Common use of Monthly Monitoring of Hospital Clause in Contracts

Monthly Monitoring of Hospital. Within thirty (30) days after the end of every month during the Rate Years covered by this Agreement, the Hospital will provide the HSCRC with a brief written report designed to help the HSCRC to monitor the Hospital’s compliance with this Agreement, to facilitate communication between the Hospital and the HSCRC staff, and to promote the success of the GBR model. This report should include the following information, which will be modified from time to time by HSCRC and the Hospital: a. Year-to-date experience, for the current and prior year, for readmissions and comparisons of actual readmissions levels to targets, including inter-hospital readmissions experience from CRISP, for all payers combined and on a separate basis for Medicare; b. Year-to-date experience for the current and prior year for MHACs/PPCs and associated comparisons to MHAC/PPC targets; c. Changes in payer mix year-to-date versus prior year; d. Changes in market share; e. Compliance with the Hospital’s GBR constraint and the Hospital’s plan to eliminate any revenue overages through charge reductions in the remainder of the Rate Year; f. Trends in Medicare charges for the Hospital and an assessment of whether the Hospital has been successful to date in achieving the needed Medicare payment reductions; g. Trends in total regulated revenue for the Hospital broken out between revenues covered by the GBR model and revenues not covered by it with the revenues covered by the GBR model further segregated into Medicare and non-Medicare components divided between Maryland and out-of-state components; h. Trends in revenue per Equivalent Inpatient Admission (“EIPA”)/Equivalent Case Mix Adjustment Discharge (“ECMAD”); i. Trends in costs, including cost per EIPA/ECMAD, including a discussion of changes in costs relative to reductions in volumes; and j. Other information that the Hospital wishes to report regarding the successes, failures and ongoing challenges of implementing the GBR model and its related population health strategy. This supplemental information may include brief descriptions of the efforts (such as the use of emergency room care coordinators, transition care coordinators, case management, integration with community based programs, nursing home interventions, and coordination with physician delivery system changes) that the Hospital has undertaken which have been effective (or ineffective) in improving the efficiency, quality and/or processes of care. The objective of gathering such additional information is to develop a body of evidence that can be usefully shared with all Maryland hospitals that are operating under the GBR model. The HSCRC recognizes that the collection and reporting of the information described above on a monthly basis may impose an unclear or excessive burden on the Hospital; therefore, the HSCRC staff intends to work with hospital representatives to refine the monthly information reporting requirements to ensure that the Hospital can provide the kinds of information needed by the HSCRC on a monthly basis without undue hardship.

Monthly Monitoring of Hospital. Within thirty (30) days after the end of every month during the Rate Years covered by this Agreement, the Hospital will provide the HSCRC with a brief written report designed to help the HSCRC to monitor the Hospital’s compliance with this Agreement, to facilitate communication between the Hospital and the HSCRC staff, and to promote the success of the GBR model. This report should include the following information, which will be modified from time to time by HSCRC and the Hospital: a. Year-to-date experience, for the current and prior year, for readmissions and comparisons of actual readmissions levels to targets, including inter-hospital readmissions experience from CRISP, for all payers combined and on a separate basis for Medicare; b. Year-to-date experience for the current and prior year for MHACs/PPCs Maryland Hospital Acquired Conditions ("MHACs")/Potentially Preventable Complications ("PPCs") and associated comparisons to MHAC/PPC targets; c. Changes in payer mix year-to-date versus prior year; d. Changes in market share; e. Compliance with the Hospital’s GBR constraint and the Hospital’s plan to eliminate any revenue overages through charge reductions in the remainder of the Rate Year; f. Trends in Medicare charges for the Hospital and an assessment of whether the Hospital has been successful to date in achieving the needed Medicare payment reductions; g. Trends in total regulated revenue for the Hospital broken out between revenues covered by the GBR model and revenues not covered by it with the revenues covered by the GBR model further segregated into Medicare and non-Medicare components divided between Maryland and out-of-state components; h. Trends in revenue per Equivalent Inpatient Admission (“EIPA”)/Equivalent Case Mix Adjustment Discharge (“ECMAD”); i. Trends in costs, including cost per EIPA/ECMAD, including a discussion of changes in costs relative to reductions in volumes; and j. Other information that the Hospital wishes to report regarding the successes, failures and ongoing challenges of implementing the GBR model and its related population health strategy. This supplemental information may include brief descriptions of the efforts (such as the use of emergency room care coordinators, transition care coordinators, case management, integration with community based programs, nursing home interventions, and coordination with physician delivery system changes) that the Hospital has undertaken which have been effective (or ineffective) in improving the efficiency, quality and/or processes of care. The objective of gathering such additional information is to develop a body of evidence that can be usefully shared with all Maryland hospitals that are operating under the GBR model. The HSCRC recognizes that the collection and reporting of the information described above on a monthly basis may impose an unclear or excessive burden on the HospitalHospitals; therefore, the HSCRC staff intends to work with hospital representatives to refine the monthly information reporting requirements to ensure that the Hospital Hospitals can provide the kinds of information needed by the HSCRC on a monthly basis without undue hardship.

Monthly Monitoring of Hospital. Within thirty (30) days after the end of every month during the Rate Years covered by this Agreement, the each Hospital will provide the HSCRC with a brief written report designed to help the HSCRC to monitor the Hospital’s compliance with this Agreement, to facilitate communication between the Hospital and the HSCRC staff, and to promote the success of the GBR model. This report should include the following information, which will be modified from time to time by HSCRC and the Hospital: a. Year-to-date experience, for the current and prior year, for readmissions and comparisons of actual readmissions levels to targets, including inter-hospital readmissions experience from CRISP, for all payers combined and on a separate basis for Medicare; b. Year-to-date experience for the current and prior year for MHACs/PPCs Maryland Hospital Acquired Conditions ("MHACs")/Potentially Preventable Complications ("PPCs") and associated 5 This would include the purchase or divestiture of physician practices, joint-venture arrangements with other providers to establish unregulated services that duplicate or could substitute for regulated services currently provided by the Hospital (such as, but not limited to, unregulated clinic, urgent care, or ambulatory surgery services), or other non-hospital services. comparisons to MHAC/PPC targets; c. Changes in payer mix year-to-date versus prior year; d. Changes in market share; e. Compliance with the Hospital’s GBR constraint and the Hospital’s plan to eliminate any revenue overages through charge reductions in the remainder of the Rate Year; f. Trends in Medicare charges for the Hospital and an assessment of whether the Hospital has been successful to date in achieving the needed Medicare payment reductions; g. Trends in total regulated revenue for the Hospital broken out between revenues covered by the GBR model and revenues not covered by it with the revenues covered by the GBR model further segregated into Medicare and non-Medicare components divided between Maryland and out-of-state components; h. Trends in revenue per Equivalent Inpatient Admission (“EIPA”)/Equivalent Case Mix Adjustment Discharge (“ECMAD”); i. Trends in costs, including cost per EIPA/ECMAD, including a discussion of changes in costs relative to reductions in volumes; and j. Other information that the Hospital wishes to report regarding the successes, failures and ongoing challenges of implementing the GBR model and its related population health strategy. This supplemental information may include brief descriptions of the efforts (such as the use of emergency room care coordinators, transition care coordinators, case management, integration with community based programs, nursing home interventions, and coordination with physician delivery system changes) that the Hospital has undertaken which have been effective (or ineffective) in improving the efficiency, quality and/or processes of care. The objective of gathering such additional information is to develop a body of evidence that can be usefully shared with all Maryland hospitals that are operating under the GBR model. The HSCRC recognizes that the collection and reporting of the information described above on a monthly basis may impose an unclear or excessive burden on the HospitalHospitals; therefore, the HSCRC staff intends to work with hospital representatives to refine the monthly information reporting requirements to ensure that the Hospital Hospitals can provide the kinds of information needed by the HSCRC on a monthly basis without undue hardship.

Monthly Monitoring of Hospital. Within thirty (30) days after the end of every month during the Rate Years covered by this Agreement, the Hospital System will provide the HSCRC with a brief written report designed to help the HSCRC to monitor the each Hospital’s compliance with this Agreement, to facilitate communication between the Hospital System and the HSCRC staff, and to promote the success of the GBR model. This report should include the following information, which will be modified from time to time by HSCRC and the Hospital: a. Year-to-date experience, for the current and prior year, for readmissions and comparisons of actual readmissions levels to targets, including inter-hospital readmissions experience from CRISP, for all payers combined and on a separate basis for Medicare; b. Year-to-date experience for the current and prior year for MHACs/PPCs Maryland Hospital Acquired Conditions ("MHACs")/Potentially Preventable Complications ("PPCs") and associated comparisons to MHAC/PPC targets; c. Changes in payer mix year-to-date versus prior year;; 5 This would include the purchase or divestiture of physician practices, joint-venture arrangements with other providers to establish unregulated services that duplicate or could substitute for regulated services currently provided by the Hospital (such as, but not limited to, unregulated clinic, urgent care, or ambulatory surgery services), or other non-hospital services. d. Changes in market share; e. Compliance with the each Hospital’s GBR constraint and the Hospital’s plan to eliminate any revenue overages through charge reductions in the remainder of the Rate Year; f. Trends in Medicare charges for the each Hospital and an assessment of whether the each Hospital has been successful to date in achieving the needed Medicare payment reductions; g. Trends in total regulated revenue for the each Hospital broken out between revenues covered by the GBR model and revenues not covered by it with the revenues covered by the GBR model further segregated into Medicare and non-Medicare components divided between Maryland and out-of-state components; h. Trends in revenue per Equivalent Inpatient Admission (“EIPA”)/Equivalent Case Mix Adjustment Discharge (“ECMAD”); i. Trends in costs, including cost per EIPA/ECMAD, including a discussion of changes in costs relative to reductions in volumes; and j. Other information that the Hospital System wishes to report regarding the successes, failures and ongoing challenges of implementing the GBR model and its related population health strategy. This supplemental information may include brief descriptions of the efforts (such as the use of emergency room care coordinators, transition care coordinators, case management, integration with community based programs, nursing home interventions, and coordination with physician delivery system changes) that the each Hospital has undertaken which have been effective (or ineffective) in improving the efficiency, quality and/or processes of care. The objective of gathering such additional information is to develop a body of evidence that can be usefully shared with all Maryland hospitals that are operating under the GBR model. The HSCRC recognizes that the collection and reporting of the information described above on a monthly basis may impose an unclear or excessive burden on the HospitalHospital System; therefore, the HSCRC staff intends to work with hospital representatives to refine the monthly information reporting requirements to ensure that the Hospital System can provide the kinds of information needed by the HSCRC on a monthly basis without undue hardship.

Monthly Monitoring of Hospital. Within thirty (30) days after the end of every month during the Rate Years covered by this Agreement, the Hospital System, on behalf of the Hospitals, will provide the HSCRC with a brief written report designed to help the HSCRC to monitor the each Hospital’s compliance with this Agreement, to facilitate communication between the Hospital System and the HSCRC staff, and to promote the success of the GBR model. This report should include the following information, which will be modified from time to time by HSCRC and the HospitalHospital System: a. Year-to-date experience, for the current and prior year, for readmissions and comparisons of actual readmissions levels to targets, including inter-hospital readmissions experience from CRISP, for all payers combined and on a separate basis for Medicare; b. Year-to-date experience for the current and prior year for MHACs/PPCs Maryland Hospital Acquired Conditions ("MHACs")/Potentially Preventable Complications ("PPCs") and associated comparisons to MHAC/PPC targets; c. Changes in payer mix year-to-date versus prior year;; 5 This would include the purchase or divestiture of physician practices, joint-venture arrangements with other providers to establish unregulated services that duplicate or could substitute for regulated services currently provided by the Hospital (such as, but not limited to, unregulated clinic, urgent care, or ambulatory surgery services), or other non-hospital services. d. Changes in market share; e. Compliance with the each Hospital’s GBR constraint and the each Hospital’s plan to eliminate any revenue overages through charge reductions in the remainder of the Rate Year; f. Trends in Medicare charges for the each Hospital and an assessment of whether the each Hospital has been successful to date in achieving the needed Medicare payment reductions; g. Trends in total regulated revenue for the each Hospital broken out between revenues covered by the GBR model and revenues not covered by it with the revenues covered by the GBR model further segregated into Medicare and non-Medicare components divided between Maryland and out-of-state components; h. Trends in revenue per Equivalent Inpatient Admission (“EIPA”)/Equivalent Case Mix Adjustment Discharge (“ECMAD”); i. Trends in costs, including cost per EIPA/ECMAD, including a discussion of changes in costs relative to reductions in volumes; and j. Other information that the Hospital System wishes to report regarding the successes, failures and ongoing challenges of implementing the GBR model and its related population health strategy. This supplemental information may include brief descriptions of the efforts (such as the use of emergency room care coordinators, transition care coordinators, case management, integration with community based programs, nursing home interventions, and coordination with physician delivery system changes) that the each Hospital has undertaken which have been effective (or ineffective) in improving the efficiency, quality and/or processes of care. The objective of gathering such additional information is to develop a body of evidence that can be usefully shared with all Maryland hospitals that are operating under the GBR model. The HSCRC recognizes that the collection and reporting of the information described above on a monthly basis may impose an unclear or excessive burden on the HospitalHospital System; therefore, the HSCRC staff intends to work with hospital representatives to refine the monthly information reporting requirements to ensure that the Hospital System can provide the kinds of information needed by the HSCRC on a monthly basis without undue hardship.

Monthly Monitoring of Hospital. Within thirty (30) days after the end of every month during the Rate Years covered by this Agreement, the Hospital will provide the HSCRC with a brief written report designed to help the HSCRC to monitor the Hospital’s compliance with this Agreement, to facilitate communication between the Hospital and the HSCRC staff, and to promote the success of the GBR model. This report should include the following information, which will be modified from time to time by HSCRC and the Hospital: a. Year-to-date experience, for the current and prior year, for readmissions and comparisons of actual readmissions levels to targets, including inter-hospital readmissions experience from CRISP, for all payers combined and on a separate basis for Medicare; b. Year-to-date experience for the current and prior year for MHACs/PPCs and associated comparisons to MHAC/PPC targets; c. Changes in payer mix year-to-date versus prior year; d. Changes in market share; e. Compliance with the Hospital’s GBR constraint and the Hospital’s plan to eliminate any revenue overages through charge reductions in the remainder of the Rate Year; f. Trends in Medicare charges for the Hospital and an assessment of whether the Hospital has been successful to date in achieving the needed Medicare payment reductions; g. Trends in total regulated revenue for the Hospital broken out between revenues covered by the GBR model and revenues not covered by it with the revenues covered by the GBR model further segregated into Medicare and non-Medicare components divided between Maryland and out-of-state components; h. Trends in revenue per Equivalent Inpatient Admission (“EIPA”)/Equivalent Case Mix Adjustment Discharge (“ECMAD”); i. Trends in costs, including cost per EIPA/ECMAD, including a discussion of changes in costs relative to reductions in volumes; and j. Other information that the Hospital wishes to report regarding the successes, failures and ongoing challenges of implementing the GBR model and its related population health strategy. This supplemental information may include brief descriptions of the efforts (such as the use of emergency room care coordinators, transition care coordinators, case management, integration with community based programs, nursing home interventions, and coordination with physician delivery system changes) that the Hospital has undertaken which have been effective (or ineffective) in improving the efficiency, quality and/or processes of care. The objective of gathering such additional information is to develop a body of evidence that can be usefully shared with all Maryland hospitals that are operating under the GBR model. The HSCRC recognizes that the collection and reporting of the information described above on a monthly basis may impose an unclear or excessive burden on the Hospital; therefore, the HSCRC staff intends to work with hospital representatives to refine the monthly information reporting requirements to ensure that the Hospital can provide the kinds of information needed by the HSCRC on a monthly basis without undue hardship.