Hospital Comparison Chart
www.hospitalcompare.hhs.gov

The Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services (HHS), today announced a milestone addition to the Hospital Compare consumer Web site (www.hospitalcompare.hhs.gov). The revised comparison tool will now give consumers even better insight into the quality of care provided by their local hospitals.

The agency also unveiled the first annual update of pricing and volume information on certain elective hospital procedures, which can be found online at www.cms.hhs.gov/HealthCareConInit/02_Hospital.asp#TopOfPage.

“These improvements add to our continuing effort to provide better, value-based, health care at a lower cost for all Americans,” HHS Secretary Mike Leavitt said. “Quality standards are best developed by the medical family and hospitals. I applaud the Hospital Quality Alliance for providing information that everyone can use and agree upon for the benefit of consumers.”

The updates provide consumers with an enhanced “snapshot” that captures information on the quality of care they received from providers. Besides updated pricing and volume information, the snapshot also now includes details on new outcomes such as mortality outcome measures that reflect care of patients with heart attacks and heart failure.  Looking ahead to 2008, Medicare will add patient satisfaction information to provide even more detail to help make available the information consumers need for health care decision making.

Through the Hospital Compare Web site, CMS is working to implement the principles of a value-based system in the Medicare program. The enhancements to the site further empower consumer choice and create incentives by motivating providers to provide better care for less money. An Executive Order issued last August by President Bush directed that federal agencies that sponsor or subsidize health care commit to the four cornerstones of value-driven health care: ensuring transparent quality and price information, interoperable health information technology and incentives for high-quality, efficient health care delivery (http://www.hhs.gov/valuedriven).

The Hospital Quality Alliance (HQA) is instrumental in facilitating CMS’s communication with hospitals and helping to motivate those hospitals to continually analyze and improve the quality of their care.  Collaboration by the members of the HQA continues to ensure that public reporting efforts for hospitals are supported by a broad cross section of the health care community.

The  two 30-day hospital mortality outcome measures are enhancements that  address the care for patients with heart failure and heart attack – or acute myocardial infarction – for more than 4,500 hospitals across the country. These mortality outcome measures are risk-adjusted and take into account previous health problems to “level the playing field” among hospitals. The measures are also intended to help ensure accuracy in performance reporting. 

“In addition to providing helpful information to beneficiaries, measuring and reporting on mortality also provides hospitals with the information they need to analyze and improve performance,” CMS Acting Administrator Leslie V. Norwalk said. “All hospitals will get detailed reports from CMS for use in quality improvement.  These reports serve as a tool to help hospitals look more broadly at their outcomes and processes of care and identify ways to lower mortality risk for their patients.”

Twenty-one measures are currently available on the Web site for consumers to view, including: eight measures related to heart attack care, four measures related to heart failure care, seven measures related to pneumonia care, and two measures relates to surgical infection prevention. Unlike the process of care measures on Hospital Compare, which are updated on a quarterly basis, the mortality outcome measures will be updated annually. The first reported information on the mortality measures is based on hospital admissions that occurred between July 1, 2005, and June 30, 2006.

For those hospitals needing assistance, CMS identified several resources to ensure hospitals have the tools to improve their quality of care. In addition to technical assistance available by the agency’s Quality Improvement Organization Program, which works directly with hospitals to improve care processes, organizations such as the American Heart Association and American College of Cardiology have technical resources for hospitals targeting cardiovascular care. 

In addition to the inclusion of these outcome measures, and in order for most U.S. hospitals to receive full payment for FY 2008 for providing inpatient services, hospitals will be required to report on 27 quality measures, up from the 10 measures that have been used since 2003. While many of these facilities had already been reporting on these measures, with the change in the incentive program, results on these additional process measures will now be available for nearly every hospital in the nation, giving consumers a greater wealth of information about quality of care.

“Public reporting of pricing and quality information has moved hospitals to step up their efforts to improve,” said Norwalk.  “These new and future postings will not only ensure that patients and their families have the information they need about the quality and efficiency of care they are receiving, but that they also should continue to serve as a catalyst to improve the care delivered in our nation’s hospitals today, not tomorrow. This improvement should accelerate with next year’s posting of patient satisfaction information.”

The mortality outcome measures that are being added to Hospital Compare today were developed during the past five years using a rigorous methodology by a team of experts from Yale and Harvard Universities, and are endorsed by the National Quality Forum, a voluntary standard–setting, consensus-building organization representing providers, consumers, purchasers, and researchers.  The information is displayed in one of three categories:  “No Different than the U.S. National Rate,” “Better than the U.S. National Rate,” or “Worse than the U.S. National Rate.”

Public reporting of these and other measures is intended to empower patients and their families with information with which to engage their local hospitals and physicians in active discussions about quality of care.  In an emergency, CMS urges consumers not to view any one process or outcome measure as a tool to “shop” for a hospital.  In an emergency situation, patients should always go to the nearest, most easily accessible facility.