Their participation comes as a result of the Centers for Medicare &
Medicaid Services (CMS) Hospital Quality Initiative. Hospitals were also
encouraged by a provision in the Medicare Prescription Drug, Improvement and
Modernization Act of 2003 (MMA) that provides a financial incentive for
prospective payment system hospitals to voluntarily report quality of care
Hospitals that submit quality information under the CMS initiative are
eligible to receive the full Medicare payment for healthcare services under
MMA. Those hospitals that did not submit data will receive a .4 percent
reduction in annual Medicare payments.
Among the nation's 3,906 inpatient acute care hospitals eligible to report
quality data under MMA, 54 hospitals in Washington state met all CMS
requirements and will receive their full annual payment update from Medicare
"Washington State hospitals have long been committed to quality of care,
and their wholehearted participation in this initiative underscores that
fact," said Leo Greenawalt, president of the Washington State Hospital
Association. "In fact, this spirit of quality pervades all of our hospitals.
Even 14 smaller hospitals that are not eligible for the payment incentive have
voluntarily submitted similar data for public reporting."
"As the nonprofit healthcare quality improvement organization for
Washington State, Qualis Health is ready to help every hospital further its
efforts to improve care," said Jonathan Sugarman, MD, MPH, president/CEO of
Qualis Health. "People across the state will see the benefits of this new
information as the quality of care in Washington hospitals continues to
The Medicare 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 quality
improvement organizations (QIOs), such as Qualis Health.
"Soon, patients in Washington state will be able to use this quality
information to help them make decisions about hospital care, and hospitals can
compare their performance, ultimately improving the quality of care for
everyone," Sugarman said.
Beginning in 2005, the hospital quality data will be available on a
consumer Web site, Hospital Compare, at http://www.medicare.gov, or by calling
1-800-MEDICARE (800-633-4227). Currently, CMS publishes quality information
on http://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 people with Medicare. The measures in each
condition address key aspects of appropriate care and reflect widely accepted
standards of practice:
* Heart attack (Acute Myocardial Infarction)
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 decreased heart
* 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.
The national quality initiative is an important step in the HHS/CMS
comprehensive quality strategy, which consists of four elements:
* Ongoing, community-based quality improvement programs for providers,
* Collaboration and partnerships to leverage knowledge and resources,
* Improved information for consumers on quality of care, and
* Regulation and enforcement activities by state survey agencies and
Qualis Health is a private, nonprofit organization that offers programs
and services to generate, apply and disseminate knowledge to improve the
quality of healthcare delivery and health outcomes. In operation since 1974,
the firm has headquarters in Seattle, with offices in Boise and Anchorage.
Washington State Hospital Association (WSHA) is a trade association that
represents all 97 of Washington community hospitals. WSHA works to promote
access to healthcare and quality healthcare throughout Washington State.
Source: Qualis Health