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Hospital-Specific Reports Use Disparity Methods to Assess Outcomes

The Centers for Medicare & Medicaid Services (CMS) will provide confidential hospital-specific reports in late August, with the hope of illuminating differences in outcome rates among patient groups within a hospital and allowing for comparison of those differences across hospitals.

The agency initially will report stratified data using two disparity methods that assess outcomes for patients with social risk factors.

The hospital-specific reports will assess performance on the Hospital 30-day, All-Cause, Risk-Standardized Readmission Rate Following Pneumonia Hospitalization measure (NQF 0506). With data from the fiscal year 2019 measurement period (July 1, 2014, to June 30, 2017), CMS will use Medicare and Medicaid dual eligibility as the social risk factor for stratification of readmission rates through two methods:

  • comparing readmission rates among dual-eligible and non–dual eligible patients within a hospital; and
  • calculating readmission rates for dual-eligible and non–dual eligible patients separately, allowing comparison of dual-eligible patient performance across hospitals.

Hospitals can preview and download their reports on the QualityNet Secure Portal from Aug. 24 to Sept. 24. The confidential reports will not affect hospital reimbursements; their sole purpose is to allow hospitals to review the two disparity methods and pose questions to CMS. CMS encourages hospitals to download and save a copy of the report for future reference.

The agency will host a national provider call on Sept. 12 from 45 pm ET to review the disparity methods and answer questions. CMS also will provide educational documents, a mock report with sample data, and a user guide to aid hospitals in interpreting the reports. The agency will share how to register for the call and submit questions in an upcoming announcement.

For questions, contact Senior Director of Policy Erin O’Malley at eomalley@essentialhospitals.org or 202.585.0127.

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About the Author

Emily Schweich is a communications associate for America's Essential Hospitals.