Outcome and Payment Measures
Outcome and Payment Measures
In the interest of promoting high-quality, patient-centered care and accountability, the Centers for Medicare & Medicaid Services (CMS) collaboratively with Hospital Quality Alliance (HQA) began publicly reporting 30-day risk-standardized mortality measures for acute myocardial infarction (AMI) and heart failure (HF) in June 2007. CMS has since expanded the publicly reported outcome measures to include more conditions and procedures, and to include the 30-day readmission, 90-day complications, and excess days in acute care (EDAC) measures as well as payment measures. Publicly reporting and displaying these measures through CMS' quality improvement initiatives improves the care provided by the nation’s hospitals, increases transparency, and provides quality information to consumers and others. CMS calculates the following outcome and payment measures for public reporting annually based on claims and administrative data:
Measure Outcome | 30-day risk-standardized mortality measures | 30-day risk-standardized readmission measures | 90-day risk-standardized complications measure | 30-day excess days in acute care measures | Payment measures |
---|---|---|---|---|---|
AMI | ♦ | ♦ | ♦ | ♦ | |
CABG | ♦ | ♦ | |||
COPD | ♦ | ♦ | |||
HF | ♦ | ♦ | ♦ | ♦ | |
THA/TKA | ♦ | ♦ | ♦ | ||
PN | ♦ | ♦ | ♦ | ♦ | |
Stroke | ♦ | ||||
HW | ♦ |
Acronyms:
AMI: Acute Myocardial Infarction,
CABG: Coronary Artery Bypass Graft,
COPD: Coronary Obstructive Pulmonary Diseases,
HF: Heart Failure,
THA/TKA: Total Hip Arthroplasty and/or Total Knee Arthroplasty,
PN: Pneumonia,
HW: Hospital Wide
Additional Analyses
In addition to calculating the above measures for public reporting, CMS also conducted annual analyses of its hospital outcome measures to provide greater insight into measure trends and variation. These additional analyses used calculations reported annually on Hospital Compare on Medicare.gov.