Change
What does MY mean? MY = Measurement Year
This is a measurement comparison between year 2013 (01/01/2013 – 12/31/2013) and the year 2014
(01/01/2014 – 12/31/2014). The measurement year (MY) being analyzed is typically well after the end of that
period to allow for accurate data collection and analysis.
Why are ages included in the title?
If an age range is not included in the title, then all ages are included in the measure. Children and
adolescents are in the 6-20 age range. Adults are in the 21-64 age range. Older adults are in the age range of
64+. Charting that includes the 6-64 age range are specifically looking at children, adolescents, and adults.
Understanding the Title
12/3/2015 7
7-Day FUH HEDIS Ages 6-20 Measure by HC BH Contractors
MY 2013 to MY 2014 Percentage Point Change
What is a Percentage Point Change?
This is a comparison between the percentage points of MY 2013 and MY 2014. This is noted in the charts as
PP.
What are HC BH Contractors?
HealthChoices (HC) Behavioral Health (BH) Contractors are the individual Pennsylvania Counties or
agreements among 2 or more Pennsylvania Counties to contract together with The Department of Human
Services (DHS). There are a total of 34 HC BH Contractors in PA. Each contractor provides its own set of
data.
Understanding the Title
12/3/2015 8
What is a 30-Day Readmission Measure?
A measure that counts the number of readmissions to an in-patient psychiatric setting within 30 days of
discharge. In this case, it is the discharge and readmission that is counted. A person can have multiple
discharges and readmissions within a 30 day timeframe during the reporting period (MY 2014).
30-Day Readmission Measure by HC BH Contractors
MY 2013 to MY 2014 Percentage Point Change
Why is Readmission important?
If a readmission back to an in-patient psychiatric setting occurs within 30 days, it may indicate that the person
needs additional planning to prevent the need for a second hospitalization.
(Percentage Point Difference from MY 2013 = 1.0)
MY 2014 HealthChoices Aggregate Rate = 58.5%
Understanding the Title
12/3/2015 9
What is an Aggregate Rate?
An aggregate rate is the total rate combined across the Commonwealth of PA. In this reporting
year (MY 2014) it means that 58.5% of Health Choices individuals completed one follow up
appointment within 7 days of being discharged from an in-patient psychiatric hospital program.
What does this mean?
The aggregate rate changed by one percentage point from the previous year. In this case the aggregate
rate for MY 2013 was 57.5%, which means that the 7-Day FUH rate increased by 1% from MY 2013 to MY
2014. A higher percentage rate of 7-Day FUH from year to year is the desired outcome.
.
Understanding the Legend
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What is MY 2014 Rate?
This is the rate that people who were eligible
completed their 7 day follow-up after
hospitalization (FUH).
For example if 100 people were discharged
from in-patient care and 50 attended FUH
appointments, the rate would be 50%.
What is PPD?
PPD stands for Percentage Point
Difference. This is the difference between
the percentage from one year to the next. In
the case of this chart it is the MY 2014
percentage minus the MY 2013 percentage.
A positive change, or increase from year to
year is the desired outcome.
For example: A 30% rate in MY 2013 and a
35% rate in MY 2014 would be a 5 PPD
(increase). Likewise a 42% rate in MY 2013
and a 32% rate in MY 2014 would be a 10
PPD (decrease).
Understanding the Graph
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What do these numbers mean?
The top number is the aggregate total of the entire
BH-MCO.
The bottom number is the percentage point
change from MY 2013 to MY 2014.
This block designates the BH-MCO
The Green blocks designate the 5 different BH-
MCOs. The highest BH-MCO result is on the far
left and the lowest is on the far right:
1. Magellan Behavioral Health (MBH)
2. Community Care Behavioral Health (CCBH)
3. Community Behavioral Health (CBH)
4. Value Behavioral Health (VBH)
5. PerformCare
Understanding the Graph
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What do these numbers mean?
These are the individual HC BH Contractors in
the respective BH-MCO. This blue line is the MY
2014 rate.
For example: The MY 2014 rate for Blair County
is 66.7% of individuals completed a 7-day follow-
up appointment.
This block designates the BH-MCO
These are the individual HC BH contracts in
the respective BH-MCO. This red line is the
PPD rate.
For example: The PPD rate for Blair County
went up approximately 5 percentage points
from the MY 2013 rate.
