CMS to implement risk-adjusted, 30-day mortality measures
November 6, 2006
The Centers for Medicare & Medicaid Services (CMS) and its Hospital Quality Alliance (HQA) partners will begin publicly reporting risk-adjusted, 30-day mortality rates on the Hospital Compare website in June 2007. The rates will include data for all Medicare patients with principal hospital discharge diagnosis of acute myocardial infarction (AMI) or heart failure (HF), from all acute care and critical access hospitals in the nation. A plan to add a 30-day mortality measure for pneumonia to the public reporting process is contingent on National Quality Forum (NQF) endorsement.
In making the announcement, CMS and its HQA partners stated they will begin reporting the risk-adjusted mortality rates “in the interest of high-quality, patient centered care and accountability” and in compliance with the Deficit Reduction Act (DRA) of 2005. Publicly reporting mortality measures, the two groups said, can illustrate the variation in patient outcomes across the country and create a visible incentive for hospitals to improve patient short-term survival.
The 30-day, risk-adjusted AMI and HF mortality measures were developed by a team of clinical and statistical experts from Yale and Harvard Universities. The HQA has approved these measures as appropriate for public reporting. The measures have also been endorsed by the NQF, a voluntary standard-setting, consensus-building organization representing providers, consumers, purchasers, and researchers.
The 30-day measures will be calculated by CMS for Medicare patients, using the administrative claims data already submitted by hospitals under the Medicare program. Thus, hospitals will not need to submit new or additional information to CMS or to the QIO Clinical Data Warehouse.
Prior to the national implementation of mortality measures reporting in June 2007, CMS will conduct a "dry run" of the process, to familiarize hospitals with the background of the measures and their facility's mortality rates. In December 2006, each hospital will receive a hospital-specific report describing its mortality rates, based on 2003 Medicare claims. (The reports will be made available on the secure QualityNet Exchange website.) The rates contained in these initial reports will not be posted publicly on the Hospital Compare website.
In order to implement these measures, CMS has contracted with Colorado Foundation for Medical Care (CFMC), Colorado’s Quality Improvement Organization (QIO). Questions about the public reporting of mortality measures may be sent to CFMC at: firstname.lastname@example.org. After receiving their respective reports, hospitals will have 30 days to send comments and questions regarding the hospital-specific reports to CFMC.
See the project timeline (PDF) for a list of other important dates leading to the public reporting of mortality measures on Hospital Compare. CMS will post additional information—including documentation regarding development of the mortality models and frequently asked questions—throughout the month of November 2006 on QualityNet.