CMS Update: 13 New Quality Measures

CMS has adopted 13 of their 43 proposed new quality measures for FFY 2010. One measure, pneumonia oxygenation, has been retired, bringing the total to be reported to 42 (full list of CMS quality measures).

Two additional measures are expected to be approved next year, bringing the total up to 44. These are AMI and Pneumonia Readmit rates. Enovasis analysts expect one new measure in particular may be of concern for many hospitals: The Heart Failure 30-day Risk Standardized Readmission Measure.

According to MedPac, readmissions cost Medicare $15 billion every year—$12 billion of which is believed to be preventable. Almost 18% of Medicare patients are re-admitted to a hospital within 30 days of discharge. The Heart Failure re-admission measure, to be calculated automatically using Medicare claims data, may prove to be a source of many improvement efforts, time and resources. With this information becoming publicly available, hospitals should start monitoring and improving this rate as soon as possible.

Many hospitals have initiatives to reduce length of stay in the high-volume, high-cost heart failure category, but few monitor the repercussions of those initiatives closely. One major repercussion being a high readmission rate. If this rate is high at your hospital investigate your use of home care or other post-discharge treatment. Also analyze readmits by discharge day of the week or by post-acute provider to find clues as to what is causing returns.

Contact Enovasis Healthcare Solutions if you need assistance.