New Jersey DSRIP Performance Measurement
MMIS Measurement Results Acknowledgement
MMIS Measurement Results Acknowledgment
Please refer to this document with questions regarding the MMIS measurement results acknowledgement submission process. Any questions not addressed by this document may be referred to .
How do I acknowledge the MMIS calculated measure results?
Log in to the DSRIP web portal, click on “DSRIP Program Management” tab, scroll down to “Performance Measurement – MMIS Measure Acknowledgement” sub-tab.
There will be the following selection options available:
1. Performance Period – this performance period will only show “2013”
2. Results To Be Viewed – this selection allows you to view Stage 3 and Stage 4 results for your hospital. You may choose to view:
· Both [i.e. Stage 3 and Stage 4 Data 2013 (MMIS)]
· Stage 3 Data 2013 (MMIS)
· Stage 4 Data 2013 (MMIS)
You will have the ability to download measure results via PDF, Excel 2003, or Excel 2007 – 2010.
IMPORTANT ACTION:
On the bottom of the acknowledgement page select the box that confirms: “We have reviewed our 2013 Stage 3 and Stage 4 MMIS measure results.” and hit submit. The acknowledgement will be documented and recorded. Acknowledgement can be done separately by Stage or together.
What am I acknowledging?
By submitting the MMIS Measurement Results Acknowledgement form, you are acknowledging that you have received the 2013 Stage 3 and Stage 4 MMIS calculated measure results. Submitting the Measurement Results Acknowledgement informs the Department that you have received the measure results.
How are the measures calculated?
One primary method to measure performance is through the collection of relevant administrative claims data which is submitted for payment to the New Jersey Department of Medical Assistance and Human Services (DMAHS). In order to measure clinical performance across settings of care for the New Jersey Low Income population, the Department, with CMS approval, agreed to calculate certain DSRIP measures on the behalf of DSRIP participating hospitals. This administrative claims data is collected and adjudicated in the New Jersey Medicaid Management Information System (MMIS). The data is copied and transferred for data storage to a data warehouse managed by a DMAHS vendor.
The administrative claims data captures patient utilization that can be used to measure quality performance. It relies heavily on measuring the occurrence of a service (or lack of occurrence). This includes information for all services received and submitted for payment for all provider types. This claim adjudication information is then provided to the Centers for Medicare & Medicaid Services (CMS) and retained in the federal data warehouse.
The Stage 3 and Stage 4 performance measures were selected based on their endorsement by respected national health care bodies and their broad usage for comparing quality performance. The health care entity that developed the measure is referred to as the measure steward. The measure steward acts as the“owner” of the measure and is the entity that sought and received national measure endorsement.
The measures have been executed in accordance with the specifications defined by the measure steward. In certain cases, it has been necessary to adjust the measure stewards’ specifications in order to more closely align to the population and monitoring goals of the DSRIP program. The measure specifications within the data book are those of the measure steward unless such DSRIP changes were required.
How are the measure results validated?
The New Jersey Department of Human Services has provided the data used to compute the measure results. Unless specifically noted otherwise, Myers and Stauffer’s procedures are limited to confirming that data are loaded correctly. Measurement results are a function of the measure steward specifications, definitions and underlying data, and are not intended to imply or address the accuracy of the underlying data or any facts or findings related to New Jersey health coverage programs. Please be advised to consult the NJ DSRIP Databook and measure stewards for any applicable assumptions, limitations or restrictions.
Each measure has undergone thorough review to ensure that the measure has been calculated to the specification detailed in the data book. The source code and the results of each measure are validated against the specification.
Computed measure results are compared for reasonableness against national and state benchmarks, when available, DSRIP participating hospital peers and prior-period performance.
How can I independently validate these results?
Each measure has undergone review to ensure that the measure has been calculated to the specification detailed in the data book. The source code and the results of each measure are validated against the specification.
The measures were calculated from the administrative claims data that is collected and adjudicated in the New Jersey Medicaid Management Information System (MMIS). The MMIS data contains a broader data set than is available to any participating hospital. Therefore, results calculated by an individual hospital or health system will vary from the results calculated using the broader MMIS data set. For example, a recipient may receive health care services from a provider not affiliated with the hospital system to which the recipient is attributed. Claims for these services would be included in the measure calculation, and would not be available to the health system to use in an internal calculation of the measure.
Where can I go with additional questions?
Additional questions may be addressed via phone at 1-844-325-7811 or email to .
Prepared by Myers and Stauffer LC
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