Veterans Health Administration Hospital Performance Data

Overview of VA Transparency and Public Reporting on CMS Hospital Compare

The Veterans Health Administration (VHA) has now collaborated with the Centers for Medicare & Medicaid Services (CMS) to present information to consumers about the quality and safety of health care in VHA. Approximately 50 percent of Veterans enrolled in the VA healthcare system are eligible for Medicare and therefore have some choice in how and where they receive inpatient services. VA has adopted healthcare transparency as a strategy to enhance public trust and to help Veterans make informed choices about their health care.

Participation in Hospital Compare significantly expands VA’s outreach to Veterans and their families and offers direct comparisons of our facilities with private sector counterparts. CMS reports information about the quality of care at over 4,000 Medicare-certified hospitals across the country. VA already collects and reports much of the same data CMS reports to The Joint Commission, and is currently adopting other metrics that are reported on Hospital Compare.  

Public transparency is not new for VA. Data for VA medical centers were reported on Hospital Compare for the first time in March, 2010. Mortality and readmission results were reported for the first time in August, 2011. VA Core Hospital Measures have been available on the Joint Commission website, (www.qualitycheck.org), since 2005. VA has published additional performance measures on the VA Quality of Care website (www.va.gov/qualityofcare), since 2008. This website displays measures of hospital performance in important quality areas like safety, effectiveness, efficiency, timeliness, patient centeredness, and equity.

The following data for VA medical centers are currently available for review or download:

1. Process of Care Measures (External Peer Review Process (EPRP) Data). Process of care measures, also called measures of timely and effective care, show how often or how quickly hospitals give recommended treatments known to get the best results for people with certain common conditions.Most of the measures of timely and effective care come from the data that hospitals get from medical records of their eligible patients for whom the recommended treatment would be appropriate. The data represents those VA facilities who reported measures to The Joint Commission during the sample period. Note: SUB-1 data includes all patients admitted to the inpatient acute care hospital setting with a length of stay less than or equal to 120 days, regardless of diagnoses.

For more information on measures of timely and effective care, visit Hospital Compare.

2. Experience of Care Measures (VA Survey of Healthcare Experiences of Patients (SHEP)). The VA SHEP inpatient survey uses the same items as the Hospital Consumer Assessment of Health Providers and Systems (HCAHPS) Survey. HCAHPS is a national, standardized survey of hospital patients. The VA SHEP survey asks a random sample of recently discharged patients about important aspects of their hospital experience. These topics include communication with doctors, communication with nurses, responsiveness of hospital staff, pain management, communication about medication, discharge information, cleanliness of the hospital environment, quietness of the hospital environment, and transition of care. 

Preparing the data for public reporting includes taking certain factors into account to ensure fair comparisons among hospitals. For example, the mix of patients can differ from one hospital to the next, and these differences in the patient mix can affect a hospital’s results. Patient-mix adjustment takes these differences into account so that the survey results reported are what would be expected for each hospital if all hospitals had a similar mix of patients. These characteristics include age, education, self-reported health status, language other than English spoken at home, service line (medical, surgical, or maternity care), age by service line interactions, and lag time between discharge and survey completion. The results do not represent official HCAHPS results.

For more information on HCAHPS, visit Hospital Compare.

3. Readmission and death measures. Measures of readmissions and deaths show how often patients who are hospitalized for certain conditions experience serious problems soon after they are discharged. Measures of readmission show when patients who have had a recent hospital stay need to go back into a hospital again for unplanned care within 30 days of leaving the hospital. Measures of death show when patients die, for any reason, within 30 days of admission to the hospital. Death rates and rates of readmission show whether a hospital is doing its best to prevent complications, instruct patients at discharge, and ensure patients make a smooth transition to their home or another setting such as a nursing home.

The hospital death rates and rates of readmission are based on people with Medicare who are 65 and older. These rates are calculated using Medicare enrollment and claims data, and a complex statistical procedure. The death rates and rates of readmission are "risk-adjusted", meaning that the calculations take into account how sick patients were when they went in for their initial hospitalization. When the rates are risk-adjusted, it helps make comparisons fair and meaningful.

For more information on readmission and death measures, visit Hospital Compare.