About Health Transparency

WhyNotTheBest.org’s interactive map has been updated to include the latest round of accountable care organizations (ACOs) to join Medicare’s Shared Savings Program—bringing the total to 219 groups around the nation. Users can track the spread of ACOs and other types of quality improvement activity and performance recognition through our series of map overlays.

Users can also use the map to explore performance variation among states, counties, and hospital referral regions on measures of health care quality, safety, outcomes, patient experiences, use of health information technology, and more.

For help using the map, watch this short video demo. Or check out this infographic showcasing performance variation across the nation.

Kaiser Health News writes, for the first time the government will make information about financial relationships between doctors, teaching hospitals and drug manufacturers publicly available. To comply with a provision in the Affordable Care Act, drug and device manufacturers, along with group purchasing organizations, will have to disclose all of their payments and other compensation to physicians and teaching hospitals. The information will be gathered beginning in August and disclosed by Sept. 30, 2014 on a new website of the Centers for Medicare & Medicaid Services. The site is part of the National Physician Payment Transparency Program, an effort to bring the financial relationships to light.

There are so many report cards on hospitals that the Informed Patient Institute (IPI) runs a website that grades the raters.  IPI rates the usefulness of online doctor, hospital, and nursing home report cards.

A study published in this month’s edition of Health Affairs found that publicly reported performance data motivated physician groups  to act on some, but not all, of the quality measures.  Public reporting of how physicians and hospitals perform on certain quality of care measures is increasingly common, but little is known about whether such disclosures have an impact on the quality of care delivered to patients. The study focused on fourteen publicly reported quality of ambulatory care measures from 2004 to 2009 for the Wisconsin Collaborative for Healthcare Quality, a voluntary consortium of physician groups. Researchers also fielded a survey of the collaborative’s members and analyzed Medicare billing data to independently compare members’ performance to that of providers in the rest of Wisconsin, neighboring states, and the rest of the United States. Findings from the study indicate that physician groups in the collaborative improved their performance during the study period on many measures, such as cholesterol control and breast cancer screening. Physician groups reported on the survey that publicly reported performance data motivated them to act on some, but not all, of the quality measures. The study suggests that large group practices will engage in quality improvement efforts in response to public reporting, especially when comparative performance is displayed, as it was in this case on the collaborative’s website.

• Read full study: Publicly Reported Quality-Of-Care Measures Influenced Wisconsin Physician Groups To Improve Performance , Vol 2, No. 3, March 2013

At the request of the Department of Health and Human Services (HHS), the Measure Applications Partnership (MAP), a public-private partnership convened by the National Quality Forum (NQF), has submitted its second annual round of input regarding the performance measures currently under consideration for use in federal programs.

MAP’s work fulfills a statutory requirement for multi-stakeholder input to HHS on the selection of performance measures for public reporting and performance-based payment programs, while working to align measures being used for public and private sector programs. Encouraging the private and public sectors to use the same measurement approaches and measures is key to reducing measurement burden on providers and increasing the meaningfulness of measurement information that is increasingly used by consumers and others who purchase healthcare services.

On December 1, 2012, MAP received and began to review the list of more than 500 measures under consideration for twenty federal programs covering clinician, hospital, and post-acute care/long-term care settings. Of these, MAP supported the immediate application of 141 measures in federal programs and supported the direction of another 166 measures, contingent on further development, testing, or NQF endorsement. MAP did not support 165 measures under consideration for inclusion in federal programs. In addition, MAP recommended phased removal of 64 current measures, while also recommending six measures that are not on HHS’ list of measures under consideration be added to programs.

• The final report is now available online.
• Read full press release

In a press release published today, CMS announced 106 new Accountable Care Organizations (ACOs) comprised of doctors and health care providers, ensuring as many as 4 million Medicare beneficiaries now have access to high-quality, coordinated care across the United States.

Doctors and health care providers can establish ACOs in order to work together to provide higher-quality care to their patients. Since passage of the Affordable Care Act, more than 250 Accountable Care Organizations have been established. Beneficiaries using ACOs always have the freedom to choose doctors inside or outside of the ACO. ACOs share with Medicare any savings generated from lowering the growth in health care costs, while meeting standards for quality of care.

ACOs must meet quality standards to ensure that savings are achieved through improving care coordination and providing care that is appropriate, safe, and timely.  The Centers for Medicare & Medicaid Services (CMS) has established 33 quality measures on care coordination and patient safety, appropriate use of preventive health services, improved care for at-risk populations, and patient and caregiver experience of care.  Federal savings from this initiative could be up to $940 million over four years.

The new ACOs include a diverse cross-section of physician practices across the country. Roughly half of all ACOs are physician-led organizations that serve fewer than 10,000 beneficiaries.  Approximately 20 percent of ACOs include community health centers, rural health centers and critical access hospitals that serve low-income and rural communities.

The group announced today also includes 15 Advance Payment Model ACOs, physician-based or rural providers who would benefit from greater access to capital to invest in staff, electronic health record systems, or other infrastructure required to improve care coordination.  Medicare will recoup advance payments over time through future shared savings. In addition to these ACOs, last year CMS launched the Pioneer ACO program for large provider groups able to take greater financial responsibility for the costs and care of their patients over time. In total, Medicare’s ACO partners will serve more than 4 million beneficiaries nationwide.

Also today HHS issued a new report showing Affordable Care Act provisions are already having a substantial effect on reducing the growth rate of Medicare spending.  Growth in Medicare spending per beneficiary hit historic lows during the 2010 to 2012 period, according to the report. Projections by both the Office of the Actuary at CMS and by the Congressional Budget Office estimate that Medicare spending per beneficiary will grow at approximately the rate of growth of the economy for the next decade, breaking a decades-old pattern of spending growth outstripping economic growth.

For more information on the HHS issue brief, “Growth in Medicare Spending per Beneficiary Continues to Hit Historic Lows,” visit: http://aspe.hhs.gov/health/reports/2013/medicarespendinggrowth/ib.cfm.

Additional information about the Advance Payment Model is available at http://www.innovations.cms.gov/initiatives/ACO/Advance-Payment/index.html.

The next application period for organizations that wish to participate in the Shared Savings Program beginning in January 2014 is summer 2013.  More information about the Shared Savings Program is available at https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/sharedsavingsprogram/index.html?redirect=/sharedsavingsprogram/.

For a list of the 106 new ACOs announced today, visit: http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/sharedsavingsprogram/News.html.

The American Medical Association (AMA) announced today that more than 60 organizations have pledged their formal support to an AMA effort designed to help physicians better use health insurer-provided data reports as tools to enhance the quality and value of patient care.

To help create data reports that physicians can easily understand and use, the AMA created the “Guidelines for Reporting Physician Data” with input from public and private health insurers, state and specialty medical societies, health standard organizations, and employer and consumer coalitions. The new guidelines provide a roadmap for improving the usefulness of physician data reports by encouraging greater format standardization, process transparency and level of detail.

Among the organizations that support the use of the AMA’s Guidelines for Reporting Physician Data include Cigna, Midwest Business Group on Health, National Committee on Quality Assurance and UnitedHealth Group.

Modern Physician writes: The CMS’ proposed changes to the 2013 physician fee schedule also included potential additions and clarifications to the agency’s electronic prescribing and electronic health-record incentive programs as well as details on expanded reporting of provider performance data.

In the proposed rule, released July 6, the agency recommended adding new criteria, new hardship exemptions and an informal review process to the Electronic Prescribing Incentive Program. The program awards or penalizes physicians based on the extent of their use of e-prescribing.

For its Medicare EHR Incentive Pilot, the CMS also proposed continuing to use the same method of reporting clinical quality measures that was finalized in last year’s physician fee schedule.

 
Read more: CMS details plans for eRx changes, ACO reporting – Modern Physician http://www.modernphysician.com/article/20120709/MODERNPHYSICIAN/307099975#ixzz20D2Eu8HI ?trk=tynt

Try the new performance benchmarking options on WhyNotTheBest.org, The Commonwealth Fund’s quality improvement resource for health professionals.

New Compare by Groups reports lets users compare hospitals by various characteristics, contrasting the performance of all safety-net hospitals to for-profit hospitals, for example, or comparing rural with urban hospitals.

Using Compare by Regions reports, the user can examine aggregated hospital performance by state, county, or hospital referral region (HRR), as well as population health in communities around the nation.

Enhancements to the interactive map make it easier to explore regional variation and use overlays to track delivery system reforms, such as emerging accountable care organizations, as well as flag health care providers who have been recognized for delivering high-quality care.

Featured Reports:

• Maryland and Washington State HRRs (Region Comparison)
• Health System Hospitals vs. Non-Health System Hospitals (Group Comparison)
• Pioneer ACOs—Partners Healthcare and OSF Healthcare System (Hospital Comparison)

As reported by the BBC News: Scores indicating how happy patients are with their GP surgeries are being published online for more than 8,000 practices in England. The marks – out of 10 – reflect measures such as how easy it is to get an appointment and how well doctors and nurses explain conditions. The results, based on a nationwide survey, are on the NHS Choices website. People will be able to compare the performance of their own GPs with others in their local area and aid in the decision of which practice is best for them.

• NHS Choices: GP Surgeries