Surgical Survival Predictors May Be Next Big Quality Metric

Cheryl Clark, May 19, 2011

What's next for value-based purchasing metrics, hospital transparency, and quality scoring? Hospitals, get ready.

By now, you're getting used to the idea that public scoring and pay-for-performance have arrived. The 33 process and outcome measures hospitals  must perfect to earn up to 2% of their Medicare DRG payments – the first to take effect on July 1 – are set for the next two years.

Down the road, the Affordable Care Act says, 'The Secretary shall' select additional process or outcome measures to determine each facility's paychecks going forward. What likely endpoints will those be? What weak spots in their systems should providers be rushing to improve?

I put that question to Leah Binder, CEO of the 10-year-old Leapfrog Group, the nation's first healthcare performance coalition to evaluate and post hospital performance comparisons online. The coalition of 65 employers purchases healthcare for 34 million people, and now publishes data on 1,224 voluntarily participating hospitals with dozens of mortality and system quality metrics.

Surgical "survival predictors," will be key, Binder replies, without missing a beat.  Leapfrog's website displays predictors of death during hospitalization for patients undergoing six high-risk surgical procedures for the last two years:

• Pancreatic resection
• Esophageal resection
• Heart angioplasty
• Heart bypass surgery
• Aortic valve replacement and
• Abdominal aortic aneurysm repair

Only those hospitals with sufficient numbers of procedures are included. This isn't an old 30-day mortality statistic for conditions such as pneumonia, as in the 2014 VBP score. These numbers represent a patient's chance of future mortality.


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