New resource: Ratings for America’s Hospitals Now Available on Hospital Compare Website (MC)

This is a portal to access new info that Medicare (CMS) has released on hospitals. Medicare is trying to decrease its costs due to readmission, med errors, etc and so releasing info in addition to their project to stop paying for med errors.

Clicking on this website www.hospitalcompare.hhs.gov gets you some potentially useful info:

1. Several “process of care” indicators (for ex, the % of patients at a given hospital who were given aspirin at arrival –or other steps known to improve survival or outcome):
2. “Mortality rates”;
3. and “30 day readmission rates. (Something like 20 or 25% of Medicare patients are readmitted within 30 days—an indicator of gaps in care, not enough time to do appropriate discharge teaching and med reconciliation, etc).

Another portal to access this info is the one I sent yesterday)– click on: http://www.usatoday.com/news/health/hospitals-graphic.htm
This is a pretty cool site—lets you see a map and click directly on a city.

Mary

NEW RATINGS FOR AMERICA’S HOSPITALS NOW AVAILABLE ON HOSPITAL COMPARE WEB SITE
Individual Rates Provided on More Than 4,000 Hospitals Nationwide,
New Mortality and Readmission Data Included

Important new information was added today to the Centers for Medicare & Medicaid Services’ (CMS) Hospital Compare Web site that reports how frequently patients return to a hospital after being discharged, a possible indicator of how well the facility did the first time around. The site is www.hospitalcompare.hhs.gov.

On average, 1 in 5 Medicare beneficiaries who are discharged from a hospital today will re-enter the hospital within a month. Reducing the rate of hospital readmissions to improve quality and achieve savings are key components of President Obama’s health care reform agenda.

“The President and Congress have both identified the reduction of readmissions as a target area for health reform,” said HHS Secretary Kathleen Sebelius. “When we reduce readmissions, we improve the quality of care patients receive and cut health care costs.”

With the update announced today, Hospital Compare will provide better data on the previously posted mortality rates for individual hospitals, as well as the new data on 30-day readmissions for heart attack, heart failure, and pneumonia. Previously, Hospital Compare had provided only mortality rates for these three conditions.

Research has shown that hospital readmissions are reducing the quality of health care while increasing hospital costs. Hospital Compare data show that for patients admitted to a hospital for heart attack treatment, 19.9 percent of them will return to the hospital within 30 days, 24.5 percent of patients admitted for heart failure will return to the hospital within 30 days, and 18.2 percent of patients admitted for pneumonia will return to the hospital within 30 days.

“Providing readmission rates by hospital will give consumers even better information with which to compare local providers,” said Charlene Frizzera, CMS Acting Administrator. “Readmission rates will help consumers identify those providers in the community who are furnishing high-value healthcare with the best results.”

CMS has been tracking the outcomes of hospital care since 2007 when Hospital Compare debuted 30-day mortality rates for heart attack and heart failure. Thirty-day mortality rates for pneumonia were added to the Web site in 2008.

This year, CMS has changed the way it calculates the mortality data to provide even better information to consumers. In 2007 and 2008, Medicare used only one year of claims data to compute mortality, while the rates added to the Web site today encompass three full years of claims data (from July 1, 2005 – June 30, 2008). Although this means that consumers cannot compare data from last year’s rate with this year’s rate, the expanded data set should provide a clearer picture of how well hospitals are performing.

Using the three-year data method, CMS estimates that the national 30-day mortality rate for patients originally admitted for heart attack care is 16.6 percent. For heart failure patients, the national 30-day mortality rate is 11.1 percent, and for pneumonia patients the national rate is 11.5 percent.

“Using three years of data for our mortality measures is a critical development in our effort to inform the public about hospital quality,” said Barry M. Straube, M.D., CMS Chief Medical Officer and Director of the Agency’s Office of Clinical Standards & Quality. “More data gives a clearer picture of the quality of care delivered at different hospitals over time, which ultimately increases the value of our mortality information to hospital patients, health care payers, employers, policymakers, and other health care stakeholders.”

Both the mortality and the readmissions measures have been endorsed by the National Quality Forum (NQF) and are supported by the Hospital Quality Alliance (HQA). These measure endorsement processes are 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 achieved through the CMS measure development process, the NQF and HQA continues to ensure that public reporting efforts for hospitals are supported by a broad cross section of the health care community.

Both sets of measures are risk-adjusted and take into account previous health problems to “level the playing field” among hospitals and to help ensure accuracy in performance reporting.

The Hospital Compare Web site will show a hospital’s mortality or readmissions rate is “Better than,” “No different from,” or “Worse than” the U.S. national rate. This data information includes each hospital’s risk-standardized mortality rate (RSMR), an estimate of the rate’s certainty (also known as the interval estimate), and the number of eligible cases for each hospital. By posting hospital RSMRs, interval estimates, and the number of eligible cases, CMS is giving consumers and communities additional insight into the performance of their local hospitals in hopes that this will prompt all hospitals to work toward achieving the level of the top-performing hospitals in the country.

Hospital Compare also includes 10 measures that capture patient satisfaction with hospital care, 25 process of care measures, and two children’s asthma care measures. The site also features information about the number of selected elective hospital procedures provided to patients and what Medicare pays for those services.

Public reporting of these and other measures is intended to empower patients and their families with information they need to engage their local hospitals and physicians in active discussions about quality of care. “CMS believes that all hospitals, regardless of their readmission and mortality rates, should use the data available in these free, detailed reports to find ways to continually improve the care they deliver,” said Frizzera.

CMS urges consumers not to view any one process or outcome measure on Hospital Compare as a tool to “shop” for a hospital. The information contained on Hospital Compare is available for consumers to use in making health care decisions; although, consumers should gather information from multiple sources when choosing a hospital. For example, patients and caregivers could use the Web site to help them discuss plans of care with their trusted health care providers. In an emergency situation, patients should always go to the nearest, most easily accessible facility.

Consumers have relied on Hospital Compare since 2005 to provide information about the quality of care provided in over 4,700 of America’s acute-care hospitals. In 2008 alone, Hospital Compare had over 18 million page views, and has received about 1 million page views each month of 2009 thus far.

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CMS FACT SHEET

FOR IMMEDIATE RELEASE Contact: CMS Office of Media Affairs
July 9, 2009 (202) 690-6145

CMS EXPANDS INFORMATION FOR CONSUMERS ABOUT OUTCOMES OF CARE IN AMERICA’S HOSPITALS

Overview

The Centers for Medicare & Medicaid Services (CMS) has expanded the amount of information available on its Hospital Compare Web site at http://www.hospitalcompare.hhs.gov.

As of July 2009, the Web site will now include updated information on 30-day mortality rates for patients admitted to many inpatient hospitals for heart failure, acute myocardial infarction (heart attack), and pneumonia. The Web site also includes the debut of new 30-day readmissions measures for patients who were originally admitted to these hospitals for one of these 3 conditions.

This information is shared with consumers and providers to improve the quality and transparency of care by giving the American public and healthcare professionals better access to important hospital data. The new readmissions measures complement the mortality measures and the clinical process and patient satisfaction measures already reported on Hospital Compare to promote increased scrutiny by hospitals of patient outcomes in the service of providing the right care for every patient, every time.

Background: Data about Hospital Care

CMS has been reporting information about the quality of care available at America’s hospitals for several years. Before 2007, this information was limited to “process of care measures,” the rates of which demonstrate how well hospitals follow generally recognized protocols believed to result in the best patient outcomes. However, these “process of care measures” failed to capture how well patients fared as a result of these care protocols.

In 2007, CMS began reporting 30-day mortality rates for inpatient hospital stays related to heart attack and heart failure. CMS added 30-day mortality rates for pneumonia-related stays in 2008. Mortality rate measures are “outcome” measures because they give an indication of how the patient fared after the inpatient hospital stay. The rates themselves are actually predictions of how many patients will die within 30 days of discharge from the hospital (after having been admitted for heart attack, heart failure, and pneumonia), and are “risk adjusted” to account for extraneous influences, such as the difference among hospitals in the degree of their patients’ illnesses. CMS placed each hospital into one of three categories, based on their mortality rates: “Better than U.S. National Rate,” “No Different than U.S. National Rate,” or “Worse than U.S. National Rate.”

Updates to Hospital Compare: Adding Readmissions Data

Similar to the mortality measures, the readmissions measures are also outcome measures. In July 2009, CMS debuted a new set of measures on Hospital Compare that show 30-day all-cause readmissions for patients who had been admitted to the hospital for heart attack, heart failure, and pneumonia. About 1 in 5 patients who leave the hospital will be readmitted within 30 days of discharge. Researchers have noted that readmissions are too common and costly, and that they are often preventable.

These measures complement the mortality data already available on the Hospital Compare Web site to provide a complete picture of the outcomes of care in many of America’s hospitals. Measuring and reporting readmissions information places a spotlight on the entire spectrum of care that hospitals provide, as well as the care that patients receive from other providers after being released from the hospital. Some readmissions are inevitable; however, learning more about how well patients are doing after they leave the hospital is paramount to CMS’s goals to combat poor quality and to positively impact the lives of Medicare beneficiaries and the health of the American public overall.

Methods for Calculating Outcomes Measures

The CMS readmissions and mortality measures are risk-adjusted measures and were developed by a team of clinical and statistical experts from Yale and Harvard Universities under the direction of CMS. The National Quality Forum (NQF) endorsed the measures following a rigorous review process involving providers, consumers, purchasers, and researchers.

The model CMS uses to assess hospital readmissions and mortality rates is based on claims data and has been validated by models based on clinical data. It takes into account medical care received during the year prior to each patient’s hospital admission, as well as the number of admissions at each hospital. The model uses this information to adjust for differences in each hospital’s patient mix, so that hospitals that care for older, sicker patients are on a “level playing field” with those whose patients would be expected to be at less risk of dying within 30 days of admission.

In 2007 and 2008, CMS reported this mortality data based on one year of hospital claims. Starting in June 2009, CMS expanded its calculations to include three years of hospital claims for its mortality measures. The measures on Hospital Compare now include data on discharges that occurred from July 1, 2005, through June 30, 2008. These additional two years of data
provide a clearer picture of hospital outcomes, and will help consumers make better distinctions
among the performance levels of hospitals in their communities. Readmissions measures also reflect 3 years of data.

Certain Exclusions from Measures

Certain admissions are excluded from the calculation of the mortality and readmissions measures. For example, CMS excludes claims from its mortality calculation when a patient was enrolled in the Medicare hospice program on the first day of admission or for the 12 months prior to hospital admission because the agency recognizes that this could potentially skew the hospital’s mortality or readmissions rates. Likewise, CMS excludes from its calculation of the heart attack readmission measure patients who have been readmitted to the hospital within 30 days of a discharge after heart attack when the readmission is for the purpose of a planned cardiac treatment, such as a heart bypass or a coronary angioplasty. Lastly, CMS excludes from the mortality and readmissions measure calculations admissions of patients who left the hospital against medical advice, because those hospitals may not have been able to provide the best care possible for these patients.

In addition, CMS does not report mortality or readmissions data for hospitals that have treated fewer than 25 cases during the relevant reporting period in any of the mortality or readmission measure categories. Without at least 25 cases, CMS cannot make an accurate estimate of the hospital’s performance for a particular measure. For those hospitals with fewer cases, the Hospital Compare Web site reads, “the number of cases is too small to reliably tell how the hospital is performing.”

CMS updates most of its Hospital Compare measures quarterly. To learn more about the quality of care available at your local hospital, visit Hospital Compare at http://www.hospitalcompare.hhs.gov.

Outcome Measure Results for July 2009 Reporting
(July 2005-June 2008 Discharges)

* Number of cases too small (fewer than 25) to reliably tell how the hospital is performing.

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IMPORTANT NOTE: Maryland Hospital information is being recalculated for Hospital Compare and is not available at www.hospitalcompare.hhs.gov. Because of the way hospitals are paid under Medicare in Maryland, the claims data contains patients admitted to hospital owned rehabilitation facilities, unlike hospitals in other states. This could adversely impact the 30 day readmission rates for Maryland hospitals by counting transfers to the hospital’s rehabilitation facilities as readmissions.

In preparation for the public reporting of Hospital Compare measures, all hospitals were provided an opportunity to review their data. For this release of Hospital Compare, the preview period was in April and May, 2009. On the evening before the release of the Hospital Compare measures, one Maryland hospital brought the data issue to CMS’s attention.

CMS is uncertain of the impact on the readmission rates for any particular Maryland hospital, and believes that it is likely to be small. Nevertheless, CMS is suppressing the measures results for Maryland Hospitals due to these coding issues, unique to Maryland. CMS will correct for this coding issue for the next round of reporting.

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