Outcome Measures

Background

In the interest of promoting high-quality, patient-centered care and accountability, the Centers for Medicare & Medicaid Services (CMS) and Hospital Quality Alliance (HQA) began publicly reporting 30-day mortality measures for acute myocardial infarction (AMI) and heart failure (HF) in June 2007 and for pneumonia (PN) in June 2008. CMS has since expanded the publicly reported outcome measures to include 30-day readmission complications, and excess days in acute care (EDAC) measures as well as in-hospital adverse events and mortality. Publicly reporting these measures increases the transparency of hospital care, provides useful information for consumers choosing care, and assists hospitals in their quality improvement efforts. CMS annually calculates the following categories of outcome measures based on claims and administrative data for public reporting:

30-day risk-standardized mortality measures 

  • Acute Myocardial Infarction
  • Heart Failure
  • Pneumonia
  • Chronic Obstructive Pulmonary Disease (COPD)
  • Coronary Artery Bypass Graft (CABG)
  • Stroke

30-day risk-standardized readmission measures

  • Acute Myocardial Infarction
  • Heart Failure
  • Pneumonia
  • Hip/Knee
  • Chronic Obstructive Pulmonary Disease (COPD)
  • Coronary Artery Bypass Graft (CABG)
  • Stroke
  • Hospital-Wide Readmissions

90-day risk-standardized complications measure

  • Hip/Knee Replacement

30-day excess days in acute care measures

  • Acute Myocardial Infarction
  • Heart Failure
  • Pneumonia

AHRQ Patient Safety Indicators (PSIs)

  • PSI 04 - Death among surgical inpatients with serious treatable complications
  • PSI 90 Composite - Complication/patient safety for selected indicators

Additional Analyses

In addition to calculating the above measures for public reporting, CMS also conducts annual analyses of its hospital outcome measures to provide greater insight into measure trends and variation. These additional analyses use calculations reported annually on Hospital Compare and are compiled in the Chartbook as described below.

Hospital Performance Reports: Chartbook Series

The CMS Hospital Performance Reports present analyses that provide insight into hospital performance on publicly reported outcomes measures for patients. The Chartbook provides new information about recent trends and variation in outcomes by location, hospital characteristics, patient disparities, and cost.

The Chartbook for the claims-based, hospital-level readmission, mortality, complications, payment and excess days in acute care (EDAC) measures has been transformed into an interactive website that contains multiple data visualizations: www.CMSHospitalChartbook.com. These visualizations have been updated with measure results from the 2018 version of the measures. The Chartbook:

  • Displays national trends and distributions of hospital performance on outcomes measures.
  • Highlights regional variation in performance on outcomes measures.
  • Compares the performance of hospitals by the following hospital characteristics: teaching hospitals, safety-net hospitals, hospitals with high proportions of African-American patients, hospitals with high proportions of low income patients, hospital size, hospital ownership, and urban/rural hospitals.
  • Identifies the number of hospitals that care for a disproportionate volume of patients with social risk factors.
  • Examines how consistently hospitals perform on pairs of outcome measures.
  • Reports variation in risk-standardized Medicare payments for treatment for selected condition- and procedure-specific episodes of care.
  • Explores how a state’s overall performance on measures relates to their performance for patients with and without social risk factors.
Page Last Modified:
07/04/2019 05:48 AM