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Medicare News
Senior Citizens Can Now Learn More about Local
Hospital Services
Medicare improves Hospital Compare tools; adds
new information on cost of elective hospital procedures
 June 21, 2007 – The Centers for Medicare & Medicaid
Services today unveiled a new version of the Hospital Compare
Website that the agency says gives senior citizens and other consumers
better insight into the quality of care provided by their local
hospitals. CMS also announced the first annual update of pricing and
volume information for certain elective hospital procedures is online.
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The updates provide consumers with an enhanced
“snapshot” that captures information on the quality of care they
received from providers. Besides updated pricing and volume information,
the snapshot also now includes details on new outcomes such as mortality
outcome measures that reflect care of patients with heart attacks and
heart failure.
“These improvements add to our continuing effort to
provide better, value-based, health care at a lower cost for all
Americans,” Health and Human Services Secretary Mike Leavitt said. CMS
is an agency within HHS.
“Quality standards are best developed by the
medical family and hospitals. I applaud the Hospital Quality Alliance
for providing information that everyone can use and agree upon for the
benefit of consumers,” Leavitt added.
Looking ahead to 2008, Medicare says it will add
patient satisfaction information to provide even more detail to help
make available the information consumers need for health care decision
making.
Through Hospital Compare, CMS says it is
working to implement the principles of a value-based system in the
Medicare program. The enhancements to the site further empower consumer
choice and create incentives by motivating providers to provide better
care for less money.
An Executive Order issued last August by President
Bush directed that federal agencies that sponsor or subsidize health
care commit to the four cornerstones of value-driven health care:
ensuring transparent quality and price information, interoperable health
information technology and incentives for high-quality, efficient health
care delivery (http://www.hhs.gov/valuedriven).
The Hospital Quality Alliance (HQA) is instrumental
in facilitating CMS’s communication with hospitals and helping to
motivate those hospitals to continually analyze and improve the quality
of their care. Collaboration by the members of the HQA continues to
ensure that public reporting efforts for hospitals are supported by a
broad cross section of the health care community, according to the
agency.
The two 30-day hospital mortality outcome measures
are enhancements that address the care for patients with heart failure
and heart attack – or acute myocardial infarction – for more than 4,500
hospitals across the country. These mortality outcome measures are
risk-adjusted and take into account previous health problems to “level
the playing field” among hospitals. The measures are also intended to
help ensure accuracy in performance reporting.
“In addition to providing helpful information to
beneficiaries, measuring and reporting on mortality also provides
hospitals with the information they need to analyze and improve
performance,” CMS Acting Administrator Leslie V. Norwalk said.
“All hospitals will get detailed reports from CMS
for use in quality improvement. These reports serve as a tool to help
hospitals look more broadly at their outcomes and processes of care and
identify ways to lower mortality risk for their patients.”
Twenty-one measures are currently available on the
Web site for consumers to view, including: eight measures related to
heart attack care, four measures related to heart failure care, seven
measures related to pneumonia care, and two measures relates to surgical
infection prevention.
Unlike the process of care measures on Hospital
Compare, which are updated on a quarterly basis, the mortality outcome
measures will be updated annually. The first reported information on the
mortality measures is based on hospital admissions that occurred between
July 1, 2005, and June 30, 2006.
For those hospitals needing assistance, CMS
identified several resources to ensure hospitals have the tools to
improve their quality of care. In addition to technical assistance
available by the agency’s Quality Improvement Organization Program,
which works directly with hospitals to improve care processes,
organizations such as the American Heart Association and American
College of Cardiology have technical resources for hospitals targeting
cardiovascular care.
In addition to the inclusion of these outcome
measures, and in order for most U.S. hospitals to receive full payment
for FY 2008 for providing inpatient services, hospitals will be required
to report on 27 quality measures, up from the 10 measures that have been
used since 2003.
While many of these facilities had already been
reporting on these measures, with the change in the incentive program,
results on these additional process measures will now be available for
nearly every hospital in the nation, giving consumers a greater wealth
of information about quality of care.
“Public reporting of pricing and quality
information has moved hospitals to step up their efforts to improve,”
said Norwalk.
“These new and future postings will not only ensure
that patients and their families have the information they need about
the quality and efficiency of care they are receiving, but that they
also should continue to serve as a catalyst to improve the care
delivered in our nation’s hospitals today, not tomorrow. This
improvement should accelerate with next year’s posting of patient
satisfaction information.”
The mortality outcome measures that are being added
to Hospital Compare today were developed during the past five years
using a rigorous methodology by a team of experts from Yale and Harvard
Universities, and are endorsed by the National Quality Forum, a
voluntary standard–setting, consensus-building organization representing
providers, consumers, purchasers, and researchers.
The information is displayed in one of three
categories: “No Different than the U.S. National Rate,” “Better than
the U.S. National Rate,” or “Worse than the U.S. National Rate.”
Public reporting of these and other measures is
intended to empower patients and their families with information with
which to engage their local hospitals and physicians in active
discussions about quality of care. In an emergency, CMS urges consumers
not to view any one process or outcome measure as a tool to “shop” for a
hospital. In an emergency situation, patients should always go to the
nearest, most easily accessible facility.
Hospitals are currently collecting and reporting
information on patient experience of care using the Hospital – Consumer
Assessment of Healthcare Providers Survey instrument. The results of
these data collection efforts will be used to calculate rates that will
be displayed on Hospital Compare beginning in March 2008.
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