CMS adds outpatient data to website
Aim to help patients compare health care quality
As part of its efforts to increase transparency in health care and to help consumers make informed decisions about which hospital to choose, the Centers for Medicare & Medicaid Services (CMS) expanded the information on the Hospital Compare website, adding 10 new outpatient measures and updated information on 30-day mortality and readmission rates for heart failure, acute myocardial infarction, and pneumonia.
The revision to the website in July marks the first time that CMS has posted outpatient measures online.
CMS has launched a new website, HealthCare.gov, which includes information on insurance options, preventive care, the new health care reform laws, and a link to the Hospital Compare site.
"The more information consumers and patients have, the better the options and choices are for them when it comes to their health care. HealthCare.gov is designed to put the power of information at the fingertips of Americans, and quality compare tools are a critical part of this new website," said Health and Human Services Secretary Kathleen Sebelius in a statement.
The change will help patients and their families better compare quality at America's hospitals, according to Sebelius.
The outpatient measures include four heart attack-related measures, two surgery-related measures, and four imaging efficiency measures.
Outpatient measures for heart attack include fibrinolytic therapy administered to patients with a suspected heart attack within 30 minutes of arrival at the emergency department; aspirin on arrival for heart attack and chest pain; median number of minutes for chest pain or heart attack patients to receive an EKG; and the median number of minutes that heart attack patients who needed specialized care were in the emergency department before being transferred to another facility.
Outpatient surgical measures include the percentage of patients who were given an antibiotic within an hour before surgery to prevent infection and percentage of patients who were given the right kind of antibiotics.
"Now that the outpatient data are being made public, hospitals without good compliance should be looking at what they can do to improve their ratings," says Deborah Hale, CCS, president of Administrative Consultant Services LLC, a health care consulting firm based in Shawnee, OK.
Depending on the hospital's case management model, the appropriate person to monitor compliance may be a case manager, a utilization review nurse, or someone else, Hale adds.
"Hospitals need to look at whether it is appropriate to ask case managers in the outpatient setting to monitor this data. It goes back to whether case management departments are adequately staffed. If you add another duty to the case manager's role, something is going to fall by the wayside," Hale adds.
The imaging data tracks the percentage of outpatients who had an MRI procedure performed without trying recommended treatments such as physical therapy; the percentage of outpatients who had a follow-up mammogram or ultrasound within 45 days after a screening mammogram; and how often hospitals gave outpatients "double computer tomography" (CT) scans when a single scan may have been all that was needed.
The imaging measures were designed to reduce unnecessary exposure to contrast materials and/or radiation and to encourage hospitals to follow evidence-based guidelines about how and when to use imaging services and to reduce overuse and waste, according to a statement issued by CMS.
The imaging measures allow Medicare patients to see how efficiently facilities use imaging equipment and keep them safe from exposure to potentially harmful radiation that may not be necessary, Sebelius added.
Patients and their families can use the information to understand the risks associated with imaging technologies and talk with their doctors about which hospitals are most likely to help patients reduce those risks, according to acting CMS Administrator Marilyn Tavenner.
According to CMS, one in three Medicare beneficiaries receives MRI of his or her lower back after complaining of pain, rather than first receiving more recommended and potentially safer treatment, such as physical therapy.
"While most practitioners use imaging technology such as MRIs safely and effectively to diagnose or treat disease, studies show that overusing MRIs for lower-back pain could cause patients unnecessary stress, risk, and cost," the agency said in a statement.
In other cases, such as CT scans, the imaging technology exposes patients to the radiation used to produce the images, which means that overuse could harm their health, the statement adds.
"Adding outpatient quality measures to Hospital Compare will give consumers a more complete picture of the quality of care available at local hospitals. In particular, the heart attack and surgical care outpatient measures can be viewed alongside the inpatient data we already report for these conditions, providing a comprehensive look at what facilities in [a patient's] area are doing to provide high-quality, high-value care," says Barry M. Straube, MD, chief medical officer for CMS and directory of the agency's Office of Clinical Standards and Quality.
Hospital Compare now includes updated data for outcomes of patient care, including the new 30-day mortality rates and 30-day readmission rates for inpatients admitted for heart attack, heart failure, and pneumonia. The new data encompass three full years of claims data from July 1, 2006, to June 30, 2009.
[For more information, contact: Deborah Hale, president of Administrative Consultant Services, LLC, e-mail: [email protected].]
As part of its efforts to increase transparency in health care and to help consumers make informed decisions about which hospital to choose, the Centers for Medicare & Medicaid Services (CMS) expanded the information on the Hospital Compare website, adding 10 new outpatient measures and updated information on 30-day mortality and readmission rates for heart failure, acute myocardial infarction, and pneumonia.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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