Quality Data Public Reporting J Michael Henderson Chief Quality Officer Cleveland Clinic Health System
Public Quality Data Reporting What & Why? Hospitals & Physicians NSQIP option
WHAT: Quality Data Reporting HHS: Hospital Compare, and others State Reporting: 26 have Scorecards Commercial: Leapfrog Thomson Reuters Consumer Reports Healthgrades
There is only one public reported Scorecard that counts HHS Quality data source Hospital Compare But another is emerging Physician Compare
Implications: Hospitals probably look more than patients? driving Hospital PI Will drive Value Based Purchasing
37 measures 6 4 10 14 6 Medical, 29 Surgical 1 measure 71
Hospital Compare: Patient Safety Measures 1 Patient Safety Indicators (10) Inpatient Quality Indicators (9) 2 8 metrics/1,000 discharges 3 Central line associated blood stream infections
Hospital Compare: display of Safety measures
How is HHS looking at Cost? Medicare Spend Per Beneficiary 3 Phases: 1. 3 days prior to admission 2. Index admission 3. 30 days post disrge Data is shown as a ratio: Hospital Spend National Median
Does your Hospital participate in Registries? NSQIP to be added Oct 2012
A whole new look!! July 19 th 2012
WHY: Quality Data Reporting 1. Transparency 2. Reputation 3. Reimbursement 4. Drive Performance Improvement
Institute of Medicine Focused patients (and country) on Patient Safety 1999 2001
What do patients want? 1. Don t hurt me 2. Heal me 3. Be kind to me It s all about TRANSPARENCY
REPUTATION Increasing focus on Hospital Compare data to establish credibility US News and World Report Leapfrog Thomson Reuters Consumer Reports
REPUTATION: Heart Failure 30 day mortality and readmissions % 12 10 8 30d Mortality 6 H Hopk G M Gen o Mayo C Cle C A UCLA ol Colu F UCSF m Brigh e Duke n Penn 30 % 28 26 24 22 30d Readm 20 H G o c A ol F m e n
Penn Duke Brigh UCSF CLABSI Standard Infection Ratio 2 1 Do not report National Hopkins Mass G Mayo CC UCLA Col/Pres 0
Medicare Spend Per Benificiary Ratio to National Median 1.1 1 National Hopkins Do not report Mayo Mass Gen CC UCLA Col/Pres UCSF Brigh Duke Penn 0.9
Reimbursement: Value Based Purchasing Process of Care + HAI, PSI Patient Exp Outcomes (mortality) MSPB 2013 2014 2015
Performance Improvement Driven by Data 1. National Scorecard data 2. Hospital level data 3. Real-time data Yearly Monthly Weekly
If you can t measure it you can t manage it
Physician Quality Reporting Incentive CMS: - Physician Quality Reporting System (PQRS) - Meaningful Use - Maintenance Of Certification (MOC) - eprescribe - Physician Feedback/Value Modifier Program The Joint Commission - OPPE requirement for privileges Commercial: - Profiling from beneficiary Claims Data
What do Hospital and Physician Quality Data Reporting have in common? Pay For Reporting Pay For Performance
NSQIP OPTION
Beginning October 2012, Hospital Compare will include new surgical outcomes measures submitted on a voluntary basis by hospitals participating in the American College of Surgeon s National Surgical Quality Improvement Program database (ACS NSQIP ).
Why do this? NSQIP drives improved care for patients Clinical better than Administrative Data Change the approach for quality reporting ACS Inspiring Quality
NSQIP on Hospital Compare What to expect: 3 Measures: Lower Extremity Bypass Surgery Colon Surgery Surgery > 65 years Combined death & serious morbidity Will report as: Better than average Average Worse than average Not available
ACS-NSQIP Measures Option Cleveland Clinic data Rate Odds ratio Comment Elderly (>65) Colon Surgery Lower Ext Bypass 13.4% 0.80 Better than average 21.2% 1.09 Average 14.9% 1.23 Worse than average
Next Steps 170 NSQIP/Non-NSQIP Hospitals inquired and/or expressed interest All should explore and understand this option
Hospital Compare to do 1. Review your measure results as contained in your SAR 2. Commit to being a Quality Leader and showing your data on Hospital Compare 3. Electronic submission for all: Addendum to your contract Exhibit Form Measure Selection Deadline: August 13th
Takeaways Transparency: data should be reported Data drives PI: accountability Hospital and Physician reporting NSQIP reporting heralds a new era