hospital quality

Joint Commission says hospital quality improving

Anne Zieger — Mon, 24 Nov 2008 22:33:52 -0500

A new study from The Joint Commission has concluded that U.S. hospitals have steadily improved the quality of patient care over the past six years. The study, which analyzed National Patient Safety Goal compliance and quality measures on several common treatments and procedures, found some dramatic improvements in the areas it measured.

For example, hospitals in the study provided smoking cessation advice to 98.2 percent of heart attack patients in 2000, compared with 66.6 percent in 2002; they also improved their results in giving this advice to heart failure patients and patients with pneumonia. Furthermore, hospitals improved dramatically in providing discharge instructions to heart failure patients (30.9 percent to 77.5 percent) screening and vaccinating pneumonia patients for pneumococcus. Outcome measures improved as well. Heart attack care results, for example, improved to 96 percent in 2007 from 86.9 percent in 2002 on evidence-based measures of care.

Of course, for every positive quality result, there's always some downside. In this case, hospital quality varied widely, and some hospitals did better than others in treating particular conditions. Take heart failure: While hospitals in the highest performing state provided discharge instructions to heart failure patients 92.1 percent of the time, the lowest-performing state's hospitals provided such instructions only 56.6 percent of the time.

To learn more about this study:
- read the report

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CMS awards $7M to top performers in P4P program

Anne Zieger — Wed, 18 Jun 2008 09:11:10 -0400

CMS has announced that it will award a collective $7 million this year to the 112 top performing hospitals in its ongoing pay-for-performance project with Premier. The best performer, Sacred Heart Medical Center in Spokane, Wash., will receive the highest quality incentive payment of $385,342 after getting top ratings in four out of five clinical areas being measured. All hospitals are reporting data on heart attacks and heart failure, coronary artery bypass grafts, pneumonia, and hip and knee replacements.

Officials with the P4P program, which is in its third year, say that there has been substantial and continual improvement among all 250 participating hospitals in 36 states. Hospitals in the CMS/Premier Hospital Quality Incentive Demonstration have raised quality of care by an average of 15.8 percent during the first three years, as evaluated by 30 measures in five clinical areas, CMS officials reported. To date, CMS has awarded $24.5 million in bonuses to top performers in the program.

To learn more about the CMS quality improvement project:
- read this Modern Healthcare article (reg. req.)

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AHA says CMS hospital quality measures aren't ready

Wed, 11 Jun 2008 06:59:57 -0400

As things stand, hospitals soon will have to report on 72 quality measures (up from 30) if they want to receive full Medicare reimbursement. However, most of the new quality measures proposed by CMS for its fiscal 2009 budget aren't ready to be reported on yet, according to the American Hospital Association.

Of the 43 new measures CMS has proposed, only 10 have been adopted by the Hospital Quality Alliance, and what's more, many have not been endorsed by the National Quality Forum, wrote the AHA in a letter to the agency. AHA doesn't believe that the 33 measures not yet adopted by the Hospital Quality Alliance are ready for reporting. What's more, adding that many more measures may actually confuse hospitals as to what their priorities should be, according to AHA Executive Vice President Rick Pollack.

To learn more about the AHA's concerns:
- read this Modern Healthcare article (reg. req.)
- read the AHA's comments (.pdf)

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Medicare releases volume, customer satisfaction data

Mon, 31 Mar 2008 07:59:58 -0400

For the first time, Medicare has released volume and payment information for a list of selected conditions, along with the results from its new consumer satisfaction survey, the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). Medicare already posts hospital quality data for heart attack, heart failure, pneumonia and surgical care to its Hospital Compare website. The agency now will add information showing how often Medicare patients were admitted to hospitals for a set of conditions, as well as what Medicare paid for treatments to the site and HCAHPS data. The HCAHPS data includes feedback from more than 2,500 hospitals participating in the program's launch.

To learn more about Medicare's plans:
- read this Modern Healthcare article (reg. req.)

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CMS P4P program shows improvements

Fri, 01 Feb 2008 06:59:58 -0500

Hospital costs and mortality rates are going down under CMS's pay-for-performance project, according to a new analysis. Under the Hospital Quality Incentive Demonstration project, which began in 2003, the median hospital cost per patient has declined by more than $1,000 across the first three years of the project. What's more, the median mortality rate went down by 1.87 percent. The Premier healthcare alliance, which manages the project, reached this conclusion after analyzing more than one million patient records from more than 250 participating hospitals. According to one analysis, hospitals nationally could save 70,000 lives per year and cut costs by more than $4.5 billion annually if they made the same improvements as the participating hospitals over a three-year period.

To find out more about the analysis:
- read this Modern Healthcare article (reg. req.)

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Seattle-area healthcare "checkup" finds deficiencies

Fri, 01 Feb 2008 06:59:55 -0500

A Seattle-area health alliance has conducted what it calls a "community checkup," examining care for more than 1.6 million patients--and concluded that performance was below current standards on many measures. The research, which cost the Puget South Health Alliance a cool $1.1 million, looked at 21 types of care provided to patients in Seattle and surrounding counties, including diabetes, heart disease, depression, low back pain and preventive care. Information was drawn from 81 volunteer clinics, including about 70 percent of the insured, non-Medicare population in the region, using data drawn between January 2004 and December 2006.

The Alliance found that fewer than half of residents over 50 had gotten recommended preventive care such as colorectal cancer screenings, mammograms and pap smears. Meanwhile, about 20 percent of patients with heart disease or diabetes did not have their cholesterol checked at least once during the year assessed, the report concludes. However, Alliance leaders said that they don't intend to punish providers for deficiencies. They see the data as a "starting place from which to improve," according to executive director Margaret Stanley.

To learn more about the report:
- read this Seattle Post-Intelligencer piece

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Unclear on how hospital data affects decisions

Tue, 15 Jan 2008 06:59:56 -0500

While public policy is very much in favor of providing detailed data on hospital performance and quality, there's little evidence to suggest that this data actually affects patient decisions, according to a new study published in the Annals of Internal Medicine. While many states have established public reporting systems which require hospitals to disclose data such as infection rates or mortality levels, there's not much in the academic literature to back up claims that it affects consumer decision-making. What's more, what literature does exist suggests that consumers find report cards to be confusing rather than helpful. Researchers say that more research is needed on how reporting systems should be designed before public policymakers can have an impact on consumer health decision-making.

To find out more about the study:
- read this Modern Healthcare article (reg. req.)

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Progress slow on hospital data in IL

Wed, 09 Jan 2008 06:59:56 -0500

When advocates vent over the slow adoption of consumer-driven healthcare spending, one place they should look is Illinois. The problems encountered there in becoming a more consumer-driven health system offer a look at what's likely to come as other states get on board.

While Illinois established laws four years ago intended to gather and publish hospital safety and performance data, to date, none of the projects specified in the legislation has been passed. These include The Illinois Hospital Report Card, which was chartered to document hospital-acquired infections, the Illinois Consumer Guide to Health Care, a study of care and hospitals and surgery centers, and a third study intended to focus on serious medical errors.

Why are things moving so slowly? Well, for one thing, a consensus was reached that the original legislation was poorly drafted, and ended up being amended--but that took a year. Meanwhile, officials say that they lack adequate funding. In fact, the state's new Division of Patient Safety still has only two employees, and has just now begun ramping up its staff. Then, consider that the state's Department of Public Health has to gather data and subject it to multiple layers of review, and it's hardly surprising things have moved so slowly. Still, given that none of these are unusual problems, it doesn't bode well for the timely progress of similar efforts in other states.

To learn more about the Illinois reporting issue:
- read this piece from the Chicago Tribune

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Critical-access hospitals not part of CMS quality program

Mon, 17 Dec 2007 06:59:56 -0500

Raising some hackles, CMS has made the decision to exclude critical-access hospitals from its Hospital Outpatient Quality Data Reporting program. The program, which kicks off in April 2008, will require hospital outpatient departments to report on seven quality measures, most of which are heart-attack related. CMS's move has raised the ire of these hospitals, many of already provide inpatient quality data to CMS's Hospital Compare website. Starting in 2009, hospitals who don't participate in this program could face a 2 percent cut in their annual outpatient update.

To find out more about these issues:
- read this Modern Healthcare piece (reg. req.)

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CMS program would base hospital pay on performance

Tue, 27 Nov 2007 06:59:58 -0500

CMS is proposing a new quality-reporting program which would cut Medicare payments to hospitals, but give money back if the hospitals performed well on the agency's quality measures. The new "value-based purchasing" program would withhold a percentage of each discharge or DRG payment. For the first year of the program, which would require approval from Congress, CMS would begin by paying hospitals just for reporting. In year two, however, CMS would base rewards 50 percent on hospital reporting, and 50 percent on how well they met quality standards. By the third year, incentives would be based completely on performance. This effort would build on the existing hospital quality reporting program instituted in 2005.

To learn more about the proposal:
- read this Modern Healthcare piece
- read the CMS report (.pdf)

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