27 Aug 2025
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MVC Virtual Networking Event: Leveraging Claims Data for Rural & Critical Access Hospital Quality Initiatives

MVC Virtual Networking Event: Leveraging Claims Data for Rural & Critical Access Hospital Quality Initiatives

August 27, 2025 | 0 Comments | , , , ,

On August 21, 2025, MVC Coordinating Center hosted a virtual networking event providing members from rural, critical access, and acute care hospitals with an opportunity to make professional connections and discuss strategies for leveraging claims data. Twenty-three MVC members from twenty different hospitals and eight health systems participated in the ninety-minute event.

The event began with an ice breaker activity and a brief interactive quiz reviewing the number of and CMS requirements for rural and critical access hospitals (CAHs). This portion of the event concluded with a survey of MVC value metrics most relevant to quality improvement (QI) at rural and CAHs revealing most sites are focused on sepsis follow-up (Figure 1).

Figure 1. Most relevant MVC value metrics to QI at your site

The networking event continued with a presentation by MVC’s Engagement Manager Jessica Souva, MSN, RN, C-ONQS highlighting MVC’s history with critical access and rural hospitals and the addition of ED-based episodes. Starting in 2016, CAHs began joining MVC membership and today twenty-four different CAH sites are active MVC members.

Souva emphasized the need to better serve this group by understanding their unique challenges. She then shared unblinded data on hospital-level index emergency department (ED) visits with behavioral health ICD-10 code rates for 30-day ED-based episodes from January 1, 2021 to November 30, 2024. Prior to sharing the data, members were asked where they thought their hospital’s rate would fall compared to the MVC All average, most felt their rates would be higher than the average. After sharing the data, most members found their rates to be lower than expected.

Aggregate data for conditions with the highest ED episode and inpatient episode volumes across all rural and CAHs from January 1, 2022 to December 31, 2024 were also shared (Figure 2). Souva encouraged members to discuss opportunities for benchmarking and custom analytics during the breakout session with this data in mind.

Figure 2. Conditions with the highest ED and inpatient episode volumes

vertical bar graphs of conditions with the highest ED and inpatient episode volumes

The breakout discussions were structured to engage attendees in conversations about the challenges and strategies to address leveraging claims data for rural and CAHs. After breaking into two smaller groups, attendees were provided with three primary discussion prompts to reflect upon:

  1. Data Possibilities: What data sources and metrics are frequently utilized to determine outcomes and impact of process improvements in the inpatient or ED setting?

MVC members reported that various internal data platforms and benchmarking tools such as Vizient, Premiere, and Q-Centrix are used by critical access and rural health sites. They also noted frequently using metrics provided by various collaborative quality initiatives (CQIs) (e.g., HMS, MEDIC, etc.) and Medicare Beneficiary Quality Improvement Project (MBQIP) Core Measure sets to evaluate process improvements. When asked how MVC can optimize benchmarking for rural and CAHs, attendees explored options for comparing data with similar-sized sites and increased alignment between CQI pay-for-performance (P4P) metrics.

  1. Data Sharing: Which stakeholders are commonly engaged in determining strategies and indicators of successful QI initiative implementation?

The discussions in both breakout rooms highlighted the importance of involving clinical leads, physician champions, and quality improvement oversight boards for the success of QIs. One hospital noted that they additionally include an executive sponsor for each QI which they find helps to drive QI forward. Others noted a shift in culture towards encouraging ownership of QI implementation to front line staff. They noted that with adjustments to quality departments’ scope and capacity, quality leadership can focus more on the “why” versus the “how” of QI.

  1. Conditions & Follow-Up Care: Are there specific conditions currently focused on reducing ED return visits and/or inpatient readmissions?

Key conditions of focus identified by MVC members include readmissions, chronic obstructive pulmonary disease (COPD), congestive heart failure (CHF), pneumonia, sepsis and diabetes. When asked if the data shared today inspired interest in new conditions or processes to investigate in the future, members noted interest in continuing to explore the utilization of behavioral health in ED-based episodes.

Feedback from members on MVC’s August Virtual Networking Event included:

  • “I enjoyed participating and sharing during this event.”
  • “This was very helpful. I would love more meetings like this specific to critical access hospitals and small rural hospitals.”
  • “These networking events are always great and provide great insight into what is happening across the state. It allows us to share ideas but there is also a validation component that we are all experiencing a lot of the same challenges and barriers.”
  • “This was a great networking event. As a member of an organization going through multiple ‘changes’, it was awesome to see how larger acute or rural hospitals tend to their QI projects.”
  • “There was a lot of great dialogs about changing culture and how we approach quality improvement.”

MVC looks forward to hosting additional networking events in the future to increase collaboration and connection with MVC’s members. The next networking opportunity will be an in-person networking dinner on October 9, 2025, the evening before MVC’s Fall Collaborative-Wide meeting. If you are interested in attending, please register for this event here. Please note that space is limited.

30 Apr 2025
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MVC Virtual Networking Event: Collaborative Learning in Post-Discharge Follow-up for Sepsis Patients

MVC Virtual Networking Event: Collaborative Learning in Post-Discharge Follow-up for Sepsis Patients

April 30, 2025 | 0 Comments | , , ,

On April 16, 2025, MVC hosted a virtual networking event providing members with an opportunity to make professional connections and discuss strategies for improving post-discharge follow-up for sepsis patients. Forty-six MVC members from thirty-three hospitals and seven health systems participated in the ninety-minute event. 

The event kicked off with an ice breaker activity (Figure 1) and an interactive quiz on common sepsis patient demographics, symptoms, and discharge care best practices.  

Figure 1

Prior to starting the breakout discussion groups, MVC’s Engagement Manager, Jessica Souva, MSN, RN, C-ONQS presented unblinded hospital-level 14-day follow-up after sepsis rates for 30-day inpatient episodes from July 1, 2023, to June 30, 2024. 

The breakout discussions were structured to engage attendees in conversations about challenges and strategies to addressing barriers in patient follow-up after sepsis. This goal was accomplished by providing groups with specific scenarios and types of approaches to improve follow-up after discharge for sepsis patients (Figure 2)

Figure 2

What challenges are MVC members facing related to follow-up after discharge for sepsis patients? 

MVC members reported that sepsis patients often face challenges in scheduling follow-up appointments, not knowing when to contact their provider for early warning signs and being readmitted before their scheduled post-discharge follow-up appointments. Contributing factors include lack of provider ability, incomplete patient or family education, and sub-optimal discharge dispositions.  

What are MVC members doing to improve their rates of follow-up after discharge for sepsis patients?  

During the breakout discussions, attendees shared that they are addressing the identified challenges through a multifaceted approach focusing on patient education, communication, resource access, team collaboration, and data evaluation. 

Patient Education and Empowerment 

  1. Discharge Paperwork: Include a phone number for patients to call with questions or concerns and to schedule follow-up appointments. This allows patients to seek follow-up care sooner. 
  2. Family Involvement: Educate and involve family members to facilitate follow-up care by ensuring they understand the importance. 
  3. Empowering Survivor Stories: Share stories from patient survivors through interviews, surveys, or patient advisory councils. These stories can be used to educate current patients, their families, and providers. 

Communication and Coordination 

  1. Care Coordinator/Nurse Navigator: Assign a care coordinator or nurse navigator as the point of contact post-discharge. Care Coordinators and Nurse Navigators can help patients understand factors influencing readmission and how to mitigate these factors. 
  2. Continuous Communication: Maintain open communication between inpatient and outpatient case managers regarding transitions of care. 
  3. “Call Back Crew”: Build a team to follow up with patients, reinforce education, and use call centers to identify trends and improve follow-up processes. 

Resource Access 

  1. Scheduling Follow-Up Appointments: When possible, schedule follow-up appointments before discharge. 
  2. Discharge Clinics: Block time for a dedicated provider to staff a clinic for patients who do not have or are unable to get an appointment with their PCP. This type of clinic can reduce return ED visits and readmissions by providing support, education, and resources. 
  3. Educate Staff About Under-utilized Resources: Local Area Agencies on Aging can facilitate access to free or low-cost services to improve the home setting for patients aged 65+. Many insurance providers, like Medicare Advantage/BCBSM provide additional support post-discharge with designated case managers.  

Team Collaboration and Internal Processes 

  1. Multi-Disciplinary Approach: Include care management and various therapies to support patient recovery. Ensure all patients receive a physical and occupational therapy evaluation to screen basic functional needs before discharge and determine the best future care setting. 
  2. Unified Team Message: Ensure therapy, physician, and care management teams provide a unified message to patients. 
  3. Improve Team Reliability and Training: Build internal trust and, consequently, patient trust. Provide physicians with training on how to conduct difficult discussions with patients and their families, ensuring patients understand their situation and the benefits of alternative approaches when recommended by medical professionals. 

Data and Evaluation 

  1. Patient Interviews and Surveys: Include a readmission nurse on the patient care team to interview readmitted patients and learn from their experiences.  The readmission nurse can act as a liaison between quality and hospital care teams, highlighting patients needing special attention and collecting feedback. 
  2. Retrospective Review: Complete a retrospective review of the patient’s journey to identify improvements needed in education and communication upon readmission for the same reason. 
  3. Care Transition Programs: Add sepsis patients to Care Transition Programs to trigger alerts for retrospective review of readmission cases and to identify improvement areas. 

What are members saying about the MVC April Virtual Networking Event? 

  • “Very fun and informational event. I like the smaller break out sessions to foster meaningful conversation and then bringing the ideas of the smaller groups to the entire group.” 
  • “Very well organized. I loved the interactive piece.” 
  • “I enjoyed the pre-break out group survey/quiz questions to help with engagement…it is less intimidating to speak up in the smaller groups than when everyone is in on large group.” 
  • “I enjoyed the networking aspect of this event and look forward to others in the near future. MVC Site Engagement Coordinators did a wonderful job facilitating this event and engaging the participants.” 
  • “It was reassuring to hear that many of the hospitals across the state are having the same issues and working on similar projects. It gave me a sense that my own hospital is on the right path.” 

MVC looks forward to hosting more virtual networking events throughout the year to increase collaboration and connection with MVC’s members. If your hospital or organization has a networking topic they would like to share, please email us. We would love to hear from you.