CMS releases data on quality to help patients choose providers

Updates provide quality metrics for hospitals and physicians
By Dr. Patrick Conway, CMS Deputy Administrator for Innovation and Quality and Chief Medical Officer

The Centers for Medicare & Medicaid Services (CMS) today released data on the quality of care provided by physician group practices, Accountable Care Organizations (ACOs) and hospitals. These data are available on Physician Compare, Hospital Compare and Data.Medicare.gov.

The performance information released this month will give patients and families additional information they can use to inform their selection of a hospital or physician practice. Health care professionals differ in the quality and safety of care they provide and these websites empower consumers with information to help with health care decisions, encourage providers to strive for higher levels of quality, and drive overall health system improvement.

The data released today includes:

• Information on Hospital Value-Based Purchasing Program 2015 payment adjustments The Hospital Value-Based Purchasing Program provides a useful snapshot of how hospitals are performing on important quality indicators of patient care, quality, efficiency, and well-being. It is one of many Affordable Care Act programs Medicare is implementing to pay for quality instead of quantity. The program ties a portion of payments to hospitals’ performance on certain quality measures such as death within 30 days after a heart attack and patient experience of care.
   
  The portion of FY 2015 Medicare payments available to fund the value-based incentive payments increases from 1.25 to 1.5 percent of the base operating DRG payment amounts to all participating hospitals. The total amount available for value-based incentive payments in FY 2015 will be approximately $1.4 billion.

  Data from the third year of the program indicates that hospitals are improving care and outcomes for Medicare beneficiaries. More hospitals this year will experience a positive change in their payments (1,714) compared to the number of hospitals that will experience a negative change (1,375) – a reversal of last year  This change indicates that many hospitals are improving the quality of care delivered to patients.
   
  More information on the Hospital Value-Based Purchasing program payment adjustments can be found here: http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/FY2015-IPPS-Final-Rule-Home-Page-Items/FY2015-Final-Rule-Tables.html.

• Updated performance results on diabetes and cardiovascular care by some physician group practices and ACOs

  CMS has posted the publicly reported 2013 Physician Quality Reporting System (PQRS) Group Practice Reporting Option measures for the 139 group practices and 214 Shared Savings Program Accountable Care Organizations (ACOs) and 23 Pioneer ACOs.

• Hospital performance results on Hospital-Acquired Conditions (HACs) such as central line-associated bloodstream infections, catheter associated urinary tract infections, pressure ulcers and accidental punctures or lacerations
  HACs are a group of reasonably preventable conditions that patients did not have upon admission to a hospital, but developed during the hospital stay. The HAC Reduction Program uses public reporting and financial incentives to encourage hospitals that treat Medicare beneficiaries to reduce HACs and improve patient safety.
   
  To determine hospital performance under the HAC Reduction Program, CMS computes a Total HAC Score for each hospital. The higher a hospital’s Total HAC Score, the less well the hospital performed under the HAC Reduction Program. Beginning in FY 2015, the law requires a payment reduction of one percent for those hospitals that rank in the top quartile of Total HAC Scores.
   
  More information on the HACs Reduction program and HAC scores can be found here: http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/HAC-Reduction-Program.html.

CMS is committed to providing useful and current quality performance data. The Compare sites empower consumers with information to help with health care decisions, encourage providers to strive for higher levels of quality, and drive overall health system improvement. While consumers and patients are the main audience for the Compare sites, stakeholders can visit Data.Medicare.gov and use the same data that power the Compare websites in easy-to-use formats.
 
CMS is committed to transparency of data about quality and cost of care provided by physicians, hospitals and other health care professionals. This transparency is critical to transforming the health care delivery system to achieve the three aims of better care for patients, better health for communities and spending dollars wisely.

 

Home Health Compare Site to Offer New Tools for Consumers

By Dr. Patrick Conway, CMS Deputy Administrator for Innovation and Quality and Chief Medical Officer

Consumers have many options when choosing a health care provider. Providers vary in the quality of the care they give, and everyone wants to choose the provider who will be best for themselves or their loved ones. Yet frequently the choice must be made quickly and without the time for consumers to locate and review a wide range of information sources.

The Centers for Medicare & Medicaid Services (CMS) has established the Compare sites on Medicare.gov as the official CMS source for information about the quality of health care providers so that consumers have a single, easy-to-access source of information to support their decision-making.

Yet sometimes even the information on the Compare sites can seem like “too much of a good thing” – too much information, too many measures to consider. Therefore, CMS has been adding new tools to the Compare sites in order to make the information there easier to use.  These include “star” ratings, similar to the ratings that consumers can review on websites for other products and services, which summarize the detailed information on health care provider quality that the sites already offer and make it more accessible to consumers.

We plan to add star ratings to Home Health Compare as early as the summer of 2015. None of the current information on the site will be removed; rather, the star ratings are intended to be an additional tool to support consumers’ health care decision-making. Over the coming months, we will be sharing the details of our proposed method for calculating the star ratings and soliciting input from consumers, home health providers, and other stakeholders, so that we can make the Home Health Compare star ratings as reliable and useful as possible.

We are excited to be expanding our support for home health care consumers, and we hope that the data will lead to continuing improvement in the quality and efficiency of the services that are provided to our beneficiaries.