Hospital Quality Reporting
WVMI's staff is prepared to assist hospitals with the Hospital Quality Alliance (HQA) and Reporting Hospital Quality Data for Annual Payment Update (RHQDAPU), the current public reporting initiatives.
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 this initiative are updated quarterly on Hospital Compare.
The Reporting Hospital Quality Data for Annual Payment Update (RHQDAPU) initiative 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 RHQDAPU 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 RHQDAPU initiative 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 2010, CMS requires that hospitals submit data regarding AMI, HF, PN and SCIP clinical quality measures to the QIO Clinical Warehouse beginning with first quarter 2009 discharges. Additionally, hospitals are required to meet 80% reliability on validation.
Hospitals must submit aggregate population and sample size countsfor 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). Beginning Quarter 1 2008, submit zero cases in the warehouse.
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 AMI, HF and PN 30-day risk standardized readmission measures, 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.
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 RHQDAPU initiative will receive a reduction of 2.0 percent in their Medicare Annual Payment Update for fiscal year 2010. To avoid the reduction in their Annual Payment Update, hospitals must meet specific requirements outlined in the RHQDAPU Participation Steps (Reference Checklist) for FY 2010, available on QualityNet.
Please refer to our new submission deadline chart for an updated public reporting, medical record validation, HCAHPS and HOP QDRP data submission schedule, through 2010.
Benefits of Participating
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, Quality Insights offers technical assistance and educational training in submitting data and improving quality of care.