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WVMI staff is available to assist hospitals with the Hospital Quality Alliance (HQA) and the Hospital Quality Initiative, or the Hospital Inpatient Quality Reporting Program (formerly called RHQDAPU), the current public reporting initiatives as well as the Value Base Purchasing (VBP) program.
The Hospital Quality Alliance is a private/public venture involving the Centers for Medicare & Medicaid Services, the American Hospital Association, the Federation of American Hospitals, the Joint Commission on Accreditation of Healthcare Organizations, the Association of American Medical Colleges, as well as other stakeholders. Results from hospitals participating in these initiatives are updated quarterly on CMS' Web site. View the quality measures for these quality initiatives.
The Hospital Quality Initiative, known as the Hospital Inpatient Quality Reporting Program (formerly called RHQDAPU), was initially developed as a result of the Medicare Prescription Drug, Improvement and Modernization Act (MMA) of 2003. Section 5001(a) of Pub. 109-171 of the Deficit Reduction Act (DRA) of 2005 set out new requirements for the Hospital Inpatient Quality Reporting Program, which build on the ongoing voluntary Hospital Quality Initiative.
That initiative is intended to equip consumers with quality of care information to make more informed decisions about their health care, while encouraging hospitals and clinicians to improve the quality of inpatient care provided to all patients. The hospital quality of care information gathered through the initiative is available to consumers on the Hospital Compare Web site.
The Hospital Inpatient Quality Reporting Program requires hospitals to submit data for specific quality measures for health conditions common among people with Medicare, and which typically result in hospitalization. For fiscal year 2011, CMS requires that hospitals submit data regarding AMI, HF, PN and SCIP clinical quality measures to the QIO Clinical Warehouse beginning with first quarter 2010 discharges. Additionally, selected hospitals are required to meet 75% reliability on validation.
Hospitals must submit aggregate population and sample size counts for Medicare and non-Medicare discharges for AMI, HF, PN and SCIP to CMS via QualityNet.
Hospitals must continuously collect and submit HCAHPS data (monthly or quarterly).
For the AMI, HF and PN 30-day risk standardized mortality measures, CMS uses enrollment data as well as Part A and Part B claims for Medicare fee-for-service patients to calculate the mortality measures.
For the AHRQ Patient Safety Indicators (PSI) and Inpatient Quality Indicators (IQI), CMS uses enrollment data as well as Part A and Part B claims for Medicare fee-for-service patients to calculate these measures. No hospital data submission is required to calculate these measure rates.
Hospitals that do not participate in the Hospital Inpatient Quality Reporting Program will receive a reduction of 2.0 percent in their Medicare Annual Payment Update. To avoid the reduction in their Annual Payment Update, hospitals must meet specific requirements outlined in the RHQDAPU Participation Steps (Reference Checklist) for FY 2011, available on QualityNet. The new reference checklist for FY 2011 is now available on our Hospital Quality Reporting Resources and Forms page.
Hospitals benefit from publicly reporting quality of care information in several ways. Participation helps hospitals highlight their successes and identify and focus on areas for improvement in quality of care. Also, using national and local benchmarks helps hospitals assess performance. Hospitals have the opportunity to give consumers important information about quality of care to help them compare and make informed decisions. In addition to these benefits, WVMI offers technical assistance and educational training in submitting data and improving quality of care.
Learn about data transmission and the validation/appeals process.
Only an organization's QualityNet Security Administrator and registered users can access the secure QualityNet Web site, My QualityNet. In order to become a QualityNet Security Administrator (each organization should designate at least two people as QualityNet Security Administrators), please read the instructions and complete the registration form. The completed form should be mailed (faxed and e-mailed forms will not be accepted) to:
Jill Manna WVMI 2601 Market Place St., Suite 320 Harrisburg, PA 17110