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CMS, HHS and HQA Team-Up for New Website Tool

[By Staff Writers] 

In the next initiative of the consumer empowerment and/or patient advocacy movement, it seems that the CMS, HHS and the HQA have just teamed-up to produce a new online tool to help patients compare inpatient services for selected procedures and populations. 

Direct from the Website

Welcome to Hospital Compare. This tool provides you with information on how well the hospitals care for all their adult patients with certain conditions or procedures. This information will help you compare the quality of care hospitals provide. Talk to your doctor about this information to help you, your family and your friends make your best hospital care decisions.

Hospital Compare was created through the efforts of the Centers for Medicare & Medicaid Services (CMS), the Department of Health and Human Services (HSS), and other members of the Hospital Quality Alliance: Improving Care through Information (HQA). The information on this website has been provided primarily by hospitals that have agreed to submit quality information for Hospital Compare to make public.

Assessment

The site is still a work-in-progress, but here is the latest direct link:

http://www.hospitalcompare.hhs.gov

Hopefully, conditions and procedures will be added, and subspecialties like pediatrics will be included going forward.

Conclusion

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Filed under: Quality Initiatives | 3 Comments »

Practice Patterns and Outcomes Reporting

By Brent A. Metfessel MD, MS, CMP™ (Hon)

Quality Profiling

Quality medical profiling and healthcare delivery metrics and outcomes analysis look beyond mere healthcare finances and costs. As readers of the Executive-Post are aware, pure financial analysis is the stuff of physician economic profiling; an emerging science to be sure.

Typically, good quality medical care leads to improved costs since stable patients have fewer unplanned visits, less emergency room usage, and a reduced frequency of hospital admissions, all of which save money. 

HEIDIS® Data

The Health Plan Employer Data and Information Set (HEDIS®) contains measures obtainable from claims, survey, provider, membership, and medical record data.

HEDIS® was developed in conjunction with the National Center for Quality Assurance (NCQA) and is a widely accepted specification for quality measures. 

Consumers, managed care organizations, and accrediting bodies have a high level of interest in the evolving HEDIS® metrics, to date.

These measures are divided up into a number of categories:

• Preventive services:  Includes childhood and adolescent immunization status, breast and cervical cancer screening rates, chlamydia screening in women, assistance with smoking cessation, and well-child visits.
• Access to care:  Includes access to preventive, primary care, prenatal and postnatal care services.
• Utilization:  Contains measures of frequency of selected procedures, inpatient utilization such as average lengths of stay for maternity and mental health patients, C-section and VBAC rates, and other measures of inpatient and outpatient utilization.
• Acute and chronic illness care: Examples are rates of beta-blocker use post-MI, comprehensive diabetes care (such as annual retinal exams), control of high blood pressure, appropriate medications for asthma patients, and follow-up within 30 days after hospitalization for mental illness.
• Provider data and statistics:  Includes residency completion information, board certification, and provider turnover.
• Membership statistics:  These measures deal with member demographics and total membership in the health plan.
• Survey data:  Includes member satisfaction survey results.

Assessment

The NCQA is continually revising its measures in the HEDIS® product and provides new versions annually. But, although HEDIS® contains many measures of quality of care; it provides few measures of actual clinical outcomes.

Conclusion

Have you experienced, or been reviewed, using any of these measures in your own hospitals or healthcare institution; please comment?

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Healthcare Organizations: www.HealthcareFinancials.com

Administrative Terms: www.HealthDictionarySeries.com

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