Top performers in the third year of the CMS hospital pay-for-performance demonstration project said that the key to success has been getting all clinical staff on board with the idea, and showing a strong commitment to quality at the top.
The CMS/Premier Hospital Quality Incentive Demonstration last week announced $7 million in incentive payments to 112 of the 250 hospitals participating in 36 states. The hospitals were judged on the delivery of 30 care measures in five clinical areas: heart attack and failure, coronary artery bypass grafts, pneumonia and hip and knee replacements.
If youre serious about this, you need to put the people and resources in place to achieve success, said Mark Kestner, vice president and chief quality officer for Alegent Health, a not-for-profit, nine-hospital system based in Omaha, Neb., that got top scores in the five areas and received $330,000 in incentive payments this year for its four participating facilities.
The CMS has awarded a total of $24.5 million in the first three years of the project. The project was extended another three years, and is now testing the effectiveness of other incentives, including awarding payments to the most improved facilities. The CMS is also adding test areas such as stroke care. In Spokane, Wash., 561-bed Sacred Heart Medical Center, received the highest payment this year of $385,342. The CMS used data from 1.1 million patient records for the year ended Sept. 30, 2006, to calculate the results.
For the first time, hospitals that didnt meet minimum quality standards in the third year had to pay penalties. Nine hospitals will pay a total of $103,922 for 11 underperforming areas. Two of the nine underperforming hospitals dropped out of the project, according to Premier.
Still, Premier executives said the improvements over time have been remarkable. At the end of the first year, 129 hospitals across 233 clinical areas were below the payment threshold compared with the nine underperformers in year three. Overall quality has improved by an average of 15.8% during the three years.