HQEP Data Dictionary

Cost Metrics

Inpatient Small Bowel Obstruction – All Fixed & Variable Direct Costs Associated With Inpatient Diagnosis Code K56 (YTD Average)

Outpatient Lap Chole – All Fixed & Variable Direct Costs Associated With SDC Procedure Description Like “Lap Cholecystectomy” Based On Dc Date (YTD Average)

Laparoscopic Or Lap-Assisted Hysterectomy – All Direct Costs Associated With SDC Procedure With Description Like “Lap Assisted Vaginal Hysterect” Or “Lap Total Hysterectomy” (YTD Average)

Outpatient Inguinal Hernia Repair – All Fixed & Variable Direct Costs Associated With SDC Or INO Procedure Description Including “Hernia Inguinal” (YTD Average)

Health Plan Metrics

Medical Expenses Per Member Per Year (PMPY) РTotal Paid / Total Count Of Members = PMPM; Rolling 12 Month Average (PMPM*12) = PMPY [Baseline = 18 Month PMPM average] ED Utilization (Visits Per 1,000) РAnnual Number Of ED Visits Per Thousand

Adult Preventive Care Visits For High Risk Population – Number Of At-Risk Members (Identified By Biometrics Screenings) Who Have An Adult Preventive Care Visit With Internal Med Or Family Practice Provider (641 = At-Risk Members)

Colorectal Screening – Number Of Procedures And Tests Performed In 2018 For Eligible Population (50 + Yrs); Colonoscopy (10 Yrs), Flex Sig (5 Yrs), Cologuard/Fit (3 Yrs)

Mammogram – Number Of Mammograms Performed In 2018 For Eligible Population (50 + Yrs, Every 2 Years)

Quality/Efficiency Metrics

Inpatient Physician Hand Hygiene – Observed Rate Of Physician Hand Hygiene Compliance In The Hospital (YTD Average)

Patient Satisfaction – Provider Focus – YTD Average Of “Top Box” Answers To Provider-Specific Questions For ER, Hospital, And Outpatient Office Patient Surveys

Reduction In Use Of Oral Contrast With Abdominal Ct (ED) – Percentage of Abdominal CTs with Oral Contrast (Omnipaque) ordered by AEP

Reduction In Use Of IV Phenergan (ED) – # Doses IV Phenergan (PROME I25) Ordered By AEP Physicians (YTD Average)

PNA Hospital Readmission Rate – 30-Day All-Payer Readmission Rate With Index Admission For Pneumonia (Not Risk-Adjusted; Only For Augusta Health; Medisolv Data – YTD Average)