CMS Declares Success in Hospital Program to Report
on Quality Measures
Seven elements measured were aimed at heart attack
and surgical care
Jan. 8, 2009 More than 3,000 U.S. hospitals will
receive the full payment update for 2009 as part of the new Hospital
Outpatient Quality Data Reporting Program, which required reporting in
2008 on seven quality measures that are elements of high-quality heart
attack and surgical care, according The Centers for Medicare & Medicaid
Services (CMS).
Adds two quality measures showing how well
dialysis patients are treated for anemia, information to help seniors
better understand facility survival rates
The successful hospitals represent 99.3 percent
of all hospitals that participated in the program that began in 2008 as
an effort to strengthen the tie between the quality of care furnished to
people with Medicare in hospital outpatient departments and the payments
hospitals receive for those services, according to the CMS news
release.
We are extremely pleased to find that hospitals
have responded so successfully to the new outpatient quality measure
reporting program, said CMS Acting Administrator Kerry Weems.
The reporting program represents another major
step toward value-based purchasing of health care services to ensure
that patients with Medicare and the American taxpayers get the best
outcomes for their health care dollars.
The new reporting program was mandated by the Tax
Relief and Health Care Act (TRHCA) of 2006, and applies to all hospitals
paid under the hospital outpatient prospective payment system (OPPS).
The program does not apply to:
● Hospitals excluded from the OPPS:
● Maryland hospitals subject to special payment
rules reflecting state hospital payment laws;
● Hospitals situated outside of the 50 states,
the District of Columbia and Puerto Rico ;
● Indian Health Service Hospitals; and
● Certain other OPPS-exempt hospitals.
Under TRHCA, eligible hospitals that successfully
report outpatient quality data receive the full market basket update;
those that do not receive an update that is reduced by 2.0 percentage
points.
Data culled from the hospital reporting program
will help Medicare and the broader health care community learn more
about the quality of services available to beneficiaries in outpatient
care settings and how to improve that care. Quality data will also give
CMS a baseline of data from which an eventual pay-for-performance
outpatient system could be created.
In all, of 3,339 hospitals that participated in the
program, 3,313 will receive the full CY 2009 update under the quality
data reporting program. Of the remaining 26, that will receive the
reduced update, 18 did not report the quality data successfully, while
eight did not have a QualityNet Administrator.
In 2008, hospitals participating in the program
were required to report data on the seven quality measures that measure
important elements of high-quality heart attack and surgical care, which
is of particular importance to Medicare beneficiaries. These measures
were:
● The percentage of heart attack patients given
aspirin when they arrive at the emergency room;
● The amount of time it takes for a heart attack
patient to receive clot-busting drugs;
● The percentage of heart attack patients who
received clot-busting drugs within 30 minutes of arriving in the
emergency room;
● The average time it takes a heart attack
patient to receive an electrocardiogram test to assess heart damage once
they arrive in the emergency room;
● The average time it takes for a heart attack
patient to transfer to another hospital to receive a coronary
angioplasty as acute treatment for a heart attack;
● The percentage of surgery patients who receive
an antibiotic within one hour before surgery to help prevent infection;
and
● The percentage of surgery patients who receive
the right kind of antibiotic to help prevent infection.
The OPPS CY 2009 final rule added four imaging
efficiency measures to the seven original measures for reporting to
receive the full update in CY 2010.
For the future, CMS will be looking at ways to
strengthen the relationship between payment and quality, especially by
developing policies that will not pay for adverse health care events
that could have been prevented if the hospital followed evidence-based
guidelines, said Weems. We expect these policies will improve the
quality of care not just for people with Medicare, but for all patients
who receive services in hospital outpatient departments.
Keep up with the latest news for senior citizens, baby
boomers
Jan. 8, 2009 More than 3,000 U.S. hospitals will
receive the full payment update for 2009 as part of the new Hospital
Outpatient Quality Data Reporting Program, which required reporting in
2008 on seven quality measures that are elements of high-quality heart
attack and surgical care, according The Centers for Medicare & Medicaid
Services (CMS).