The Commonwealth Fund released the 2016 edition of The Commonwealth Fund’s Scorecard on Local Health System Performance. The scorecard assesses the state of health care in more than 300 U.S. communities from 2011 through 2014, a period when the Affordable Care Act was being implemented across the country. In comparing health care access, quality, avoidable hospital use, costs of care, and health outcomes, the Scorecard shows that many U.S. communities experienced improvements: fewer uninsured residents, better quality of care in doctors’ offices and hospitals, more efficient use of hospitals, and fewer deaths from treatable cancers, among other gains. Still, the persistence of widespread differences between areas is a reminder that many local health systems have yet to reach the potential attained elsewhere in the country.
The Hospice Timeliness Compliance Threshold Report, released by The Centers of Medicare & Medicaid Services (CMS) as part of Post-Acute Care Quality Reporting Programs is available from July 17, 2016. This report displays provider level data on Hospice Item Set (HIS) records submitted successfully to CMS. For more information, visit the Hospice Quality Reporting Spotlight & Announcements webpage.
Report Finds Majority of U.S. Hospitals Still Fail to Implement ICU Policies Known to Dramatically Lower Patient Death RatesMartina Dolan | July 18, 2016
Hospital intensive care units (ICU) see 4.6 million people annually, among them some of the nation’s sickest and most vulnerable patients. Studies show that patient survival increases by 40 percent when ICUs are staffed appropriately with highly specialized physicians called intensivists, yet a new report released by health care non-profit The Leapfrog Group and analyzed by Castlight Health indicates that only 47 percent of hospitals reporting in the 2015 Leapfrog Hospital Survey have the recommended intensivist coverage in place. Leapfrog’s standard calls for hospitals to have one or more board-certified intensivists on staff, exclusively providing care in the ICU, available for eight hours per day, seven days a week, and for intensivists to return calls within five minutes, 95 percent of the time. Hospitals can partially meet the standard by having intensivists available via telemedicine.
The National Committee for Quality Assurance (NCQA) released new technical specifications for the 2017 edition of health care’s most widely used performance improvement tool, the Healthcare Effectiveness Data and Information Set (HEDIS1). The new HEDIS technical specifications include four new measures, changes to seven existing measures and retirement of one measure.
New measures include: Standardized Healthcare-Associated Infection Ratio; Follow-Up After Emergency Department Visit for Mental Illness; Follow-Up After Emergency Department Visit for Alcohol and Other Drug Dependence; Depression Remission or Response for Adolescents and Adults.
AHA News writes: The Centers for Medicare & Medicaid Services’ approach to overall hospital quality star ratings appears to have several shortcomings, according to a new analysis by an expert in econometrics, commissioned by the AHA. Findings from the analysis suggest while it appears to give the impression of being rigorous and objective the estimation aspect is highly dependent on choice of measures and the weighting scheme is entirely subjective and highly determinant of the final outcomes.
- AHA News: http://news.aha.org/article/160706-analysis-finds-bias-in-cmss-overall-hospital-star-ratings-methodology
- Full analysis report: http://www.aha.org/content/16/16georgetownmeas.pdf (PDF0
A new report issued by the Oregon Health Authority (OHA) details the median amounts paid by commercial insurers for the most common inpatient and outpatient procedures that were performed in Oregon hospitals in 2014. Drawing on data collected in the All Payer All Claims (APAC) database, the report shows variation in prices for the same procedures among hospitals operating in the same region and across the state.
The report, “Oregon Hospital Payment Report 2014,” was mandated by Senate Bill 900, which was passed by the Legislature in the 2015 session. The goal is to provide a source of transparency to the public on hospital prices. Inpatient care accounts for as much as 30 percent of health care spending in the state.
The Agency for Healthcare Research and Quality (AHRQ) has announced that ICD-10-CM/PCS-compatible software v6.0 for SAS and WinQI will be released the week of July 12. The software will be available for download from the AHRQ QI website at: http://www.qualityindicators.ahrq.gov/Software/Default.aspx
The forthcoming software release will include:
SAS v6.0 for ICD-10-CM/PCS
Software improvements include:
- Enhancements to select indicators
- Application files organized into separate folders for user Programs, Macros and Parameter Files
- Revised program and file names for improved usability
Software downloads will be available separately for each module at: http://www.qualityindicators.ahrq.gov/Software/SAS.aspx.
WinQI v6.0 for ICD-10-CM/PCS
Software improvements include:
- Enhancements to select indicators
- Improved user-friendly interface
- Improved data loading and error checking procedures
- Option to calculate indicators for selected modules, decreasing run times for users focusing on specific modules
- Ability to drill down for patient-level reports on cases within QI numerators and denominators
Download a single ICD-10 installer package for all four modules at: http://www.qualityindicators.ahrq.gov/Software/winQI.aspx.
Due to the recent transition to ICD-10-CM/PCS (October 1, 2015), risk adjustment will not be supported in the forthcoming v6.0 SAS and WinQI software for ICD-10-CM/PCS. At least one full year of data coded in ICD-10-CM/PCS is needed in order to develop robust risk adjustment models. AHRQ expects to get a full year of ICD-10 CM/PCS coded all payer data no earlier than mid-2017.
Continuing through the remainder of 2016, v6.0 SAS and WinQI ICD-9-CM compatible software for each of the AHRQ QI modules will be released incrementally. Future announcements will provide additional detail about these ICD-9 releases.
CMS Finalizes Rule Giving Providers and Employers Improved Access to Information for Better Patient CareMartina Dolan | July 5, 2016
The Centers for Medicare & Medicaid Services (CMS) finalized new rules expanding access to analyses and data that will help providers, employers, and others make more informed decisions about care delivery and quality improvement. The new rules, as required by the Medicare Access and CHIP Reauthorization Act (MACRA), allow organizations approved as qualified entities to confidentially share or sell analyses of Medicare and private sector claims data to providers, employers, and other groups who can use the data to support improved care. In addition, qualified entities may provide or sell claims data to providers and suppliers, such as doctors, nurses, and skilled nursing facilities among others. The rule also includes strict privacy and security requirements for all entities receiving patient identifiable and beneficiary de-identified analyses or data, as well as expanded annual reporting requirements. For example, if entities receive patient identifiable data or analyses, they must use protections that are at least as stringent as what is required of covered entities and their business associates for protected health information (PHI) under the HIPAA Privacy and Security Rules.
Nearly 8 million hospital patients in 2013 were discharged for postacute care in another setting such as a skilled nursing facility or home-based care, according to newly released data from AHRQ. Those patients represented 22 percent of all hospital discharges that year. AHRQ’s analysis of such care is the first based on a nationally representative all-payer dataset, the Healthcare Cost and Utilization Project 2013 National Inpatient Sample. According to the analysis, Statistical Brief #205: An All-Payer View of Hospital Discharge to Postacute Care, 2013, the medical conditions for which patients most often need postacute care were total hip/knee joint replacement, followed by septicemia or severe sepsis, and heart failure and shock.
Data on the Illinois Hospital Report Card and consumer guide to health care Web site (healthcarereportcard.illinois.gov) has been updated. Data updates included updates to quality, infection, procedures, nurse staffing and patient safety data, was published. Hospital quality measures reported are for time-period July 1, 2014 to June 30, 2015.
Also included in this data update were:
- Updated healthcare-associated infection data on Methicillin-resistant Staphylococcus Aureus (MRSA) and Clostridium difficile events from January 1, 2015 through December 31, 2015. A statewide aggregate report of these infections is also provided.
- Updated health care-associated infection data on central line-associated blood stream infections, based on data from January 1, 2015 through December 31, 2015. Also included is a statewide aggregate report of these infections and major contributing organisms.
- Updated the adult inpatient conditions and procedures for hospitals to include data from October 1, 2014 to September 30, 2015.
- Updated the Agency for Health Research and Quality (AHRQ) “Inpatient Quality”, “Patient Safety”, and “Pediatric Quality” measures to report data from October 1, 2014 to September 30,2015.
- Updated composite “Process of Care Measures” from the Center for Medicare and Medicaid Services Hospital Compare performance measure data from July 1, 2014 to June 30, 2015.
- Updated all Process of Care measures that are used to calculate the composite data and provided state/national average for July 1, 2014 to June 30, 2015 except for those measures with insufficient data.
- Updated “Satisfaction Survey Responses” data to report the Center for Medicare and Medicaid Services Hospital Compare satisfaction measure data from July 1, 2014 to June 30, 2015.
- Updated Surgical Care Improvement Project measure data from July 1, 2014 to June 30, 2015.
- Updated nurse staffing data for the intensive care units, medical-surgical units, and maternal – child care units for hospitals to report data from October 1, 2014 to September 30, 2015. Updates include nursing hours per patient day and nursing skill mix. Also updated data on hospital employed and contract nurse staffing for each of the three unit types. For maternal-child care units, nurse staffing levels for Level III designated Neonatal Intensive Care Units is delineated in facilities with such designations.
- Updated Emergency Department measures on wait time from the Center for Medicare and Medicaid Services Hospital Compare performance measure data from July 1, 2014 to June 30, 2015.
- Updated data on the total volume of hospital emergency department visits, including the volume of patient visits admitted to hospital as well as those treated as outpatients only (treated and released) from October 1, 2014 to September 30, 2015. Also updated hospital emergency department bypass hours and the percentage of emergency department visits where patients left before being seen or against medical advice for October 1, 2014 to September 30, 2015.
- Updated state hospital designations for Trauma center and Emergency Department Approved for Pediatrics, as well as Magnet hospital designation, Baby Friendly hospital status, and Perinatal designation.
- Updated ambulatory surgical treatment centers outpatient conditions and charges on the Services page from October 1, 2014 to September 30, 2015.