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Measures to Assess Hospital Quality Are Flawed, Study Finds
The approach for assessing hospital penalties under the Hospital-Acquired Condition Reduction Program might need to be reconsidered in order to achieve the intended goal of the program.
approach for assessing hospital penalties under the
Hospital-Acquired Condition (HAC) Reduction Program might need to be reconsidered in order to achieve the intended goal of the program, according to findings published in JAMA.
relationship between the hospital quality summary score and HAC program penalization as well as publicly reported process-of-care and outcome measures from 4 clinical areas: surgery, acute myocardial infarction, heart failure, and pneumonia.
The findings of the study showed hospitals were more likely to be penalized if they had accreditations, offered advanced services, were major teaching institutions or performed better on other quality measures.
reduces payments to the lowest-performing hospitals, and researchers examined the
The HAC Reduction Program
The
“Higher-performing hospitals were penalized more because some of the measures that CMS uses to assess quality are flawed,” senior author Karl Bilimoria, MD, assistant professor in surgery-surgical oncology and director of the Surgical Outcomes and Quality Improvement Center, said in a statement. “The measures paradoxically identify high-performing hospitals as poor performers. Clearly this is not ideal for hospitals or for patients.”
ospitals with the highest quality score of 8 were penalized significantly more frequently than hospitals with the lowest quality score of 0.
Nearly one-fourth (22%) of participating hospitals were penalized and h
See the study: http://bit.ly/1PfhkJH
Comparing Breast Cancer Treatment Outcomes Between Fee-for-Service and Medicare Advantage
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Varied Access: The Pharmacogenetic Testing Coverage Divide
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Managed Care Reflections: A Q&A With Hoangmai H. Pham, MD, MPH
April 1st 2025To mark the 30th anniversary of The American Journal of Managed Care® (AJMC®), each issue in 2025 will include a special feature: reflections from a thought leader on what has changed—and what has not—over the past 3 decades and what’s next for managed care. The April issue features a conversation with Hoangmai H. Pham, MD, MPH, a member of AJMC’s editorial board and the president and CEO of the Institute for Exceptional Care (IEC).
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Bridging Care Gaps With a Systemwide Value-Based Care Strategy
March 29th 2025Mapping care management needs by defining patient populations and then stratifying them according to risk and their needs can help to spur the transformation of a siloed health care system into an integrated system that is able to better provide holistic, value-based care despite the many transitions that continue among hospital, primary, specialty, and community care environments.
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