Fifty-Four Washington Hospitals Volunteer for Medicare Quality Improvement Initiative

SEATTLE  -- The Washington State Hospital Association and Qualis Health today saluted 54 acute care hospitals in Washington State that have taken an important step toward improving quality of care.  These hospitals voluntarily submitted their quality information for eventual release to the public.

Their participation comes as a result of the Centers for Medicare &

Medicaid Services (CMS) Hospital Quality Initiative.  Hospitals were also

encouraged by a provision in the Medicare Prescription Drug, Improvement and

Modernization Act of 2003 (MMA) that provides a financial incentive for

prospective payment system hospitals to voluntarily report quality of care

information.

Hospitals that submit quality information under the CMS initiative are

eligible to receive the full Medicare payment for healthcare services under

MMA.  Those hospitals that did not submit data will receive a .4 percent

reduction in annual Medicare payments.

Among the nation's 3,906 inpatient acute care hospitals eligible to report

quality data under MMA, 54 hospitals in Washington state met all CMS

requirements and will receive their full annual payment update from Medicare

in 2005.

 "Washington State hospitals have long been committed to quality of care,

and their wholehearted participation in this initiative underscores that

fact," said Leo Greenawalt, president of the Washington State Hospital

Association.  "In fact, this spirit of quality pervades all of our hospitals.

Even 14 smaller hospitals that are not eligible for the payment incentive have

voluntarily submitted similar data for public reporting."

"As the nonprofit healthcare quality improvement organization for

Washington State, Qualis Health is ready to help every hospital further its

efforts to improve care," said Jonathan Sugarman, MD, MPH, president/CEO of

Qualis Health.  "People across the state will see the benefits of this new

information as the quality of care in Washington hospitals continues to

improve."

The Medicare Hospital Quality Initiative is designed to improve the

quality of hospital care across the nation.  The program is part of the U.S.

Department of Health and Human Services (HHS) national quality initiative that

also focuses on improving the quality of care in home health agencies and

nursing homes using hands-on training and resources from Medicare quality

improvement organizations (QIOs), such as Qualis Health.

"Soon, patients in Washington state will be able to use this quality

information to help them make decisions about hospital care, and hospitals can

compare their performance, ultimately improving the quality of care for

everyone," Sugarman said.

Beginning in 2005, the hospital quality data will be available on a

consumer Web site, Hospital Compare, at http://www.medicare.gov, or by calling

1-800-MEDICARE (800-633-4227). Currently, CMS publishes quality information

on http://www.medicare.gov for Medicare and Medicaid-certified nursing homes and

Medicare-certified home health agencies.

The data on quality of care that participating hospitals report will give

consumers information about performance in three medical conditions -- heart

attack, heart failure and pneumonia.  These conditions can result in hospital

stays and are common among people with Medicare.  The measures in each

condition address key aspects of appropriate care and reflect widely accepted

standards of practice:

     *  Heart attack (Acute Myocardial Infarction)

        Was aspirin given to the patient upon arrival at the hospital?

        Was aspirin prescribed when the patient was discharged?

        Was a beta-blocker given to the patient upon arrival at the hospital?

        Was a beta-blocker prescribed when the patient was discharged?

        Was an ACE Inhibitor given to the patient with decreased heart

        function?

     *  Heart failure

        Did the patient get an assessment of his or her heart function?

        Was an ACE Inhibitor given to the patient?

     *  Pneumonia

        Was an antibiotic given to the patient in a timely way?

        Had a patient received a pneumococcal vaccination?

        Was the patient's oxygen level assessed?

The quality measures have gone through years of extensive testing for

validity and reliability by CMS and QIOs, the Joint Commission on

Accreditation of Healthcare Organizations (JCAHO), and researchers.  The

National Quality Forum (NQF), a voluntary standard-setting, consensus-building

organization representing providers, consumers, purchasers, and researchers,

has endorsed these measures.

The national quality initiative is an important step in the HHS/CMS

comprehensive quality strategy, which consists of four elements:

     *  Ongoing, community-based quality improvement programs for providers,

     *  Collaboration and partnerships to leverage knowledge and resources,

     *  Improved information for consumers on quality of care, and

     *  Regulation and enforcement activities by state survey agencies and

        CMS.

Qualis Health is a private, nonprofit organization that offers programs

and services to generate, apply and disseminate knowledge to improve the

quality of healthcare delivery and health outcomes.  In operation since 1974,

the firm has headquarters in Seattle, with offices in Boise and Anchorage.

Washington State Hospital Association (WSHA) is a trade association that

represents all 97 of Washington community hospitals.  WSHA works to promote

access to healthcare and quality healthcare throughout Washington State.

Source: Qualis Health