Healthcare payers, providers and consumers may view an expanded and more current array of quality measures with a major update posted Thursday on two Centers for Medicare & Medicaid Services websites, Hospital Compare and Nursing Home Compare.
The agency also refreshed annual readmissions and mortality rate data, with new spreadsheets showing those hospitals that are better or worse than national averages during a three-year period. For readmissions, the data collection period of July 1, 2008 through June 30, 2011 represents the performance period that will be used to determine penalties as high as 1% of a hospital's Medicare DRG payments starting Oct. 1.
The agency has also updated performance data for hospital-acquired conditions, healthcare-associated infections, outpatient imaging safety measures and certain metrics set by the Agency for Healthcare Research and Quality that may become part of the value-based purchasing incentive payment formula.
Two new measures were added to the Website to reflect the degree to which providers were judicious in their use of certain imaging tests involving radiation. One shows rates of use of cardiac imaging stress tests, which may involve CT scans, in patients before low-risk outpatient surgery, which many experts agree is not necessary. The other indicates the number of outpatients who received brain CT scans who also got sinus CT scans at the same time.
Because CT imaging tests expose patients to high levels of radiation, patients who are being diagnosed for problems related to headaches or chronic sinus infections should undergo a sinus CT first to determine if a second CT is actually necessary. "Experts do not recommend doing both tests at once unless patients have head injuries, tumors, or serious signs of infection," the website explains.
"We all know the adage that what gets measured gets done," CMS deputy chief medical officer Shari Ling said during a conference call organized for members by the Association of Healthcare Journalists. "The measures on these sites are part of robust reporting program, or reporting programs that has been shown to help hospitals and nursing homes collect the data they need to pinpoint possible breakdowns in care and areas for improvement."
She added, "This will make it easier for patients to get exactly the information that they are looking for faster."
One of the most significant changes is a substantial addition to Nursing Home Compare, which includes hospital-specific use of anti-psychotic drugs for both long-stay and short-stay skilled nursing home patients. The site also now includes detailed quality reports specifying deficiencies when agency personnel investigated a complaint or launched a routine facility inspection.
The nursing home component shows ratings of staffing, the percentage of nursing home residents who report moderate to severe pain, received appropriate vaccines, have had urinary catheters inserted, have been physically restrained, have developed pressure ulcers, suffered falls, lost too much weight, or had major depressive symptoms.
These indicators are important to hospital leaders, because they may be indicators of improper care practices and procedures, which could result in the readmission of patients to the acute care hospitals from which they had been transferred.
The site also shows whether each nursing home facility has received a financial penalty for failure to adhere to standards of care or causing patient harm.
Both the hospital and nursing home sites now include maps to geographically locate hospitals and nursing homes, and the ability to search by hospital name. Before the update, searches could be performed only by ZIP code.
Ling said that the government's websites are increasingly popular, with more than 1.2 million visits to Hospital Compare, and more than 500,000 visits to Nursing Home Compare during the first six months of 2012.