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Modernize Hospital Payments


The Ohio Department of Medicaid (ODM) has implemented a healthcare quality initiative based on readmissions for hospital stays. This initiative, otherwise known as the Potentially Preventable Readmissions (PPR) Program, helps ODM and hospitals to identify opportunities to reduce readmissions and improve the quality of patient care while saving state taxpayer dollars. Ohio Administrative Code 5160-2-14 sets forth the policies for the PPR program. In an effort to further refine and improve the PPR program, ODM implemented changes to the PPR logic effective January 1, 2019; a summary of these program changes is published in HHTL 3352-19-02.


Hospital Report Card

In February 2015, ODM started publishing the Hospital Report Card which compares hospital readmission rates over four 12-month periods of time. This report card is updated with the most current data every six months. Hospitals also have access to hospital-specific readmissions data to further help identify which types of hospital stays have higher than expected readmission rates.


Managed Care Plan Potentially Preventable Readmissions (MCP PPR) Report Card

In July 2015, ODM released a Managed Care Plan Report Card comparing hospital readmission rates across managed care plans. The hospital-specific readmission rates compare a hospital’s PPR rate across the entire Managed Care Program as well as its rate under its contract with each plan. The Managed Care Plan Report Card compares results over a single 12-month period. This report card is updated with the most current data every six months.