Tennessee Uses AHRQ Costs and Mapping Tool, Prevention Quality Indicators for Public Reporting

As a result of attending the AHRQ workshop "Using Administrative Data to Answer State Policy Questions" sponsored by AHRQ's Knowledge Transfer Quality Diagnostic Tools for States project, Tennessee incorporated the Preventable Hospitalization Costs and Mapping Tool and the Prevention Quality Indicators (PQIs) into a State Healthcare Report Card.

Released in March 2009, the Report Card analyzes the preventable hospitalizations associated with diabetes and hypertension. It extensively uses the maps created by the Preventable Hospitalization Costs and Mapping Tool and the PQIs to present the data to report on the admissions for each county in Tennessee.

The AHRQ workshop, held in December 2008, presented information on the Preventable Hospitalization Costs and Mapping Tool and the PQIs, along with other administrative data and tools. The Tennessee team decided to add the information generated by the Preventable Hospitalization Costs and Mapping Tool and the PQIs to their Report Card, and build on momentum in Tennessee to improve the quality of Tennessee's health care. In October 2008, a brainstorming session was held with stakeholders from across the State to discuss how quality could be improved by leveraging only the financial resources and health data available to the State at that time. This brainstorming session—the "Quality 1.0 Meeting"—resulted in a decision to examine several major diseases in the State at the county level.

The Report Card demonstrates how valuable the hospital-based data is in tracking and analyzing the prevalence of disease in Tennessee. It has been used as part of the State's successful push for an all-payer claims database. Jeff Ockerman, Director of the Division of Health Planning for the State of Tennessee, located in the Department of Finance and Administration, presented PQI data in hearings of the Tennessee House and Senate Health Committees and during testimony before other committees in support of the all-payer claims database bill. An all-payer claims database would include the additional information about what is or is not happening outside of the hospital setting relating to these diseases.

Brooks Daverman, Health Quality Analyst with the Tennessee Department of Finance and Administration's Division of Health Planning, attended the AHRQ workshop. Daverman states, "The workshop made a big difference in developing the Report Card. We didn't really understand specifically how the Prevention Quality Indicators could be used. We also didn't know how the mapping software worked. If it hadn't been for the workshop, we probably wouldn't have used the quality indicators in the report at all. The tool provided a way to generate more maps and present the information from a different angle."

Daverman noted that the opportunity to bring representatives from different departments both within and outside of State government helped foster collaborative efforts. The Report Card was jointly developed by the Tennessee Department of Finance and Administration's Division of Health Planning, the Tennessee Department of Health's Division of Health Statistics, and QSource, the Medicare Quality Improvement Organization for Tennessee.

Dave Goetz, Tennessee's Commissioner of Finance and Administration, presented the Report Card in several public forums, including a meeting of the Nashville Area Chamber of Commerce. The Report Card has also been highlighted in the media, contributing to a more widespread discussion about health care quality, diabetes, and hypertension. The Chattanooga Times Free Press wrote an article detailing the Report Card's findings for Hamilton County, where Chattanooga is located.