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Direct link found between public reporting and hospital performance improvements

by Diana Bradley, Staff Writer | November 21, 2011
Mandates for public reporting of quality care data are having a positive impact on quality performance improvements, according to the 2011 Pulse Report from Press Ganey Associates, Inc., a patient health care survey provider.

"It's common sense," said Nell Wood-Buhlman, vice president, clinical products at Press Ganey. "Whenever anything is subject to scrutiny, evaluation and transparency, there tends to be an interest among those being measured to make sure they are cast in a positive light."

CMS predicts the U.S. will spend $4.6 trillion on health care annually by 2020, representing 20 percent of gross domestic product - an unsustainable course. Regardless of this spending, Press Ganey's report stated that the quality of U.S. health care requires further improvements.

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Between the 2006 inception of voluntary public reporting and 2010, when the Affordable Care Act was signed into law, a significant increase was seen in the composite score for hospital performance on the heart failure measure set. Compliance rates with recommended care have increased for most of the top MS-DRGs, including acute myocardial infarction, heart failure, pneumonia and surgical care improvement measures, showing a direct link between public reporting and a higher percentage of patients receiving quality treatment, according to the report.

"We have been in an era of public reporting for a number of years, but a fundamental shift taking place this year is not just the public reporting mandate, but a portion of every hospital's Medicare payment is now riding on hospitals performance on this data," said Wood-Buhlman. "So, it's not just a matter of getting data reported, but how you are doing on it. What we are seeing is accelerated improvement in the aspects of care subject to the Value-based Purchasing Program."

The Hospital Inpatient VBP is a nine-month reporting period for hospitals, beginning on July 1, for clinical and patient experience measures, which CMS will utilize to calculate overall VBP scores for each organization. Scores will be translated into changes in reimbursement on Oct. 1, 2012.

Despite vast health care delivery challenges in the U.S., Press Ganey's report suggests the nation may be on the right track. In the past four years, there has been a 2.25 percent increase in inpatient satisfaction scores.

A drop in home care patients' overall satisfaction between 2009 and 2010 has steadily improved and maintained a high level in the last two quarters of 2010. The report said the improvements might be due to the upcoming implementation of home health public reporting of satisfaction data through the Home Health CAHPS program, beginning spring 2012. The government has yet to announce regulations implementing the Clinician and Groups Consumer Assessment of Healthcare Providers and Systems program.

In tandem with steadily increasing data reporting requirements, over the past six years the Hospital Consumer Assessment of Healthcare Providers and Systems survey scores have been steadily rising. HCAHPS makes up 30 percent of the total hospital inpatient VBP score. Hospitals must perform above the 50th percentile on all HCAHPS measures to receive full points for consistency.

"As hospitals are subject to more and more reporting mandates and pay-for-performance mandates, they are paying close attention to a variety of performance aspects," said Wood-Buhlman. "Everything is moving in the direction we want to see it moving in."

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