Current through Pa Acts 2024-53, 2024-56 through 2024-92
Section 512-A - Selection of potentially avoidable event methodology.The department shall select a methodology for identifying potentially avoidable events and the costs associated with the events and for measuring hospital and managed care organization performance with respect to the events. The following shall apply:
(1) The department shall develop parameters for each of the potentially avoidable events in accordance with the selected methodology.(2) To the extent possible, the methodology shall be one that has been used by a state program under Title XIX of the Social Security Act (49 Stat. 620, 42 U.S.C. § 301 et seq.) or by a commercial payer in health care outcomes performance measurement and in outcome-based programs.(3) The methodology shall utilize a clinical categorical model, enable the provision of performance information on both the aggregate and case level and risk adjust scoring to account for patient severity of illness and population chronic illness burden.Added by P.L. TBD 2018 No. 40, § 3.1, eff. 3/31/2019.