Program for Evaluating Payment
Patterns Electronic Report

Provide your feedback on PEPPER.

Important Alert:

Providers who previously received their PEPPER by mail may now access it through a secure portal from this website. To access the portal click here. Providers who have been receiving their PEPPERs through QualityNet will continue to do so.

For details and more information click here. Sign up to receive an email notification for future PEPPER releases and training opportunities.

PEPPER Testimonials

View the testimonials below from our PEPPER feedback survey to learn how other hospitals are using the report.

 

As the CMI analyst and Physician Documentation Educator, I use PEPPER to pinpoint educational opportunities based on the benchmarking information provided.”

 

As the RAC Coordinator, I use the RAC target risk data—especially medical DRG with CC/MCC, 1-Day stay chest pain, 3-day SNF. Our Quality/Risk department also uses the other PEPPER data.”

 

As the UM-RN with a strong quality and clinical data analyst background I have loved the PEPPER from the first one I saw back in 2007. I think it helps to let hospitals know how they are comparing to others. This is only one aspect and each individual hospital should be able to "talk" to their specific data.”

 

As the VP of Care Coordination, I review the PEPPER for all hospitals within my system to see how we compare with region, nation and state. It is invaluable information. When we had that time frame wherein PEPPER was not available, I was panicked. I cannot get this information from any other source.”

 

I review PEPPER for use with pulling charts of the DRGs that fall out of the norms for our quarterly MS-DRG coding audits.”

 

PEPPER helps our hospital benchmark with other hospitals in our state and region and identify negative trends that may be missed opportunities otherwise.”

 

Our hospital uses PEPPER for benchmarking comparisons, review by UR committee for trends and as a tool to determine which areas of practice need further review.”

 

We use PEPPER as benchmarks against other facilities to gauge potential outlier status, and it also helps to validate internal trending conducted in real-time.”

 

Case management, quality and financial committees review PEPPERs and compare to recent or concurrent data to determine if new initiatives or interventions have been successful.”

 

Case Management reviews PEPPERs to proactively identify hot-issue trends that may need attention.”

 

PEPPER helps in determining chart audits, clinical resource utilization and trending readmission rates. PEPPER gives a snapshot of how we are doing, or did the last quarter in comparison to others.”

 

Review of PEPPER is a collaborative effort whereby outlier areas are analyzed by Case Management, Medical Records and Finance.”

 

With PEPPER we compare ourselves to other hospitals and select categories for in-depth review if we vary from state average or our previous score; we share PEPPER with documentation specialists.”

 

PEPPER data is reported to the UM committee and compared to our internal monitoring. We implemented One-day Stay monitoring several years ago and compare ourselves to the state and national levels. We've used the data to address specific DRGs that have been above the average and implement practice changes in the ED prior to admitting specific DRGs.”

 

Each PEPPER is utilized by the Resource Management, Medical Records and Corporate Compliance Office. Records are identified and audited for trends.  Data is presented to the Utilization Management Committee of Physicians and Executives.”

 

PEPPER is used for evaluation of service lines, as a focus on documentation improvement and as a RAC risk and readiness assessment.”

 

With PEPPER we examine performance over time and compare with peers as well as providing external benchmark data.”

 

PEPPER is given to HIM and Revenue to review. Having PEPPER on the Qnet is very convenient.”

 

I am the Corporate Director for four facilities and we are using PEPPER data to determine areas of concern and improvement. The data is discussed in the  UR committees and forwarded on to other appropriate committees. Action plans have been developed from study of this data.”

 

I distribute our hospital's PEPPER to several departments and each uses it in its own way. Core Measures, Utilization Review, Healthcare Information Management, Patient Revenue and Financial Analysis receive the PEPPER.”

 

I do a sample of any area in PEPPER where we are above the expected percentile. Chest Pain One-day Stays were an issue for us; we have found the attention given to it to be useful, and our percentile has improved.”

 

I keep a spreadsheet of the issues identified in our PEPPER and our scores compared to national and state scores. We use this data to abstract information.”

 

I report on PEPPER to the corporate compliance committee and we track trends. As coding manager, I utilize PEPPER to set auditing activities.”

 

I summarize and distribute PEPPER to both HIM and Care Management, at which time they review and perform internal concurrent auditing related to areas outside the 80/20 parameters.”

 

I took the PEPPER and presented it to medical staff at their monthly meeting,  pointing out some areas of concern and need for improvement. PEPPER is also presented to our compliance team.”

 

Our hospital uses its PEPPER for identification of clinical documentation improvement opportunities, areas for process improvement, risks for audits and to identify the areas where we have improved.”

 

We use PEPPER to identify areas needing additional education and for tracking improvement after educational initiatives.”

 

We use PEPPER to help identify opportunities for improvement and risk mitigation.”

 

In addition to our system's individual hospital use and analysis, we use PEPPER to aggregate, compare and share data to identify best practices; where to allocate resources and/or initiate detailed auditing; and for tracking and trending.”

 

In Case Management we look for areas in our PEPPER where we are close to or outside the national average and then determine actions to ensure we are following the regulations and that those that are outside the norm are appropriate.”

 

PEPPER information is provided to administrative staff and physicians to show how we compare to other facilities, and it also alerts us to potential RAC concerns.”

 

We use PEPPER for internal communication, validation and analysis of data compared to other information available internally, and to drive improvement when needed.” 

We use PEPPER to identify issues related to utilization, compliance, quality, medical necessity and coding/DRG validation. We use the data as a benchmarking tool and to monitor improvement within the organization as well as among our peers.”

 

Our hospital uses its PEPPER to identify trends, potential outliers and any significant changes from one quarter to the next.”

 

We use PEPPER to monitor high-risk areas and potential physician education needs related to documentation or admission practices.”

 

PEPPER is used for tracking through case management along with HIM to see if there are trends by physicians or hospital-wide, if documentation is an issue or if follow up care is needing scrutiny.”

 

We incorporate the PEPPER into our Performance Improvement Plan and our Corporate Compliance Plan.”

 

We review PEPPER for variation and focus on the areas of risk and seek to understand what is contributing. Sometimes this requires additional review and we will conduct a focus audit. We work on improving our processes if we identify a gap (actual vs. desired process or practice) and report the results and plan to our compliance committee.”

 

We review many of the categories contained in the PEPPER to assure we are meeting medical necessity. We have made a real effort in review and changing our One-day Stay patterns and are also looking at readmissions currently based on the PEPPER data.”

 

We utilize the PEPPER in a variety of ways. Here are some broad areas:  1) Review at the Utilization Review Committee, 2) Utilize to focus drill down reviews if any outlier areas, 3) Utilize benchmarks to determine goals for focus areas, 4) Educate Administration and Medical Staff on opportunities for improvement and 5) Educate Case Management team on areas of focus.”

 

We've been using the data in our PEPPER for several years to help our hospital identity potential risk areas that may be indicative of a coding or documentation problem. If we are really high compared to our peers, it is a red flag to us. We do probe audits to see if our risk is realized. Now that RACs are here, we can say we've already looked at and addressed many of the RAC hot topics.”

 

Our PEPPER is presented at UR committee, reviewed with coding department, documentation specialists, CM, social workers and senior management.”

 

Our hospital uses PEPPER for process improvement. We focus on 3-day qualifying stays and increased emergency admits from the ED. We organized a team to reduce 30-day readmissions. We instituted a clinical documentation specialist and review PEPPER outliers in clinical core groups.”

 

The QI Director, Compliance Officer, HIM Director and Case Management Director all meet to review every new PEPPER. The report is also sent to the CEO and CFO, and the team can investigate any questions they may have. We look for trends and outliers and have on occasion completed an intensified review of certain DRG admissions to identify and validate how we are coding/applying admission review and continued stay criteria. We compare our LOS with other facilities. Finally, the QI Director and Compliance Officer reviews the PEPPER with the compliance committee.”

 

Our PEPPER is reported at UR committee. We drill into data when we are shown as outliers. Explanations are provided to Medical Staff, Administration and Corporate as needed. Corrective action plans are also instituted as needed.”

 

Resource Management and Case Management uses PEPPER as a tool to assess performance. HIM uses PEPPER to assess documentation and coding. Revenue uses PEPPER for analysis and benchmarking.”

 

Our hospital reviews the results of our PEPPER trends on the graphs. If we appear too high or too low we conduct internal reviews to understand the outcomes.”

 

Our hospital's PEPPER is reviewed at the utilization review medical committee. The readmission rate and One-day Stay information is reported to the medical executive committee and the board and reviewed with case management and CDI staff.”

 

The PEPPERs are reviewed at our utilization review committee meeting and with the case management staff and at the compliance committee meetings.  Our hospital develops action plans for indicators that fall out two or more consecutive quarters. Action plans always include educational components.”

 

PEPPER information is shared with our hospital UM committee, senior leadership, Medical Records department and corporate compliance. It is very helpful and assists us in identifying areas for internal auditing and education.”

 

Our hospital uses PEPPER for internal audits, RAC request pre-review, cost analysis, physician report card and governing board updates.”

 

Our PEPPER is reviewed by the Quality Director and the AVP of Finance. Once the review is completed, the results are discussed with the department heads, directors and managers.”

 

We review PEPPER to look for trends and potential for under/over coding and also for case management in strategizing inpatient vs. observation.”

 

Our hospital analyzes PEPPER data and compares internal data to identify patterns and variations.”

 

Our quality manager receives the PEPPER and sends it to the administrative group that reviews the data and identifies any trends or risk areas. The PEPPER data are also discussed in the compliance meetings.”

 

Our Utilization Management Team (multidisciplinary) reviews the PEPPER data for each quarter. It is used to identify areas of opportunity to ensure quality care, quality and compliant coding, quality documentation and compliant utilization review.”

 

PEPPER is used to communicate to our hospital staff, medical staff and board. We use it as a learning, utilization review and quality improvement tool.”

 

PEPPERs are shared with the administration, revenue cycle management committee, coding staff and medical staff as both an education offering and to identify areas of improvement.”

 

PEPPERs are utilized by a variety of disciplines. The data are shared with staff of QRM, HIM, as well as with the Medical Director. Any significant variances are reported up to the Board of Trustees through the Compliance Committee. The PEPPER has also been the springboard for reviews/follow-up training, both internal and external.”