Quality incentive project puts focus on IT

By Healthcare IT News
12:00 AM

A new Medicare demonstration project designed to reward hospitals for how their quality of care compares with other facilities will highlight the importance of information technology.

Data collection for the Hospital Quality Incentive Demonstration Project, being managed by the Premier hospital alliance and the Centers for Medicare and Medicaid Services, began last fall. Initial results for the study, which will last three years, may be available as early as this summer.

A total of 278 hospitals have signed up for the project. The hospitals can receive higher Medicare payments if they rank among the top performers in five clinical areas - heart attack, coronary artery bypass graft, heart failure, community-acquired pneumonia, and hip and knee replacement.

The project represents another example of the concept of shifting reimbursement strategy to reward organizations that provide higher quality care. And the project points to the increasing role IT should play in improving that care, Premier executives say.

"This is one of a number of initiatives that make clear the importance of using comparative data, clinical and process improvement in hospitals," said Todd Wilkes, director of applications development for Premier, a San Diego-based alliance owned by 200 hospitals and hospital systems. "This trend is making it obvious that hospitals need to invest in this area."

Premier for years has offered benchmarking services to hospitals. For example, about 400 hospitals submit data for Perspective, a national clinical database that holds detailed information about patients' episodes of care. Those capabilities garnered interest from CMS on the quality project.

Premier has adopted more than 30 quality indicators related to the five clinical areas, said Brett Bennett, vice president of healthcare informatics.

Hospitals must submit patient data, which then are mapped to Premier's standard definitions.

Comparative rankings eventually will appear on the CMS Web site, Bennett said, probably starting this summer. The site will contain data on the top 50 percent of participating hospitals. All data will be mapped and validated before it is submitted to CMS.

"CMS is interested in driving quality improvement in the industry and rewarding it," Bennett said. "Currently, CMS pays the same amount for surgical procedures without recognizing whether it was a high-quality procedure or successful. The agency feels that it can drive process change and improvement in clinical care."

While the payment increments in the project are small - the top 10 percent of hospitals will get 2 percent more in reimbursement, and the next 10 percent will get 1 percent more - the results could be significant for large hospitals that serve high Medicare populations.

Hospitals that succeed in the project probably will be those that take full advantage of IT, said Charles Townson, COO of Spartanburg (S.C.) Regional Healthcare System, which is participating in the project.

"We have to use technology in the quality improvement process," he said. "A lot of the measurements are tied to clinical results, and IT will help us with that."

The project also will heighten the need to automate the physicians who admit patients to its facilities, Townson said.

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