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February 21, 2008

Upcoming Hospital Specific Public Reports

TO:	Chief Executive Officers
	Chief Financial Officers
	Chief Medical Officers
	Directors of Quality
	Public Relations Directors
	COMPdata Contacts

There are upcoming activities and reports that will specifically display hospital specific information at national and local levels that hospitals should be aware of and be able to respond to public inquiries.

National Reporting
Medicare has targeted March 27 as the release of new public information on the Hospital Compare web site. In addition to the previous process measurements on heart failure, heart attack, pneumonia, surgical infection prevention, and select mortality measurements; Hospital Compare will also include patient satisfaction information and Medicare payment and volume for select DRGs. In addition to new information, the web site has also been redesigned based upon consumer and patient input and will be released on March 27.

Patient Satisfaction (HCAHPS). For the first time, patient satisfaction results will be publicly shared in a comparative manner for participating hospitals that have agreed to share their results publicly. Each hospital had the opportunity to decide whether or not they would share this first set of results publicly. In the future, PPS hospitals will need to agree to share in order to receive their full market basket increase for Medicare inpatient care.

Hospitals were able to preview their HCAHPS results and to make comments to Medicare prior to the preview close date. As noted in prior IHA communications, some of the results are based upon the bundling of individual question scores into composite scores and other results are based upon individual questions. Please remember that there are adjustments that were made on each hospital’s results based upon the survey mode and the patient mix. While the survey mode methodology and co-efficients are publicly available, the patient mix methodology and co-efficients are not which creates great difficulty in comparing hospital internal results from vendors to Medicare results. For further explanation, please see IHA’s prior memos (click here).

The patient satisfaction topics to be included in the March release include the following results on 6 composite scores and 4 individual topics:

How often did doctors communicate well with patients (composite score)

How often did nurses communicate well with patients (composite score)

How often did patients receive help quickly from hospital staff (composite score)

How often was patients’ pain controlled (composite score)

How often were patient rooms and bathrooms kept clean (individual score)

How often was the area around the patient’s room kept quiet at night (individual score)

Were patients given information about what to do during their recovery upon discharge (composite score)

How do patients rate the hospital (individual score)

Would patients recommend the hospital to friends and family (individual score)

The hospital comparative results will be available in tabular formats as well as horizontal bar charts (somewhat similar to current displays).

Select DRGs Volume and Payment. Medicare will also release for the first time in a coordinated display, the individual hospital Medicare patient volume and average Medicare payment for approximately 43 individual DRGs. This information will be based upon federal fiscal year 2006 fee for service claims – which will cover inpatient discharges from October 1, 2005 through September 30, 2006. While Medicare already shares some information on Medicare volumes and ranges for payments, it is not an exact comparison to the existing public information to be displayed on the Hospital Compare web site. However, to help you get a relative sense of the information to be displayed at end of March, click here.

Consumers will be able to select DRGs and hospitals and compare results. Included in the results will be information on a hospital’s status on accreditation, emergency services availability, and participation in process, mortality, and patient satisfaction measurements.

Hospital Quality Alliance Information. As pointed out to IHA by one of our members, the Hospital Quality Alliance now displays information on their meetings, including meeting material. If you would like to see some of the information discussed at the meetings, you can find it by clicking here. If you would like to get a sneak preview of the Hospital Compare web site and how all of this information might look (knowing there is still tweaking going on with Hospital Compare site) please click here.

Preparing For Release. It is not too early to start preparing your hospital internal and external communications about the Hospital Compare information release in March. As Hospital Compare is already widely utilized by consumers, the web site enhancements will draw more consumers to the site. With the addition of easy to understand patient satisfaction results and the public display of volumes and payments, hospitals should expect more inquiries from the public and the media than in the past.

State Reporting
IDPH Web Site Development. On February 14, the Illinois Department of Public Health (IDPH) reconvened the Consumer Guide and Hospital Report Card Act Advisory Group. The purpose of the meeting was to review and provide advice to IDPH on their planned web site developments of the Consumer Guide and Hospital Report Card.

IDPH staff and their consultants discussed the various state consumer guides on hospitals and ambulatory surgery centers and found that the easiest to navigate with comprehensive information was found on the New York and Florida state agency sites. The Advisory Group supported moving ahead with the New York and Florida models to guide development. Additionally, IDPH presented the opportunities and challenges ahead in advancing the developments as to whether to internally or externally develop the web sites. Based upon the need to complete the web site and provide the information to the public by the end of 2008, the Advisory Group supported IDPH’s approach of using external resources.

As IHA had undertaken similar analysis with members of the IHA Quality Improvement Advisory Group, the New York and Florida site preferences were consistent with IHA’s review. While the IDPH development is just working its way through internal state processes, it is probably several months away from being available to consumers.

If anyone is interested in seeing the New York or Florida sites, they are publicly accessible at New York (click here) and Florida (click here).

IDPH Sale of Hospital Data. Under the Consumer Guide legislation and the administrative rules approved, IDPH was given authority to make available hospital inpatient and outpatient administrative (UB-837- claims) data and ambulatory surgery data similar to the prior practices under the former Illinois Health Care Cost Containment Council (IHCCCC).

IDPH has received numerous requests from vendors, health plans, national hospital reporting organizations, and media for the hospital information. Purchasers of the data are limited in the variables they can request and access is based upon HIPAA privacy considerations and intended use of information.

Given the sale of hospital data prior to IDPH development and release of a Consumer Guide occurring later this summer or fall, hospitals should be prepared for questions from the media or consumers on their hospital data. While it is impossible to gauge the types of questions to be posed to hospitals from a variety of viewpoints, hospitals are urged to designate contacts within the hospital that can respond to the inquiries. As IDPH will be releasing the same information available on COMPdata, hospitals are encouraged to utilize their resources to ensure the accuracy of any information developed or manipulated by other organizations. As with any aggregation or statistical analysis of hospital data, hospitals should always ask for a copy of the methodology to determine how the results were calculated.

IHA Educational Programs. In order to help hospitals navigate through the variety of information and sources for these types of information, IHA will be announcing shortly a series of educational programs to assist hospitals. These programs are being developed to target a wide audience within hospitals as the information transparency discussions will involve many areas of hospitals.

As has been the situation for the past couple of years, many developments are occurring rapidly and simultaneously. IHA will continue to keep you updated and informed so that you can be prepared for the impending reports on your hospital’s performance. If you have additional questions, please e-mail Pat Merryweather at pmerryweather@ihastaff.org. Thank you.