Bill Text: CT SB00407 | 2014 | General Assembly | Comm Sub

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Bill Title: An Act Concerning A Hospital Quality Of Care Initiative.

Spectrum: Bipartisan Bill

Status: (Introduced - Dead) 2014-03-24 - Favorable Change of Reference, House to Committee on Appropriations [SB00407 Detail]

Download: Connecticut-2014-SB00407-Comm_Sub.html

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General Assembly		Raised Bill No. 407
February Session, 2014		LCO No. 2230
		*_____SB00407HS_APP031914____*
Referred to Committee on HUMAN SERVICES
Introduced by:
(HS)

AN ACT CONCERNING A HOSPITAL QUALITY OF CARE INITIATIVE.

Be it enacted by the Senate and House of Representatives in General Assembly convened:

Section 1. (NEW) (Effective from passage) (a) As used in this section:

(1) "Attainment score" means the percentage of quality of care goals achieved by a hospital in a given year.

(2) "Commissioner" means the Commissioner of Social Services.

(3) "Department" means the Department of Social Services.

(4) "Healthcare Effectiveness Data and Information Set" or "HEDIS" means a set of performance measures that rates a health plan's or facility's performance in the areas including, but not limited to, (A) quality of care, (B) access to care, and (C) member satisfaction with the health plan, facility or doctors.

(5) "Hospital-Community Connection Program" or "HCCP" means a department program in which a hospital participates in the department's inpatient discharge care management program, intensive care management program and performance measurements.

(6) "Hospital share formula" means the share of the maximum funding a hospital may receive for improved quality of care indicators as measured by multiplying the hospital's attainment score by its share of expenditures and by the amount in the supplemental HCCP payment pool.

(7) "Inpatient discharge care management program" means a program established by the department in which the department places dedicated staff in a hospital to collaborate with the hospital in developing comprehensive discharge plans for safe and effective transition of care from the hospital to alternate care settings, primarily for patients who are at high risk for readmission.

(8) "Inpatient prospective payment system hospital market basket" means the annual Medicare payment rate increase for hospital services published annually in the Federal Register.

(9) "Intensive care management program" means a program established by the department where a hospital collaborates with the department's dedicated staff to promote continuity of care and compliance with an established hospital discharge plan as the patient transitions to alternate levels of care. The program primarily focuses on patients who have two or more readmissions within thirty days of their dates of discharge or a repeated history of leaving the hospital against medical advice.

(10) "Plan all-cause readmission rates" means the percentage of admitted patients that have a readmission within a specified period of time.

(11) "Predictive modeling" means the use of technology to analyze health data to predict a health outcome.

(12) "Quality of care indicators" means performance measurements or participation in programs that include, but are not limited to: (A) Participation in the intensive care management program and inpatient discharge care management program; (B) a reduction in the number of hospital readmissions; and (C) improvements in the management of chronic conditions such as asthma, diabetes, congestive heart failure and chronic obstructive pulmonary disease, or COPD, as measured by a reduction in the number of times patients suffering from these diseases needed to be admitted to a hospital to treat their disease.

(13) "Supplemental HCCP payment pool" means state and federal funds earmarked for hospitals that participate in the department's HCCP program to enhance quality of care, including an annual state appropriation equal to three per cent of the amount paid under the state Medicaid program to hospitals for the most recently completed year for which complete data is available.

(b) The Commissioner of Social Services, in consultation with the Connecticut Hospital Association, shall establish a hospital reimbursement system that provides financial incentives under the state Medicaid program to hospitals that demonstrate improvement in quality of care indicators. Not later than July 1, 2014, the department and the Connecticut Hospital Association shall agree on (1) the content and frequency of performance reporting, and (2) the form and frequency of meetings to discuss and share best practices on implementing the requirements of the quality of care program. The department shall provide hospitals access to summary and Medicaid program baseline and ongoing performance reports, predictive modeling analytics and other data analytics.

(c) From July 1, 2014, to June 30, 2015, hospitals may earn financial incentives for participating in (1) the inpatient discharge care management program, (2) the intensive case management program, or (3) a program to stabilize or reduce state-wide all-cause readmission rates. Hospitals may earn up to one-third of the supplemental HCCP payment pool total for participating in each program, apportioned based on the hospital share formula.

(d) From July 1, 2015, to June 30, 2017, hospitals may earn financial incentives for participating in (1) the inpatient discharge care management program, (2) the intensive care management program or programs to stabilize or reduce (3) all-cause readmissions, (4) COPD admissions, (5) chronic heart failure admissions, or (6) adult asthma admissions. Hospitals may earn up to one-sixth of the supplemental HCCP payment pool total for participating in each program, apportioned based on the hospital share formula.

(e) On October 1, 2014, and annually thereafter, the commissioner shall update hospital payment rates established pursuant to section 17b-239 of the general statutes by utilizing the inpatient prospective payment system hospital market basket. To be eligible for the full amount of the update, a hospital shall provide timely emergency department and inpatient admission data as well as HEDIS reporting data, in a manner and frequency as determined jointly by the department and the Connecticut Hospital Association. The commissioner shall update by the inpatient prospective payment system market basket less two percentage points payments to a hospital that does not provide (1) timely emergency department data, (2) inpatient admission data, and (3) HEDIS data.

Sec. 2. (Effective July 1, 2014) There is established an account to be known as the "Supplemental HCCP payment pool account", which shall be a separate, nonlapsing account within the Department of Social Services. The account shall contain an annual appropriation equal to three per cent of the amount paid to hospitals for the most recently completed year for which complete data is available. Moneys in the account shall be expended by the Department of Social Services for the purposes of improving quality of care at hospitals.

This act shall take effect as follows and shall amend the following sections:
Section 1	from passage	New section
Sec. 2	July 1, 2014	New section

HS

Joint Favorable C/R

APP