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How CMS Makes Quality Data Public While Still Keeping It Secret

Cheryl Clark, for HealthLeaders Media, September 26, 2013

This time-intensive and brain-boggling process didn't have to be so complicated. The agency could have released this on its consumer-friendly Hospital Compare site, as it used to do, and as many were promised it would. This spring in an interview with me, agency officials said HAC data was no longer included under the agency's pay-for-performance reporting program and would be publicly available. But that response didn't explain why the data CMS continues to collect couldn't continue to be posted on Hospital Compare.

CMS appears to have released this update without really releasing it, in part to straddle the fence in a long-standing and acrimonious disagreement between hospitals and consumer and employer groups that purchase insurance. Their debate is over whether these potentially embarrassing exhibitions of patient harm pass the statistical "small numbers" smell test, especially with some types of HACs that are extremely rare.

The American Hospital Association says the data isn't reliable, and points to a report commissioned by CMS that the industry group says indicated as much. That November 2011 report "show[s] these measures are unreliable and have not been validated as Medicare calculates them," Nancy Foster, the AHA's vice president for quality and patient safety policy, said in an email Wednesday in response to a request for comment.

"In fact, the multi-stakeholder Measure Application Partnership (MAP) urged CMS not to publish these data due to these problems with the measures. It is unfortunate that data of poor quality is being published and used to unfairly rate hospitals,” Foster says.

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