Hospitals will face even greater quality pressure as the CMS begins to require public reporting of outpatient measures on its Web site Hospital Compare.
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CMS Web site to report outpatient results
Beginning in June 2010, Hospital Compare will start reporting certain outpatient quality measures, according to the 2010 outpatient prospective payment system final rule. Hospitals that don't comply with quality data reporting requirements could see their payments reduced by 2%.
The requirement comes on the heels of the 2-year-old Hospital Outpatient Quality Data Reporting Program, in which hospitals voluntarily submit data on 11 measures of outpatient treatment, such as whether the appropriate antibiotics were given to surgical patients, or the median time it takes to transfer a heart attack patient to another facility. Hospitals will continue to report on those 11, and the CMS is implementing a validation requirement to ensure that the chart-abstracted data are being reporting accurately. According to the 2010 final rule, whether or not hospital data is considered “validated” through that process will not affect financial reimbursement through 2011.
Including the measures is another good step toward complete transparency, according to El Camino Hospital. The Mountain View, Calif.-based hospital participates in the CMS outpatient reporting program as well as a voluntary state reporting initiative dubbed California Hospital Assessment and Reporting Taskforce.
Showing good performance on process measures is an indicator that those processes have a positive impact on all care, said Eric Pifer, chief medical officer of El Camino.
But process measures focus on specific, discrete steps of care that don't always capture the “full breadth” of outpatient care, he added. “Doctors get frustrated with whole care being reduced to one, discrete measure.”
The inclusion of outpatient measures on Hospital Compare has always been part of the plan, said Nancy Foster, vice president of quality and patient safety for the American Hospital Association. “It's a set of measures we've been very excited about including.” The AHA and several other organizations make up the Hospital Quality Alliance, which collaborates with the CMS to maintain the Hospital Compare site.
Having the outpatient measures available will help to provide a broader perspective of care, Foster said. It will be especially helpful among certain patient populations—such as heart attack patients—who may arrive at a smaller facility's emergency department, are stabilized and then sent to a larger hospital, she said.
Hospitals currently report on process measures as well as mortality, readmissions and patient-satisfaction outcomes for admitted patients.
The 28 process measures look at care related to heart attack and heart failure, pneumonia, surgical improvement and asthma for children, while mortality and readmission outcomes are scored in heart attack, heart failure and pneumonia.
The Hospital Quality Alliance and the CMS are working to ensure that the outpatient and inpatient data are presented separately and clearly on the site, Foster said. “They have been testing with various focus groups how to effectively portray this information.”
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