The CMS proposed inpatient prospective payment system rule would add four new surgical process measures and one outcomes measure to bring to 32 the number of quality measures hospitals must publicly report beginning next fall to avoid being docked under the Medicare reimbursement program.
The proposed new measures are in line to be incorporated into the Medicare Reporting Hospital Quality Data for Annual Payment Update program, which began in 2001 with 10 measures.
Under the Deficit Reduction Act of 2005, beginning with the current fiscal year (and with the current load of 27 measures), most acute-care hospitals that do not submit the data will have their annual percentage increase in Medicare reimbursements cut by 2 percentage points.
The new measures are likely to increase hospitals spending on quality improvement, though by how much is not clear. Jerod Loeb, executive vice president for research at the Joint Commission, said he has heard of no estimates of how much hospitals will have to spend to collect the data to support the CMS and other reporting programs, but the lack of information technology systems makes reporting more expensive than it needs to be.
The 11 new measures added to the CMS list in just two years represent more bricks on the scale weighing in favor of healthcare IT systems capable of reporting quality measures as part of a regular program of clinical data collection and dissemination. We dont collect data as a byproduct of care delivery because we dont have an IT infrastructure yet, Loeb said. Anytime you add to the data-collection effort and you dont provide a streamlined infrastructure ... you are adding to the cost.
The proposed additional reporting measures for pre- and post-surgery patients are for payments in fiscal 2009, which starts Oct. 1, 2008. The CMS is also soliciting comments on whether and how to add other measures to the set for payments beginning in fiscal 2009.