|CMS Releases First Results Of Hospital Quality Reporting For Outpatient Services
The Centers for Medicare and Medicaid Services (CMS) has
notified more than 3,000 of the nation’s hospitals that they will
receive the full payment update for calendar year 2009 as part of the
new Hospital Outpatient Quality Data Reporting Program.
The successful hospitals represent 99.3 percent of all
hospitals that participated in the program that began in 2008 as an
effort to strengthen the tie between the quality of care furnished to
people with Medicare in hospital outpatient departments and the
payments hospitals receive for those services.
"We are extremely pleased to find that hospitals have
responded so successfully to the new outpatient quality measure
reporting program," said CMS Acting Administrator Kerry Weems. "The
reporting program represents another major step toward value-based
purchasing of healthcare services to ensure that patients with Medicare
and the American taxpayers get the best outcomes for their healthcare
The new reporting program was mandated by the Tax Relief and Health care Act (TRHCA) of 2006.
Under TRHCA, eligible hospitals that successfully report
outpatient quality data receive the full market basket update; those
that do not receive an update that is reduced by 2.0 percentage points.
Data culled from the hospital reporting program will help Medicare and
the broader healthcare community learnmore about the quality of
services available to beneficiaries in outpatient care settings and how
to improve that care.
Quality data will also give CMS a baseline of data from
which an eventual pay-for-performance outpatient system could be
In all, of 3,339 hospitals that participated in the
program, 3,313 will receive the full calendar year (CY) 2009 update
under the quality data reporting program. Of the remaining 26, that
will receive the reduced update, 18 did not report the quality data
successfully, while eight did not have a QualityNet Administrator.
In 2008, hospitals participating in the program were
required to report data on the seven quality measures that measure
important elements of high-quality heart attack and surgical care,
which is of particular importance to Medicare beneficiaries. These
- The percentage of heart attack patients given aspirin when they arrive at the emergency room;
- The amount of time it takes for a heart attack patient to receive clot-busting drugs;
- The percentage of heart attack patients who received clot-busting drugs within 30 minutes of arriving in the emergency room;
- The average time it takes a heart attack patient to
receive an electrocardiogram test to assess heart damage once they
arrive in the emergency room;
- The average time it takes for a heart attack patient
to transfer to another hospital to receive a coronary angioplasty as
acute treatment for a heart attack;
- The percentage of surgery patients who receive an antibiotic within one hour before surgery to help prevent infection; and
- The percentage of surgery patients who receive the right kind of antibiotic to help prevent infection.
The outpatient prospective payment system CY 2009 final
rule added four imaging efficiency measures to the seven original
measures for reporting to receive the full update in CY 2010.
Address: Centers for Medicare and Medicaid Services, 7500 Security Boulevard, Baltimore, MD 21244; (877) 267-2323, www.cms.gov.