Press Releases

INFORMATION ON HOSPITAL QUALITY NOW AVAILABLE

Americans will be better able to compare the quality of care in nearly all of the nation’s hospitals using quality information now available from the Centers for Medicare & Medicaid Services (CMS) and the Hospital Quality Alliance (HQA) for the first time ever. 

The new information provides consumers with standardized assessments of the care that nearly 4,200 hospitals across the country provide to all adult patients, based on valid and reliable measures that have been shown to reflect quality of care.   Hospital Compare is available on the Internet at www.hospitalcompare.hhs.gov or www.medicare.gov.   Consumers without web access can call 1-800-MEDICARE (1-800-633-4227) to get the same information on hospital quality. 

“Hospital Compare gives consumers and health professionals quality of care information to help them make more informed decisions about their health care, while providing stronger rewards and support for high-quality, efficient care in the nation’s hospitals,” said CMS Administrator Mark B. McClellan, M.D., Ph.D.  “Not only are we spending more on our health care, but where we choose to get our care matters more than ever before.  Valid, consistent measures of quality care are an important tool to help us make sure we are getting the most for our health care dollars.”

Hospital Compare is the result of a public-private collaboration of government agencies, hospitals, quality experts, purchasers, consumer groups and other health care organizations.  These organizations are working together to develop and implement a national strategy for hospital quality measurement and advancing quality of care.  Many hospitals have been willing to move beyond the minimum set of measures identified by the Medicare Modernization Act payment incentive provision.

“The Hospital Compare will help consumers make more informed decisions about hospital care and will give hospitals the data they need to ensure that they are providing high-quality care,” said Agency for Healthcare Research and Quality Director Carolyn M. Clancy, M.D.  “I would like to commend CMS and the Hospital Quality Alliance for using public reporting to provide information that will benefit consumers, hospitals and the nation.”

In addition, hospitals can call on the expertise of Medicare’s Quality Improvement Organizations (QIOs) for additional assistance in further improving their quality measures. 

“We are providing measures on 17 dimensions of quality now,” said Dr. McClellan. “And we are working hard to make even more comprehensive information on quality available soon. Not every beneficiary needs to pay attention to every measure, but we are developing a much stronger foundation for supporting and rewarding better quality care.  That’s also why we are working with the HQA, the National Quality Forum and other groups to build on these measures.  Together we are committed to achieving our common goal of providing the highest quality care.”

Nearly all of the nation’s eligible hospitals have voluntarily reported up to 17 measures of care for three common, serious health conditions: heart attack, heart failure and pneumonia.  The data was voluntarily submitted by the nation’s hospitals.   Ten of the 17 measures were included in the financial incentive provision established by the Medicare Modernization Act of 2003 and can be viewed on Hospital Compare (the seven additional measures are marked with an asterisk).  The measures include:

Heart attack (acute myocardial infarction)

1. Aspirin at arrival
2. Aspirin at discharge
3. Beta-blocker at arrival
4. Beta-blocker at discharge
5. ACE inhibitor for left ventricular systolic dysfunction (LVSD)
6. Percutaneous transluminal coronary angioplasty (PTCA) within 90 minutes of arrival*
7. Thrombolytic agent (clot buster) within 30 minutes of arrival*
8. Smoking cessation counseling*

Heart failure

9. Left ventricular function (LVF) assessment
10. ACE inhibitor for left ventricular systolic dysfunction (LVSD)
11. Smoking cessation counseling*
12. Discharge instructions*

Pneumonia

13. Initial antibiotic received within 4 hours of hospital arrival
14. Pneumococcal vaccination status
15. Oxygen assessment
16. Smoking cessation counseling*
17. Blood culture performed before initial antibiotic received*

Like the other comparative databases available at www.medicare.gov (Nursing Home Compare, Home Health Compare, Dialysis Facility Compare and the Medicare Personal Plan Finder), Hospital Compare will be dynamic, which means that improvements will continue to be made.  In addition to refining the clinical measures hospitals will report, the HQA has endorsed the collection of information about patients’ experiences, and CMS and AHRQ are developing a standardized patient perspective of care survey, known as Hospital-CAHPS (H-CAHPS), which will be added to Hospital Compare in the future.

CMS is continuing to implement the provision of the Medicare Modernization Act of 2003 (MMA) that provides a financial incentive for hospitals to report quality of care data for 10 clinical measures by linking the reporting of these data to the payments they receive for treating Medicare beneficiaries.  Although reporting is voluntary, inpatient acute care hospitals that do not report will get a 0.4 percentage point reduction in their annual Medicare fee schedule update.

"We strongly believe that payment incentives work to get quality reporting and quality improvement, when we use measures that are clinically valid and feasible to produce,” said Dr. McClellan.  “That’s why we will be asking for recommendations on how to better collect and validate the quality measure data that will be used to determine a hospital's payment update factor under the Inpatient Prospective Payment System when we issue the proposed rule in the near future.”

CMS’ Quality Initiative uses a multi-prong approach to drive systems, support and provide incentives to facilities – and the clinicians and professionals working in those settings – in their efforts to achieve superior care through:

• Ongoing regulation and enforcement conducted by state survey agencies and CMS;
• New professional and consumer hospital quality information on our websites, www.cms.hhs.gov and www.medicare.gov and at 1-800-MEDICARE;
• The testing of rewards for superior performance on certain measures of quality;
• Continual, community-based quality improvement programs through our Quality Improvement Organizations (QIOs); and,
• Collaboration and partnership to leverage knowledge and resources.