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Hospitals are Top Performers in National Study
December 20, 2005
Committed to improving healthcare quality, Providence Medical Center, Kansas City, Kan., located near Cabela’s and Nebraska Furniture Mart, and Saint John Hospital, Leavenworth, Kan. participated in a national project, called CMS/Premier Hospital Quality Incentive Demonstration (HQID) involving more than 260 hospitals. As part of the study, Providence and Saint John volunteered to have their quality data for high-volume clinical conditions, including acute myocardial infarction (AMI), coronary surgery bypass graft (CABG), heart failure, pneumonia and hip/knee replacement surgery analyzed in a standard way. Each year, Medicare will pay top performers more for delivering high quality healthcare and will publish the quality data from the top 50 percent of participants.
Based on its first year overall quality scores, Providence rated in the top 10 percent in the areas of AMI and Hip/Knee Replacement and in the top 20 percent in pneumonia care. Saint John rated in the top 10 percent in pneumonia, and both hospitals rated in the top 30 percent in heart failure care.
“Providing outstanding patient care has always been our primary mission and focus,” said Jim Paquette, CEO for Providence and Saint John. “We were pleased to participate in this demonstration and are proud that our performance was rated among the best.”
“Over time, healthcare costs can be controlled by meeting quality standards that provide treatment before a condition worsens and that eliminate unnecessary procedures.” He added, “Our commitment to quality and service excellence is attributed to our caring, competent and compassionate caregivers—our physicians, nurses, and support staff who provide cutting edge care in a culture of loving care. “This recognition of “top performer” belongs to our more than 1,500 employees and more than 500 physicians and others.”
Data from the first year of HQID, validated by CMS and reported publicly, demonstrate a significant improvement in the quality of care across five clinical focus areas as measured by 33 nationally standardized and widely accepted quality indicators. The average improvement across the clinical areas was 6.6 percent. These performance gains have outpaced those of hospitals involved in other national performance initiatives. Approximately 235 acute myocardial infarction (heart attack) patients nationwide were saved as a result of quality improvements in that related focus area alone.
Medicare is awarding $8.85 million to hospitals that achieved the highest levels of performance at the end of the first year of the project. This is the first time that Medicare has awarded actual monetary bonuses to healthcare providers in a pay-for-performance demonstration.
The pay-for-performance model demonstrated in the project includes financial incentives and public recognition for top-performing hospitals as well as financial penalties for hospitals that do not improve above a pre-defined quality measure threshold by the third year of the project.
Additionally, Premier’s relationship with participants enabled implementation of effective, collaborative knowledge transfer programs supporting identification and dissemination of best practices of top performers, a key component to the rapid pace of performance improvement.
The financial component of the HQID will reward hospitals performing in the top 10 percent for a given clinical focus with an additional 2 percent bonus on their Medicare payments for patients in that clinical area. Hospitals in the second decile will receive a 1 percent bonus.
Composite quality scores, an aggregate of all quality measures, improved between the first and last quarters of the first year of the demonstration in all five clinical focus areas:
• From 87 percent to 91 percent for patients with acute myocardial infarction (heart attack).
• From 65 to 74 percent for patients with heart failure.
• From 69 percent to 79 percent for patients with pneumonia.
• From 85 percent to 90 percent for patients with coronary artery bypass graft.
• From 85 percent to 90 percent for patients with hip and knee replacement.
The range of variance among participating hospitals also is closing, as those hospitals in the lower deciles continue to improve their quality scores and close the gap between themselves and the demonstration’s top performers.
“Excellence is one of our core values that encourages us to be our best every day,” said Barbara Tirrell, Patient Care Services Administrative Director. “Our outstanding clinical performance begins with executive support, a strong culture of quality, and the dedication of the appropriate resources.”
For a complete review of the demonstration, the year one results, and to view those hospitals ranking in the top 50 percent in each focus area, visit www.premierinc.com/qualitydemo <http://www.premierinc.com/qualitydemo>.
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