CMS releases more hospital quality data

The Centers for Medicare & Medicaid Services recently expanded the hospital data it posts online in hopes of increasing transparency for patients and doctors.

The CMS Hospital Compare Web site now will report how frequently patients return to a hospital after being discharged, a possible indicator of how well a facility provided patient care the first time around. The site also will provide more complete data on previously posted mortality rates for individual hospitals. In addition, updated information on 30-day mortality rates for patients admitted for heart attack, heart failure and pneumonia will be available online (link).

On average, one in five Medicare beneficiaries discharged from a hospital will re-enter it within a month, CMS said. Reducing the rate of hospital readmissions is a key component of President Obama's health reform agenda, according to the agency.

The new data show that for patients admitted to a hospital for heart attack, 19.9% return to the hospital within 30 days after discharge; 24.5% admitted for heart failure will return within the month; and 18.2% treated for pneumonia will be readmitted within that time frame.

Cutting readmissions

"Providing readmission rates by hospital will give consumers even better information with which to compare local providers," said Charlene Frizzera, CMS acting administrator. "Readmission rates will help consumers identify those providers in the community who are furnishing high-value health care with the best results."

Unplanned rehospitalizations cost Medicare $17.4 billion annually, according to an April 2 New England Journal of Medicine study. But it is possible to reduce readmissions, experts said.

Doctors and hospitals that have reengineered discharge processes and improved follow-up care with community clinics, skilled nursing facilities and home health agencies have cut readmissions by 20% to 50%, said Stephen F. Jencks, MD, MPH, lead author of the NEJM study.

He said the new Hospital Compare data could spur wider implementation of quality changes to cut preventable rehospitalizations.

"A smart physician or a smart hospitalist or a guy running a private practice out there is going to start thinking, 'How high should this issue be on my priority list?' " said Dr. Jencks, a health care consultant who formerly ran Medicare's Quality Improvement Organizations Program. "For the practicing physicians, this data is an invitation to deal with something that is driving them crazy -- the fragmentation of care."