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Medicare News
Cash Rewards Make Substantial Improvement in
Hospital Care Finds CMS
CMS pays out almost $9 million to top hospitals in
demonstration
 January 28, 2007 If you want better quality care
from hospitals, give them a cash incentive. The Centers for Medicare &
Medicaid Services says it has produced "substantial improvement" in a
demonstration project it has operated for two years. But, it took a lot
of cash - the reward
payments have been a whooping $8,690,447 for the 115 top performing
hospitals.
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Related Stories |
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Hospital Performance Guidelines for Heart Failure
are Failing Senior Citizens
Medicare & Medicaid pay-for-performance programs
may not work
 January 2, 2007 It sounds like a good idea.
Experts devise a set of performance standards for hospitals that, if
followed, are expected to assure better results in the treatment of the
3.6 million senior citizens hospitalized each year with heart failure.
Since this is the leading cause of hospitalization for senior citizens
covered by Medicare, it makes sense for Medicare to pay a little more
to the hospitals willing to use the standards. But, like many good
ideas, this one, too, has run into a problem - four of five hospital
performance measures for heart failure do not appear to accurately
reflect the quality of care provided.
Read more...
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Participants in the Premier Hospital Quality
Improvement Demonstration reported significant improvement in quality of
care across five clinical focus areas measured by more than 30
nationally standardized and widely accepted quality indicators, reports
CMS.
The average improvement in the projects second
year was 6.7 percentage points, for total gains of 11.8 percentage
points over the projects first two years.
CMS has been considering the integration of
quality and payment systems as a way to maximize the value of Medicare
payments, said CMS Acting Administrator Leslie V. Norwalk, Esq.
These latest results provide one more piece of solid evidence that
pay-for-performance works.
Launched in October 2003 by CMS and the Premier
Inc. healthcare alliance, the value-based purchasing project is part of
an overall shift in Medicare to pay based on value, not volume of
services, CMS says.
The first national project of its kind, the
Hospital Quality Improvement Demonstration (HQID) is designed to
determine if economic incentives to hospitals are effective at improving
the quality of inpatient care.
The Premier hospital demonstration is showing that
even limited additional payments, focused on supporting evidence-based
quality measures, can drive across-the-board improvements in quality,
fewer complications, and reduced costs, said Norwalk .
With results like these, which enable us to
measure and improve the quality of care delivered to Medicare
beneficiaries, tied to the public reporting of quality and pricing
information that is easily accessible to consumers and providers,
consumers will now have more tools than ever before to select providers
that consistently deliver high quality, efficient care, Norwalk said.
At the same time, by paying for quality care, CMS
supports hospitals, physicians, and other health care providers in their
efforts to deliver the best care in the most efficient way possible.
The Premier project involves more than 250
hospitals across the nation, which submit data to Premier for validation
and analysis. In turn, Premier submits the data to CMS.
Participating hospitals report process and outcome
measures in five clinical areas acute myocardial infarction (AMI),
heart failure, coronary artery bypass graft (CABG), pneumonia, and hip
and knee replacement and are scored based upon their performance in
these clinical areas.
The value-based purchasing policies used in the
demonstration project include financial incentives for the top 20
percent of high scoring hospitals in each of the five clinical areas.
The top 10 percent of all hospitals receive a 2 percent incentive
payment for patients in that clinical area. Hospitals in the second
decile receive a 1 percent incentive payment. Hospitals in the top 50
percent of each clinical area receive public recognition on the CMS
website.
Hackensack University Medical Center in Hackensack
, NJ , was a top performer in all five areas for the second year in a
row, providing high-quality care for 2,853 Medicare patients. Their
total award across the five clinical areas will be approximately
$744,000.
Charleston Area Medical Center in Charleston , WV
, received the second highest incentive award, $701,000, for achieving
top performance in four clinical areas. Charleston Area Medical Center
also received the highest single award, $432,901, in one clinical area
for providing high quality care to 883 Medicare patients who had CABG
procedures.
The second largest single award totals $250,775 and
will be provided to the Bone and Joint Hospital in Oklahoma City , OK ,
for exceptionally high quality of care for patients receiving hip and
knee replacement procedures.
The average composite quality scores, an aggregate
of all quality measures within each clinical area, improved
significantly between the inception of the program and the end of Year 2
in all five clinical focus areas:
● From 87.5 percent to 94.4 percent for patients
with AMI (heart attack)
● From 84.8 percent to 93.8 percent for patients
with coronary artery bypass graft.
● From 64.5 percent to 82.4 percent for patients
with heart failure.
● From 69.3 percent to 85.8 percent for patients
with pneumonia.
● From 84.6 percent to 93.4 percent for patients
with hip and knee replacement.
In addition, the range of variance among
participating hospitals is closing, as those hospitals in the lower
quality range continue to improve their quality scores and close the gap
between themselves and the demonstrations top performers.
For complete information about the HQID project and
to view a list of those hospitals ranking in the top 50 percent in each
focus area, visit
www.cms.hhs.gov/HospitalQualityInits.
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