First New York/New Jersey Health Care Report Car...(dently validated performance measurement...),Health

Date:9/6/2007

dently validated performance measurements submitted by all commercial HMOs to the New York State Department of Health and New Jersey Department of Banking & Insurance. National comparison data are from the National Committee for Quality Assurance's (NCQA) Quality Compass(TM) database. Data used in this report represent HMO performance in 2005 -- the most recent year for which validated data are available. HMO premium data are from the New York State Department of Insurance and New Jersey Department of Banking and Insurance and represent the current rates.

Hospital performance data are from the Hospital Compare database, and are from the fourth quarter of 2005 to third quarter of 2006. Developed by a landmark voluntary, public-private partnership of the U.S. Centers for Medicare & Medicaid Services (CMS) and national hospital and consumer organizations, Hospital Compare is based on data voluntarily submitted by nearly all of the nation's hospitals. Thirty-day mortality rates are from Hospital Compare, while inpatient mortality was calculated from state administrative databases SPARCS (NY) and UB-92 (NJ) using the Agency for Healthcare Research and Quality Inpatient Quality Indicator methodology and 3M risk-adjustment model, except for cardiac bypass and angioplasty procedures where the report uses state-reported data if available. Composite scores are generated by IPRO. Computerized order entry, ICU staffing and safe practice data are from a national hospital survey conducted by the Leapfrog Group from August 1, 2006 to July 31, 2007.

Medicaid payments are computed by IPRO from New York State Department of Health (NYSDOH) data and represent the current rates, based on diagnosis-related groups (DRGs). Medicaid uses the DRG classification to determine how much hospitals should be reimbursed. Hospital charges are from the NYSDOH New York State Planning and Research Cooperative System (SPARCS) database. These data cover the fourth quarter of 2005 to third qua
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SOURCE Health Accountability Foundation Copyright©2007 PR Newswire. All rights reserved

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