The CMS has unveiled its newly expanded Hospital Compare website, which now features outpatient as well as inpatient quality data.
Compare and contrast
Updated website now features imaging services
With the addition of nine outpatient measures, the site offers visitors a more comprehensive look at how their local hospitals treat patients across the continuum of care, Barry Straube, the CMS' chief medical officer and director of the Office of Clinical Standards and Quality, said during a conference call. Created in 2005, the site allows users to enter a ZIP code or city and state, and then evaluate up to three hospitals at a time using a range of quality measures.
Medical imaging services account for four of the new outpatient measures, signaling the CMS' heightened focus on imaging overuse and waste. For instance, one of the imaging measures provides the percentage of outpatients with low back pain who had an MRI without first receiving other less invasive treatments such as physical therapy.
Another measure tells users the proportion of many outpatient CT scans of the chest at a particular hospital that were actually “combination” or “double” scans. A high number could perhaps mean that the facility is giving too many patients double scans when single scans could be sufficient, the CMS said. CT scanning has come under scrutiny in recent months because of incidences of accidental radiation overdoses.
“For some time, Medicare beneficiaries have had access to reasonable and necessary imaging technologies, which have revolutionized how well doctors and patient treat a host of diseases,” Marilyn Tavenner, who served as acting administrator of the CMS, said in a news release. “But by adding information to the website today, we can help patients and their families to understand the risks associated with these technologies and talk with their doctors about which hospitals are most likely to help patients reduce those risks.”
Richard Umbdenstock, president and CEO of the American Hospital Association, praised the new additions to the site, but he also cautioned that some outpatient measures, particularly those related to imaging, are still “an evolving science.”
“Those are frequency measures and we don't know what the right number is yet,” he said. “I want to urge consumers to use this information jointly in conversation with their physicians and caregivers.”
The CMS also added two new measures related to antibiotic administration in outpatient surgery patients, and four measures related to outpatient therapies and care processes for patients with chest pain or possible heart attack. For instance, site users can now see the average number of minutes it takes their local hospital's outpatient facility to administer an electrocardiogram to patients who report chest pain, or the number of patients with chest pain or possible heart attack who received aspirin within 24 hours.
The CMS also updated 30-day readmission and mortality rates for care of inpatients with heart attack, heart failure and pneumonia. The new rates were calculated using data from July 1, 2006, through June 30, 2009, according to the release. Thirty-day mortality rates for heart attack fell by 16.2% during the three-year period, dropping slightly from the 16.6% decrease recorded from 2005 through 2008. Mortality rates for heart failure and pneumonia stayed relatively the same.
Readmission rates for all three conditions also hovered around the same mark as they did during 2005 through 2008, the agency said. But having more updated information is now enabling the CMS to track performance trends over time, Straube said. Specifically, he said, it allows the CMS to see which hospitals are consistently performing above and below the national rate for mortality and readmissions so it can target efforts accordingly.
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