09/02/2004 - IPRO Announces New York Hospitals Now Reporting Quality of Care Data
Contact:
Dennis Tartaglia/Whitney Wasserman 212/481-7000
Sheila McCullagh/ Martha Carney 516/326-7767
For Immediate Release
IPRO Announces New York Hospitals Now Reporting Quality of Care Data
Consumers Win as Hospitals Work to Improve Care
Lake Success, NY, September 2, 2004 - One hundred eighty-nine eligible hospitals in New York State have taken a major step toward a commitment to improving their quality of care by registering to submit quality information, the Centers for Medicare & Medicaid Services (CMS) announced today.
"People on Medicare and other hospital patients will benefit from this new information and will get further benefits as the quality of care in the nation's hospitals improves," said CMS Administrator Mark B. McClellan, M.D., Ph.D.
Under the Medicare Modernization Act of 2003 (MMA) hospitals that submit quality information to CMS will be eligible to receive the full Medicare payment for health care services under the MMA. Hospitals that do not submit data will receive a 0.4 percentage point reduction in their annual Medicare payments.
Among the nation's 3906 inpatient acute care hospitals eligible to report quality data under MMA, 98.3 percent met all of CMS's requirements and will receive the full annual payment update (APU) from Medicare in 2005.
"When it comes to quality reporting, payment incentives are nearly 100 percent effective - and in turn, quality information will provide further incentives to improve the quality of care available to millions of Americans," McClellan said. "As patients and doctors start using this quality information to help them make decisions about hospital care, hospitals will start using it to improve their performance."
Medicare's Hospital Quality Initiative is designed to improve the quality of hospital care across the nation. The program is part of the U.S. Department of Health and Human Services' (HHS) national Quality Initiative that also focuses on improving the quality of care in home health agencies and nursing homes using hands-on training and resources from Medicare's Quality Improvement Organizations (QIOs).
"Soon, patients in New York will be able to use this quality information to help them make decisions about hospital care, and hospitals can compare their performances, ultimately improving the quality of care for everyone," said Clare B. Bradley, M.D., M.P.H., Chief Medical Officer, IPRO.
Beginning early in 2005, the hospital quality data will be available on a consumer Website, Hospital Compare, at www.medicare.gov, or by calling 1-800-MEDICARE (800-633-4227). Currently, CMS publishes quality information on www.medicare.gov for Medicare and Medicaid-certified nursing homes and Medicare-certified home health agencies.
The data on quality of care that participating hospitals report will give consumers information about performance in three medical conditions - heart attack, heart failure and pneumonia. These conditions can result in hospital stays and are common among Medicare beneficiaries. The measures in each condition address key aspects of appropriate care:
Was aspirin given to the patient upon arrival at the hospital?
Was aspirin prescribed when the patient was discharged?
Was a beta blocker given to the patient upon arrival at the hospital?
Was a beta blocker prescribed when the patient was discharged?
Was an ACE inhibitor given to the patient with heart failure?
Did the patient get an assessment of his or her heart function?
Was an ACE inhibitor given to the patient?
Was an antibiotic given to the patient in a timely way?
Had a patient received a pneumococcal vaccination?
Was the patient's oxygen level assessed?
The quality measures have gone through years of extensive testing for validity and reliability by CMS and QIOs, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), and researchers. The National Quality Forum (NQF), a voluntary standard-setting, consensus-building organization representing providers, consumers, purchasers, and researchers, has endorsed these measures.
With nearly 20 years of experience in health care quality evaluation and improvement, IPRO holds major contracts with state and federal governments to review the cost and quality of services provided to Medicaid recipients, Medicare beneficiaries, and patients enrolled in managed care organizations. Based in Lake Success, New York, IPRO also holds contracts with private-sector clients to improve the quality of privately financed services.
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