Most of the quality measures the CMS included in its proposed inpatient prospective payment system hospital rule for fiscal 2009 arent yet ready for prime time, provider groups warned in comments to the agency.
The CMS in its rulemaking has proposed to increase to 72 from 30 the quality measures hospitals need to report to Medicare to receive full reimbursement. (One existing quality measure has been proposed for retirement). Hospitals that fail to report on all of the quality measures would receive an update of only 1%, which would equal the full update minus 2 percentage points.
Of these 43 new measures, only 10 have been adopted by the Hospital Quality Alliance, and many have not been endorsed by the National Quality Forum, wrote Richard Pollack, the American Hospital Associations executive vice president, in a letter to CMS acting Administrator Kerry Weems that accompanied the AHAs comments. We do not believe the other 33 measures proposed by CMS are ready for reporting at this time, he wrote.
Adding such a large number of measures provides no direction to hospitals on quality-improvement priorities, Pollack wrote.
Premier, a healthcare alliance that represents more than 2,000 not-for profit hospitals, expressed similar concerns.
While Premier is pleased that CMS continues to show a strong commitment to pay-for-reporting, we have reservations about the volume of measures proposed and whether they are truly mature enough for public reporting and tying to payment, said Blair Childs, Premiers senior vice president of public affairs, in a written statement.
In its comments, Premier outlined a framework the CMS could follow for integrating these types of measures into the public-reporting program, suggesting the agency pick a few measures each year that have satisfied the criteria proposed by Premier.
The program should be slowly and steadily expanded rather than growing exponentially, Childs wrote. We strongly recommend that CMS prioritize the measures according to their value in improving quality and reducing costs, their utility to patients, the level of burden imposed on hospitals and their readiness for implementation.