News Releases

Fifty-nine eligible hospitals in Arizona have taken their first step toward a commitment to improving their quality of care by voluntarily registering to submit quality information, the Centers for Medicare & Medicaid Services announced today.

"People on Medicare and other hospital patients will benefit from this new information and will get further benefits as the quality of care in the nation's hospitals improves," said CMS Administrator Mark B. McClellan, M.D., Ph.D.

Under the Medicare Modernization Act of 2003 (MMA) hospitals that submit quality information to CMS will be eligible to receive the full Medicare payment for health care services under the MMA. Hospitals that do not submit data will receive a 0.4 percentage point reduction in their annual Medicare payments.

Among the nation's 3906 inpatient acute care hospitals eligible to report quality data under MMA, 98.3 percent met all of CMS's requirements and will receive the full annual payment update (APU) from Medicare in 2005.

"When it comes to quality reporting, payment incentives are nearly 100 percent effective ? and in turn, quality information will provide further incentives to improve the quality of care available to millions of Americans," Dr. McClellan said. "As patients and doctors start using this quality information to help them make decisions about hospital care, hospitals will start using it to improve their performance."

Medicare's 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's Quality Improvement Organizations (QIOs).

"Soon, patients in Arizona will be able to use this quality information to help them make decisions about hospital care, and hospitals can compare their performances, ultimately improving the quality of care for everyone," said Herb Rigberg, MD, CEO of HSAG, Arizona's QIO.

Beginning early in 2005, the hospital quality data will be available on a consumer Website, Hospital Compare, at www.medicare.gov, or by calling 1-800-MEDICARE (800-633-4227). Currently, CMS publishes quality information on 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:

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 heart failure?

Heart failure
- Did the patient get an assessment of his or her heart function?
- Was an ACE Inhibitor given to the patient?

Pneumonia
- 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.

About Health Services Advisory Group (HSAG)
For 25 years HSAG has provided innovative leadership on health care quality improvement projects for Federal, state and private sector clients. Founded by a group of medical professionals in 1979, HSAG is one of most experienced quality improvement organizations in the nation. HSAG is recognized as an agent of change in the industry because of the company's successful collaboration with providers across the continuum of care.