New Patient Safety Data on Hospital Compare
Early this month, the Centers for Medicare and Medicaid Services (CMS) published new data on the incidence of central line–associated bloodstream infections in hospital ICUs on its Web site Hospital Compare. The data show wide variation across the nation in the number of these infections, which are considered preventable by following care guidelines.
CMS also published performance data on serious complications, such as cases of collapsed lung due to medical treatment or serious blood clots after surgery. Instead of the actual complication rates, the reports identify hospitals as being "worse than," "no different than," or "better than" the national rate.
The federal government's expanded public reporting efforts lay the groundwork for Medicare to penalize hospitals with high rates of hospital-acquired infections and other safety problems—as required by the Affordable Care Act. Rates of readmission and mortality and patient experience measures, among others, will also be factored into hospitals' performance data. Medicare will begin considering the patient safety measures in its hospital payment as early as fall of 2013.
Hospital officials and other groups, including a National Quality Forum panel and the Association of American Medical Colleges, have argued that the complications data should not be linked to payment since the measures are not adequately risk adjusted nor validated and not intended to be used for comparison. In a Feb. 13 report in Kaiser Health News. they also raised concerns about the practices of using administrative data such as billing information rather than medical records to determine complications rates.
Nation's Largest Insurer to Pay for Quality
UnitedHealth Group, Inc., the nation's largest insurer, has begun to overhaul its fees for health care providers—joining other insurers and the federal government in the trend to move away from fee-for-service payments to a system that would pay for quality, rather than quantity, of care. As reported in the Wall Street Journal, the insurer is rolling out new contracts nationwide that link provider compensation to quality goals, such as avoiding readmissions and hospital-acquired conditions or delivering recommended preventive care. Patients' experiences would also be taken into account. Between 50 percent and 70 percent of the carrier's commercially insured patients could be affected by the new contracts by 2015.
NQF Endorses Efficiency Measure
The National Quality Forum has endorsed measures of health care resource use and costs—the first of their kind to receive this endorsement. The Total Cost of Care and Resource Use measures were developed by HealthPartners, a Minn.-based nonprofit HMO, and take into account the cost of care as well as the resources used. Health care executives, insurers, employers, government, consumers, and others can use the measures as a common reference point in assessing the efficiency of accountable care organizations and other provide groups.