Using Peer Support to Improve the Accuracy of IPHIS

March 11, 2016

WelcomeVirtual Office Hours

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11:30 AM WelcomeReview of agenda & objectives

Beth White, MSN,OPQC

11:35 AM Improving accuracy in IPHIS variables related to principal payment source, particularly

Ohio Medicaid

John Paulson, MSODH Statistician

11:55 AM Open Lines Jay Iams, MDOPQC Lead OB Faculty, John and Beth

12:28 PM Additional resources & Next month’s topics

Beth

Agenda

Objectives

• Improve accuracy in IPHIS variables related to principal payment source

• Discuss troublesome issues confronting birth registry data abstraction related to principal payment source

• Describe successful strategies to consistently meet the challenge of accurate IPHIS documentation.

“The focus of healthcare for women and infants over the next century depends on the quality of the data collected by those who fill out the

birth certificates.”

Bill Callaghan, MD MPHChief, Maternal and Infant Health BranchDivision of Reproductive HealthCenters for Disease Control and Prevention

December 1, 2011

Payer Information in Vital StatisticsWhy is accuracy important?

• The birth certificate is a legal document: future generations may wish to know this information

• Birth certificate medical data are used to improve public health and to offer services to mothers

• Knowing payer of delivery informs mother’s socio-economic status and is associated with many outcomes.

• Helps to assess health coverage of pregnant women via Medicaid expansion under the Affordable Care Act

Principal Source of PaymentFacility Tab

From the Guide to Completing the Facility Worksheet for Live BirthRev. 10/14

3. Principal source of payment

Definitions

Instructions

Sources

Key words/Abbreviations The principal source of payment at the time of delivery: • Private insurance (Blue

Cross/Blue Shield, Aetna, etc.) • Medicare • Medicaid (or a comparable

State program) • Purchase directly or self-pay

(no third party identified) • Other - (Indian Health Service,

CHAMPUS/ TRICARE, other government [federal, state, local])

• Uninsured

Check the box that best describes the principal source of payment for this delivery. If “other” is checked, specify the payer.

If the principal source of payment is not known, mark “unknown”.

This item should be completed by the facility. If the birth did not occur in a facility, it should be completed by the attendant or certifier. This item should reflect knowledge of the most up to date managed care product names in this hospital’s service area.

1st Hospital Face Sheet 2nd Admitting Office Face Sheet 3rd Admitting Office Managed Care reference

Principal Source of Payment: The Facility Worksheet*

• Principal source of payment for this delivery (At time of delivery):• Health insurance through Private insurance current or former employer or

union.• Other Government• Medicaid – (Please refer to the Medicaid Card Example Tip Sheet)• Purchased directly • Uninsured • Unknown• Champus/Tricare• Other (Specify, e.g., Indian Health Service)

_________________________________•

• *rev. 10/14

Principal Source of Payment Ohio Medicaid HMO

Non-Medicaid Health Insurance: Just a Sample:

All Health Insurance Marketplace and Medicaid plans cover pregnancy and childbirth.

Many Private Health Insurance Carriers in Ohio Some have both private and Medicaid products! Ask if you’re not sure.

IPHIS Screen Principal Source of Payment

Principal Source of Payment in IPHIS

Principal payer of delivery, 2015 births

Principal Source of Payment unknown by hospital size and year

Percent of birth records with unknown payer

Low birth weight rate by payer of delivery, 2015 births

Principal payer Medicaid deliveries, Ohio 2015 by mother’s race and age

Mother’s age

Principal Source of Payment in Vital Statistics

• The single best thing you can do to ensure good payer data in the birth registry is to understand the Medicaid Managed Care Providers in your birth population and correctly assign those to the Medicaid payer choice in IPHIS.

Your Turn: Open Discussion

• What challenges do you have with IPHIS?• What would you like to ask or tell your

birth certificate abstractor colleagues?

Additional Resources

• vitalsupport.odh.ohio.gov• ODH/Vital Statistics Help Desk:

614-466-2531, Option 3• Availability of slides on OPQC.net• Revised Guide to Completing the Facility

Worksheet for Live Birth • Revised Facility Worksheet• 2014 Additional IPHIS Variables:

OPQC/ODH.Vital Statistics

What’s NextWebinars/VOH Next Webinar: Newer Challenges in IPHIS Accuracy, Part I: Same Sex Couples, Surrogacy, Other New Changes Friday, May 6, 2016 11:30 AM

Next Virtual Office Hours: Breastfeeding and Exclusive Breast feeding variables

Friday, April 15, 2016 11:30 AM

Regional Workshops May 17, 2016,

9:00 AM to Noon Doctor’s Hospital, Columbus, Ohio

May 24, 2016, 9:00 AM to Noon St. Luke’s Hospital, Maumee (Toledo), Ohio

June 7, 2016, 9:00 AM to Noon Aultman Hospital, Canton, Ohio

5 Online IPHIS ModulesAlways Free! Always Available!

Go at Your Own Pace! Great Overview of IPHIS!

• IPHIS Self Study Modules:https://opqc.net/projects/BirthRegistryAccuracyResources

For Your Participation!