News Releases

Health Services Advisory Group, the Medicare Quality Improvement Organization (QIO) of Arizona, is now offering acute-care Prospective Payment System (PPS) hospitals across the state free training on the Program for Evaluating Payment Patterns Electronic Report (PEPPER) electronic reporting tool.

PEPPER provides summary statistics of administrative claims data on Centers for Medicare & Medicaid Services (CMS) target areas (areas likely to have payment errors due to billing, DRG/coding and/or admission necessity issues). Arizona hospitals can use PEPPER to review their data for the current quarters and the previous three fiscal years for each of the areas targeted for improvement by CMS, and compare their performance to that of the other acute-care PPS hospitals within their state. They can also use the tool to compare their own data across years to identify significant changes in billing practices; pinpoint areas in need of auditing; identify potential DRG under- or over-coding problems; and identify target areas such as one-day inpatient admissions. PEPPER can also provide hospitals with benchmarks on where they stand on compliance and audit risk, and this training will help in these risk reduction efforts.

This training is provided at the direction of CMS through TMF Health Quality Institute, the Texas-based QIO, which is under contract with CMS as the Hospital Payment Monitoring Program (HPMP) Quality Improvement Organization Support Center, and is responsible for developing PEPPER. TMF subcontracted with IPRO, the New York-based QIO, to conduct this training.

"Despite its potential to help with compliance and financial management practices, many hospitals underutilize PEPPER," says Kathy Terry, Ph.D., Senior Director, Medicare/Federal Health Care Assessment at IPRO. "Learning how to use PEPPER can seem difficult and our goal is to reduce the intimidation factor so that all appropriate hospitals in Arizona can more easily access this innovative tool."

Administrators/Chief Executive Officers in all acute-care PPS hospitals in the nation have now received a CD. The CD will contain a brief overview of the HPMP and PEPPER, a description and agenda for the training, a link to register for the training and a link to participate in an online community forum. The CD will also provide information on the targeted audiences within your hospital (e.g., Compliance Officers, Utilization and Health Information Management Professionals, etc) and how the data will be useful to each audience and to the hospital overall. The trainings will be web-based with audio accompaniment and will include a detailed review of the PEPPER report that is available to each acute-care PPS hospital. There will be many general trainings, which are scheduled to run from late October through early January 2006. Following the general training sessions, IPRO will offer three advanced sessions. The sessions will cover advanced PEPPER interpretation, a DRG/Coding topic area in detail, and a Utilization topic area in detail. On completion of the program, one of the general sessions and all three advanced training sessions will be made available to all acute care hospitals on CD.

Training will be conducted via a combination of Webinar learning sessions and dissemination of print and/or audio-visual materials. General sessions will cover the history, intent, use, navigation, meaning and implications of PEPPER. Advanced Webinar training will focus on more complex and specific issues and uses of PEPPER.

To reap the benefits of your hospital data, be sure to review the PEPPER CD and register for the training sessions at www.pepperinfo.org. More information may also be found at www.pepperinfo.org.