Dec 18, 2014

CMS releases data on quality to help patients choose providers

Patrick Conway, M.D., M.Sc.
CMS Deputy Administrator for Innovation and Quality and Chief Medical Officer

The Centers for Medicare & Medicaid Services (CMS) today released data on the quality of care provided by physician group practices, Accountable Care Organizations (ACOs) and hospitals. These data are available on Physician Compare, Hospital Compare and

The performance information released this month will give patients and families additional information they can use to inform their selection of a hospital or physician practice. Health care professionals differ in the quality and safety of care they provide and these websites 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.

The data released today includes:

  • Information on Hospital Value-Based Purchasing Program 2015 payment adjustments
    The Hospital Value-Based Purchasing Program provides a useful snapshot of how hospitals are performing on important quality indicators of patient care, quality, efficiency, and well-being. It is one of many Affordable Care Act programs Medicare is implementing to pay for quality instead of quantity. The program ties a portion of payments to hospitals’ performance on certain quality measures such as death within 30 days after a heart attack and patient experience of care.

    The portion of FY 2015 Medicare payments available to fund the value-based incentive payments increases from 1.25 to 1.5 percent of the base operating DRG payment amounts to all participating hospitals. The total amount available for value-based incentive payments in FY 2015 will be approximately $1.4 billion.

    Data from the third year of the program indicates that hospitals are improving care and outcomes for Medicare beneficiaries. More hospitals this year will experience a positive change in their payments (1,714) compared to the number of hospitals that will experience a negative change (1,375) – a reversal of last year  This change indicates that many hospitals are improving the quality of care delivered to patients.

    More information on the Hospital Value-Based Purchasing program payment adjustments can be found here:
  • Updated performance results on diabetes and cardiovascular care by some physician group practices and ACOs
    CMS has posted the publicly reported 2013 Physician Quality Reporting System (PQRS) Group Practice Reporting Option measures for the 139 group practices and 214 Shared Savings Program Accountable Care Organizations (ACOs) and 23 Pioneer ACOs.
  • Hospital performance results on Hospital-Acquired Conditions (HACs) such as central line-associated bloodstream infections, catheter associated urinary tract infections, pressure ulcers and accidental punctures or lacerations
    HACs are a group of reasonably preventable conditions that patients did not have upon admission to a hospital, but developed during the hospital stay. The HAC Reduction Program uses public reporting and financial incentives to encourage hospitals that treat Medicare beneficiaries to reduce HACs and improve patient safety.

    To determine hospital performance under the HAC Reduction Program, CMS computes a Total HAC Score for each hospital. The higher a hospital’s Total HAC Score, the less well the hospital performed under the HAC Reduction Program. Beginning in FY 2015, the law requires a payment reduction of one percent for those hospitals that rank in the top quartile of Total HAC Scores.

    More information on the HACs Reduction program and HAC scores can be found here:

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 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.