CMS Releases Quality Data To Help Patients Choose Providers

By Megan Williams, contributing writer

Finding quality providers is an ongoing challenge for patients, and CMS has just released quality metrics that can be used by software developers to build apps and other ways to make the data more accessible and useful to general patient populations.

Quality-Centered Data

The Centers For Medicare and Medicaid Services released data on physician group practices, ACOs, and hospitals that reflects the quality of care the organizations provide. They are available in three places, Physician Compare, Hospital Compare, and Data.Medicare.gov.

The information gives patients and families additional insight into their selection of hospitals and physicians practices — essential in an environment where quality and safety can vary. The websites are intended to empower patients in their healthcare decisions, and to simultaneously encourage providers to work toward higher levels of quality, eventually resulting in system-wide improvement.

The Data

The data includes three specific elements:

• Hospital Value-Based Purchasing Program 2015 Payment Adjustments. This is a look at how hospitals are performing with respect to indicators of care, quality, efficiency, and well-being. It is part of Medicare’s efforts to implement a pay for quality payment structure, as opposed to the historical quantity-based system that’s currently in place. Data released so far has revealed that hospitals are actually improving their services for Medicare beneficiaries, and that it’s expected that more hospitals will see a positive change in their payments, than those that will experience a negative change. This fact would be a reversal from last year’s results.
• Updated Performance Results. The results include diabetes and cardiovascular care data from some physician group practices and ACOs. CMS posted the 2013 Physician Quality Reporting System (PQRS) Group Practice Reporting Option measure for 139 group practices and 214 Shared Savings Program Accountable Care Organizations (ACOs) and 23 Pioneer ACOs.
• Hospital Performance Results On Hospital-Acquired Conditions (HACs). This includes data on conditions such as central line-associated bloodstream infections, catheter associated urinary tract infections, pressure ulcers, and accidental punctures or lacerations. The HAC reduction program aims to encourage hospitals treating Medicare patients to reduce HACs and improve safety through public reporting and financial incentives.

The agency finished the announcement with this statement: “CMS is committed to providing useful and current quality performance data. The Compare sites empower consumers with information to help with health care decisions, encourage providers to strive for higher levels of quality, and drive overall health system improvement. While consumers and patients are the main audience for the Compare sites, stakeholders can visit Data.Medicare.gov and use the same data that power the Compare websites in easy-to-use formats.

CMS is committed to transparency of data about quality and cost of care provided by physicians, hospitals and other health care professionals. This transparency is critical to transforming the health care delivery system to achieve the three aims of better care for patients, better health for communities and spending dollars wisely.”