(Note: You may need to click on the image to open it in a new browser.)
Saturday, April 30, 2011
Performance of Indiana Hospitals on Patient Experience of Care Measures for Value Based Purchasing
The following table shows the performance of Indiana hospitals on the HCAHPS measures CMS has indicated will be a part of the Value Based Purchasing program. This table is based on HospitalCompare data released April 11, 2011based on data collected from April 2009 to March 2010.
(Note: You may need to click on the image to open it in a new browser.)
(Note: You may need to click on the image to open it in a new browser.)
CMS Announces final details of Value Based Purchasing for Inpatient Acute Care
On April 29th, CMS announced the final rules of its upcoming Value Based Purchasing program for Inpatient Acute Care. This long anticipated program transitions the inpatient care provided to Medicare beneficaries from "pay for reporting" to "pay for performance".
The HHS press release itself is of little value to the healthcare quality professional. You can view it here: http://www.hhs.gov/news/press/2011pres/04/20110429a.html. However, it links to a CMS press release that contained more details. You can view it here: http://www.cms.gov/apps/media/press/factsheet.asp?Counter=3947.
Although these rules become effective with fiscal year 2013, CMS also released the list of measures for 2014 as well.
The following are excerpts from the CMS press release:
PERFORMANCE SCORING:
Performance Period: CMS has established a performance period that runs from July 1, 2011 through March 31, 2012, for the FY 2013 Hospital VBP payment determination. CMS anticipates that in future program years, if it becomes feasible, it may propose to use a full year as the performance period.
Scoring Methods: CMS will score each hospital based on achievement and improvement ranges for each applicable measure. A hospital’s score on each measure will be the higher of an achievement score in the performance period or an improvement score, which is determined by comparing the hospital’s score in the performance period with its score during a baseline period.
For scoring on achievement, hospitals will be measured based on how much their current performance differs from all other hospitals’ baseline period performance. Points will then be awarded based on the hospital’s performance compared to the threshold and benchmark scores for all hospitals. Points will only be awarded for achievement if the hospital’s performance during the performance period exceeds a minimum rate called the “threshold,” which is defined by CMS as the 50th percentile of hospital scores during the baseline period.
For scoring on improvement, hospitals will be assessed based on how much their current performance changes from their own baseline period performance. Points will then be awarded based on how much distance they cover between that baseline and the benchmark score. Points will only be awarded for improvement if the hospital’s performance improved from their performance during the baseline period.
Finally, CMS will calculate a Total Performance Score (TPS) for each hospital by combining the greater of its achievement or improvement points on each measure to determine a score for each domain, multiplying each domain score by the proposed domain weight and adding the weighted scores together. In FY 2013, the clinical process of care domain will be weighted at 70 percent and the patient experience of care domain will be weighted at 30 percent.
Incentive Payment Calculations: CMS will utilize a linear exchange function to calculate the percentage of value-based incentive payment earned by each hospital. Those hospitals that receive higher Total Performance Scores will receive higher incentive payments than those that receive lower Total Performance Scores. CMS will notify each hospital of the estimated amount of its value-based incentive payment for FY 2013 through its QualityNet account at least 60 days prior to Oct. 1, 2012. CMS will notify each hospital of the exact amount of its value-based incentive payment on Nov. 1, 2012.
FISCAL YEAR 2013 MEASURES
Clinical Process of Care Measures
AMI-7a - Fibrinolytic Therapy Received Within 30 Minutes of Hospital Arrival
AMI-8a - Primary PCI Received Within 90 Minutes of Hospital Arrival
HF-1 - Discharge Instructions
PN-3b - Blood Cultures Performed in the ED Prior to Initial Antibiotic Received in Hospital
PN-6 - Initial Antibiotic Selection for CAP in Immunocompetent Patient
SCIP-Inf-1 - Prophylactic Antibiotic Received Within One Hour Prior to Surgical Incision
SCIP-Inf-2 - Prophylactic Antibiotic Selection for Surgical Patients
SCIP-Inf-3 - Prophylactic Antibiotics Discontinued Within 24 Hours After Surgery End Time
SCIP-Inf-4 - Cardiac Surgery Patients with Controlled 6AM Postoperative Serum Glucose
SCIP-Card-2 - Surgery Patients on a Beta Blocker Prior to Arrival That Received a Beta Blocker During the Perioperative Period
SCIP-VTE-1 - Surgery Patients with Recommended Venous Thromboembolism Prophylaxis Ordered
SCIP-VTE-2 - Surgery Patients Who Received Appropriate Venous Thromboembolism Prophylaxis Within 24 Hours Prior to Surgery to 24 Hours After Surgery
Patient Experience of Care Measures (HCAHPS)
· Communication with Nurses
· Communication with Doctors
· Responsiveness of Hospital Staff
· Pain Management
· Communication About Medicines
· Cleanliness and Quietness of Hospital Environment
· Discharge Information
· Overall Rating of Hospital
ADDITIONAL MEASURES FINALIZED FOR FY2014
Mortality Measures:
· Mortality-30-AMI: Acute Myocardial Infarction (AMI) 30-day Mortality Rate
· Mortality-30-HF: Heart Failure (HF) 30-day Mortality Rate
· Mortality-30-PN: Pneumonia (PN) 30-Day Mortality Rate
Hospital Acquired Condition Measures:
· Foreign Object Retained After Surgery
· Air Embolism
· Blood Incompatibility
· Pressure Ulcer Stages III & IV
· Falls and Trauma: (Includes: Fracture, Dislocation, Intracranial Injury, Crushing Injury, Burn, Electric Shock)
· Vascular Catheter-Associated Infections
· Catheter-Associated Urinary Tract Infection (UTI)
· Manifestations of Poor Glycemic Control
AHRQ Patient Safety Indicators (PSIs), Inpatient Quality Indicators (IQIs), and Composite Measures:
· Complication/patient safety for selected indicators (composite)
· Mortality for selected medical conditions (composite)
The HHS press release itself is of little value to the healthcare quality professional. You can view it here: http://www.hhs.gov/news/press/2011pres/04/20110429a.html. However, it links to a CMS press release that contained more details. You can view it here: http://www.cms.gov/apps/media/press/factsheet.asp?Counter=3947.
Although these rules become effective with fiscal year 2013, CMS also released the list of measures for 2014 as well.
The following are excerpts from the CMS press release:
PERFORMANCE SCORING:
Performance Period: CMS has established a performance period that runs from July 1, 2011 through March 31, 2012, for the FY 2013 Hospital VBP payment determination. CMS anticipates that in future program years, if it becomes feasible, it may propose to use a full year as the performance period.
Scoring Methods: CMS will score each hospital based on achievement and improvement ranges for each applicable measure. A hospital’s score on each measure will be the higher of an achievement score in the performance period or an improvement score, which is determined by comparing the hospital’s score in the performance period with its score during a baseline period.
For scoring on achievement, hospitals will be measured based on how much their current performance differs from all other hospitals’ baseline period performance. Points will then be awarded based on the hospital’s performance compared to the threshold and benchmark scores for all hospitals. Points will only be awarded for achievement if the hospital’s performance during the performance period exceeds a minimum rate called the “threshold,” which is defined by CMS as the 50th percentile of hospital scores during the baseline period.
For scoring on improvement, hospitals will be assessed based on how much their current performance changes from their own baseline period performance. Points will then be awarded based on how much distance they cover between that baseline and the benchmark score. Points will only be awarded for improvement if the hospital’s performance improved from their performance during the baseline period.
Finally, CMS will calculate a Total Performance Score (TPS) for each hospital by combining the greater of its achievement or improvement points on each measure to determine a score for each domain, multiplying each domain score by the proposed domain weight and adding the weighted scores together. In FY 2013, the clinical process of care domain will be weighted at 70 percent and the patient experience of care domain will be weighted at 30 percent.
Incentive Payment Calculations: CMS will utilize a linear exchange function to calculate the percentage of value-based incentive payment earned by each hospital. Those hospitals that receive higher Total Performance Scores will receive higher incentive payments than those that receive lower Total Performance Scores. CMS will notify each hospital of the estimated amount of its value-based incentive payment for FY 2013 through its QualityNet account at least 60 days prior to Oct. 1, 2012. CMS will notify each hospital of the exact amount of its value-based incentive payment on Nov. 1, 2012.
FISCAL YEAR 2013 MEASURES
Clinical Process of Care Measures
AMI-7a - Fibrinolytic Therapy Received Within 30 Minutes of Hospital Arrival
AMI-8a - Primary PCI Received Within 90 Minutes of Hospital Arrival
HF-1 - Discharge Instructions
PN-3b - Blood Cultures Performed in the ED Prior to Initial Antibiotic Received in Hospital
PN-6 - Initial Antibiotic Selection for CAP in Immunocompetent Patient
SCIP-Inf-1 - Prophylactic Antibiotic Received Within One Hour Prior to Surgical Incision
SCIP-Inf-2 - Prophylactic Antibiotic Selection for Surgical Patients
SCIP-Inf-3 - Prophylactic Antibiotics Discontinued Within 24 Hours After Surgery End Time
SCIP-Inf-4 - Cardiac Surgery Patients with Controlled 6AM Postoperative Serum Glucose
SCIP-Card-2 - Surgery Patients on a Beta Blocker Prior to Arrival That Received a Beta Blocker During the Perioperative Period
SCIP-VTE-1 - Surgery Patients with Recommended Venous Thromboembolism Prophylaxis Ordered
SCIP-VTE-2 - Surgery Patients Who Received Appropriate Venous Thromboembolism Prophylaxis Within 24 Hours Prior to Surgery to 24 Hours After Surgery
Patient Experience of Care Measures (HCAHPS)
· Communication with Nurses
· Communication with Doctors
· Responsiveness of Hospital Staff
· Pain Management
· Communication About Medicines
· Cleanliness and Quietness of Hospital Environment
· Discharge Information
· Overall Rating of Hospital
ADDITIONAL MEASURES FINALIZED FOR FY2014
Mortality Measures:
· Mortality-30-AMI: Acute Myocardial Infarction (AMI) 30-day Mortality Rate
· Mortality-30-HF: Heart Failure (HF) 30-day Mortality Rate
· Mortality-30-PN: Pneumonia (PN) 30-Day Mortality Rate
Hospital Acquired Condition Measures:
· Foreign Object Retained After Surgery
· Air Embolism
· Blood Incompatibility
· Pressure Ulcer Stages III & IV
· Falls and Trauma: (Includes: Fracture, Dislocation, Intracranial Injury, Crushing Injury, Burn, Electric Shock)
· Vascular Catheter-Associated Infections
· Catheter-Associated Urinary Tract Infection (UTI)
· Manifestations of Poor Glycemic Control
AHRQ Patient Safety Indicators (PSIs), Inpatient Quality Indicators (IQIs), and Composite Measures:
· Complication/patient safety for selected indicators (composite)
· Mortality for selected medical conditions (composite)
Sunday, April 17, 2011
Unadjusted "Fall and Trauma" Rates for Hospitals in Indiana
On April 6, 2011, CMS released a spreadsheet linked to its Hospital Compare website showing the frequency of the eight (8) Hospital Acquired Conditions (HAC) in hospitals participating in the Medicare Program. This data set is of Medicare beneficiaries only, is not risk adjusted for the severity of the patients, and is based on administrative data only for patients discharged between Oct 1, 2008 to June 30, 2010.
The data can be downloaded from CMS here.
The table below shows the performance of the listed Indiana hospitals for the "Fall and Trauma" measure sorted from high to low.
| Hospital name | Rate (per 1,000 discharges) | Number of eligible discharges (Denominator) | Number of HACs (Numerator) | National HAC rate (per 1,000 discharges) |
|---|---|---|---|---|
| UNITY MEDICAL AND SURGICAL HOSPITAL | 7.634 | 131 | 1 | 0.564 |
| RIVERVIEW HOSPITAL | 2.428 | 3707 | 9 | 0.564 |
| THE HEART HOSPITAL AT DEACONESS GATEWAY LLC | 1.878 | 1065 | 2 | 0.564 |
| SAINT CATHERINE REGIONAL HOSPITAL | 1.641 | 1219 | 2 | 0.564 |
| FAYETTE REGIONAL HEALTH SYSTEM | 1.553 | 1932 | 3 | 0.564 |
| REID HOSPITAL & HEALTH CARE SERVICES | 1.257 | 9549 | 12 | 0.564 |
| FRANCISCAN PHYSICIANS HOSPITAL LLC | 1.233 | 811 | 1 | 0.564 |
| MEMORIAL HOSPITAL OF SOUTH BEND | 1.205 | 9955 | 12 | 0.564 |
| ST. CLARE MEDICAL CENTER | 1.179 | 1697 | 2 | 0.564 |
| WITHAM HEALTH SERVICES | 1.174 | 1704 | 2 | 0.564 |
| KOSCIUSKO COMMUNITY HOSPITAL | 1.084 | 2767 | 3 | 0.564 |
| PARKVIEW HUNTINGTON HOSPITAL | 1.065 | 939 | 1 | 0.564 |
| INDIANA UNIVERSITY HEALTH ARNETT HOSPITAL | 1.02 | 4904 | 5 | 0.564 |
| MARION GENERAL HOSPITAL | 0.962 | 4158 | 4 | 0.564 |
| HENRY COUNTY MEMORIAL HOSPITAL | 0.957 | 3134 | 3 | 0.564 |
| BLUFFTON REGIONAL MEDICAL CENTER | 0.944 | 2118 | 2 | 0.564 |
| CLARK MEMORIAL HOSPITAL | 0.932 | 8581 | 8 | 0.564 |
| INDIANA UNIVERSITY HEALTH NORTH HOSPITAL | 0.906 | 3313 | 3 | 0.564 |
| COMMUNITY HOSPITAL NORTH | 0.9 | 6664 | 6 | 0.564 |
| ST. FRANCIS HOSPITAL - BEECH GROVE | 0.853 | 9377 | 8 | 0.564 |
| THE ORTHOPAEDIC HOSPITAL | 0.788 | 1269 | 1 | 0.564 |
| ST. VINCENT CARMEL HOSPITAL, INC. | 0.767 | 2609 | 2 | 0.564 |
| ST. MARGARET MERCY - DYER | 0.725 | 5515 | 4 | 0.564 |
| WESTVIEW HOSPITAL | 0.7 | 1429 | 1 | 0.564 |
| INDIANA UNIVERSITY HEALTH WEST HOSPITAL | 0.689 | 4352 | 3 | 0.564 |
| ELKHART GENERAL HOSPITAL | 0.676 | 8879 | 6 | 0.564 |
| GOOD SAMARITAN HOSPITAL | 0.641 | 6241 | 4 | 0.564 |
| DEARBORN COUNTY HOSPITAL | 0.617 | 3239 | 2 | 0.564 |
| DUPONT HOSPITAL LLC | 0.603 | 1658 | 1 | 0.564 |
| BALL MEMORIAL HOSPITAL INC | 0.591 | 11840 | 7 | 0.564 |
| METHODIST HOSPITALS, INC | 0.588 | 13602 | 8 | 0.564 |
| ST. CATHERINE HOSPITAL, INC | 0.576 | 5211 | 3 | 0.564 |
| INDIANA ORTHOPAEDIC HOSPITAL LLC | 0.565 | 1770 | 1 | 0.564 |
| COMMUNITY HOSPITAL | 0.557 | 16165 | 9 | 0.564 |
| COMMUNITY HOSPITAL SOUTH, INC. | 0.549 | 5468 | 3 | 0.564 |
| SAINT ANTHONY MEDICAL CENTER | 0.545 | 9179 | 5 | 0.564 |
| SAINT JOSEPH REGIONAL MEDICAL CENTER - SOUTH BEND | 0.541 | 11100 | 6 | 0.564 |
| LUTHERAN HOSPITAL OF INDIANA | 0.535 | 13088 | 7 | 0.564 |
| INDIANA HEART HOSPITAL, THE | 0.528 | 3791 | 2 | 0.564 |
| ST. MARY'S MEDICAL CENTER OF EVANSVILLE INC | 0.514 | 11672 | 6 | 0.564 |
| GOSHEN GENERAL HOSPITAL | 0.489 | 4088 | 2 | 0.564 |
| PORTER HOSPITAL, LLC, VALPARAISO HOSP CAMPUS | 0.481 | 10389 | 5 | 0.564 |
| PARKVIEW HOSPITAL | 0.465 | 10748 | 5 | 0.564 |
| MAJOR HOSPITAL | 0.457 | 2189 | 1 | 0.564 |
| BLOOMINGTON HOSPITAL | 0.445 | 8981 | 4 | 0.564 |
| ST. FRANCIS HOSPITAL - MOORESVILLE | 0.435 | 2299 | 1 | 0.564 |
| DEACONESS HOSPITAL INC | 0.422 | 18959 | 8 | 0.564 |
| SCHNECK MEDICAL CENTER | 0.421 | 2378 | 1 | 0.564 |
| JOHNSON MEMORIAL HOSPITAL | 0.421 | 2378 | 1 | 0.564 |
| TERRE HAUTE REGIONAL HOSPITAL | 0.411 | 4861 | 2 | 0.564 |
| MEMORIAL HOSPITAL AND HEALTH CARE CENTER | 0.385 | 5190 | 2 | 0.564 |
| UNION HOSPITAL INC | 0.383 | 13057 | 5 | 0.564 |
| ST. JOSEPH HOSPITAL | 0.381 | 2626 | 1 | 0.564 |
| FLOYD MEMORIAL HOSPITAL AND HEALTH SERVICES | 0.375 | 10678 | 4 | 0.564 |
| WILLIAM N WISHARD MEMORIAL HOSPITAL | 0.368 | 5431 | 2 | 0.564 |
| ST. VINCENT HOSPITALS AND HEALTH SERVICES | 0.358 | 19569 | 7 | 0.564 |
| CLARIAN HEALTH PARTNERS, INCORPORATED | 0.321 | 28027 | 9 | 0.564 |
| ST. FRANCIS HOSPITAL - INDIANAPOLIS | 0.313 | 6388 | 2 | 0.564 |
| COLUMBUS REGIONAL HOSPITAL | 0.296 | 6766 | 2 | 0.564 |
| THE KING'S DAUGHTERS' HOSPITAL AND HEALTH SERVICES | 0.28 | 3574 | 1 | 0.564 |
| ST. ELIZABETH EAST | 0.244 | 4090 | 1 | 0.564 |
| COMMUNITY HOSPITAL EAST | 0.244 | 8195 | 2 | 0.564 |
| LA PORTE HOSPITAL AND HEALTH SERVICES | 0.235 | 4263 | 1 | 0.564 |
| ST. MARGARET MERCY HEALTHCARE CENTERS - HAMMOND | 0.228 | 8754 | 2 | 0.564 |
| ST. MARY MEDICAL CENTER, INC. | 0.224 | 8912 | 2 | 0.564 |
| ST. ELIZABETH CENTRAL | 0.219 | 4558 | 1 | 0.564 |
| COMMUNITY HOSPITAL OF ANDERSON AND MADISON COUNTY | 0.179 | 5601 | 1 | 0.564 |
| SAINT JOHN'S HEALTH SYSTEM | 0.169 | 5918 | 1 | 0.564 |
| SAINT ANTHONY MEMORIAL HEALTH CENTER | 0 | 5335 | 0 | 0.564 |
| KENTUCKIANA MEDICAL CENTER LLC | 0 | 619 | 0 | 0.564 |
| MEMORIAL HOSPITAL | 0 | 1480 | 0 | 0.564 |
| HENDRICKS REGIONAL HEALTH | 0 | 3423 | 0 | 0.564 |
| DAVIESS COMMUNITY HOSPITAL | 0 | 1727 | 0 | 0.564 |
| HOWARD REGIONAL HEALTH SYSTEM | 0 | 4148 | 0 | 0.564 |
| PHYSICIANS' MEDICAL CENTER LLC | 0 | 180 | 0 | 0.564 |
| SURGICAL HOSPITAL OF MUNSTER | 0 | 31 | 0 | 0.564 |
| ST. JOSEPH HOSPITAL & HEALTH CENTER, INC | 0 | 3856 | 0 | 0.564 |
| PINNACLE HOSPITAL | 0 | 542 | 0 | 0.564 |
| HANCOCK REGIONAL HOSPITAL | 0 | 2989 | 0 | 0.564 |
| MONROE HOSPITAL | 0 | 1335 | 0 | 0.564 |
| ST. VINCENT HEART CENTER OF INDIANA, LLC | 0 | 5756 | 0 | 0.564 |
| WOMEN'S HOSPITAL, THE | 0 | 114 | 0 | 0.564 |
| PARKVIEW WHITLEY HOSPITAL | 0 | 807 | 0 | 0.564 |
| STARKE MEMORIAL HOSPITAL | 0 | 785 | 0 | 0.564 |
| PARKVIEW NOBLE HOSPITAL | 0 | 1175 | 0 | 0.564 |
| SAINT JOSEPH REGIONAL MEDICAL CENTER - PLYMOUTH | 0 | 1773 | 0 | 0.564 |
| DEKALB MEMORIAL HOSPITAL INC | 0 | 1100 | 0 | 0.564 |
| MORGAN HOSPITAL AND MEDICAL CENTER | 0 | 1472 | 0 | 0.564 |
| ORTHOPAEDIC HOSPITAL AT PARKVIEW NORTH LLC | 0 | 1039 | 0 | 0.564 |
ACOs are here! ...but will it be everywhere?
Details of the long awaited CMS ACO proposed rules were released on March 31, 2011 and posted in the April 7, 2011 edition of the Federal Register.
The Federal Register entry can be found here.
The Centers for Medicare and Medicaid Services also simultaneously posted fact sheets and other resources about the proposed ACOs rules:
- Summary of Proposed Rules.
- Summary of the 65 ACO Performance Measures
- Other Federal Agencies Addressing the Legal Issues of ACO Participation
- The Press Release Announcing the ACO Rules
- CMS Fact Sheet about what Providers Need to Know of ACOs
No doubt there will be significant commentary provided by healthcare organizations throughout the country over the next few months. The comment period closes on June 6, 2011. ACO final rules go into effect January 1, 2012.
Subscribe to:
Posts (Atom)
Posts
