50 TOP CARDIOVASCU 50 TOP CARDIOVASCULAR HOSPITALS, 2014 A NATIONAL BENCHMARKS REPORT
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1 50 TOP CARDIOVASCU 50 TOP CARDIOVASCULAR HOSPITALS, 2014 A NATIONAL BENCHMARKS REPORT Performance Report Prepared For: Sample MEDICARE ID:
2 50 TOP CARDIOVASCULAR HOSPITALS, 2014 Sample REPORT NOTES Comparison Groups So that we can compare your hospital with others most like it, we assign each hospital to one of three comparison groups according to size, teaching status, and residency/fellowship program involvement: Teaching hospitals with cardiovascular residency programs (CARDIO TEACHING) Teaching hospitals without cardiovascular residency programs (TEACHING) Community hospitals (COMMUNITY) and Groups In the Truven Health Analytics 50 Top Cardiovascular s study, we select 50 hospitals (winners) based on overall performance in the most recent year of data available: CARDIO TEACHING 15 TEACHING 20 COMMUNITY 15 group hospitals include all U.S. hospitals in our study database, excluding benchmark hospitals. In this custom report, we provide two types of comparisons: hospital versus comparison group hospitals hospital versus comparison group hospitals Measure Categories and Patient Groups We include data for acute myocardial infarction (AMI), heart failure (HF), coronary artery bypass graft (CABG) and primary percutaneous coronary intervention (PCI) patients in our analysis. Measure Category Pt Groups Measure Category Pt Groups Medical Mortality AMI, HF % CABG with IMA CABG Surgical Mortality CABG, PCI 30 Day Measures AMI, HF Complications CABG, PCI Avg Length of Stay All Core Measures AMI, HF, SCIP Cost per Case All Public Data Sets Used Measures Public Data Sources Mortality, Complications, Inpatient Quality Indicator MedPAR Federal Fiscal Yr ALOS, Cost per Case MedPAR FFY 2012 Core Measures CMS Compare (CMSHC) Oct 1, Sep 30, Day Mortality CMSHC July 1, June 30, Day Readmissions CMS SAF Jan 1, Dec 31, 2011 Cost to Charge Ratio Medicare Cost Report 2012 Use of Values When individual core measures (CMs), 30-day mortality or 30-day readmission values are missing or the reported value is insufficiently precise (patient count too low), we substitute class median values for the hospital value(s). We do this to allow overall ranking of the hospital. Note: s missing all CMs, all 30-day mortality or all 30-day readmission measures are excluded from the study. Missing Data or Incalculable Data Points No bar is displayed for the profiled hospital if values were not reported, are incalculable, or where the median was used. If a hospital was excluded from the study for missing or incalculable performance measures, we note the details at the end of the report. Winner Exclusions If a hospital was not eligible to be a winner due to statistically poor performance in mortality or complications, or If a hospital was not eligible to be a winner because it had one or more outliers (interquartile range methodology) for wage- and severityadjusted cost per case, we note the details at the end of the report. FOR MORE INFORMATION For a Study Abstract, with full details on performance measures, methods used and winner list, visit Truven Health Analytics. All rights reserved. 2 of 14
3 50 TOP CARDIOVASCULAR HOSPITALS, 2014 Sample REPORT NOTES, con't 30-Day Readmission Measure 30-day readmission rates were not available in the Compare 2013 Q2 data set used for this study, due to suppression of the data by CMS. We used the Truven Health 30-day readmission models, which are risk-adjusted, to produce 30-day readmission indexes for AMI and HF. This methodology correlates very closely with CMS methodology. The data source used for this measure was CMS Standard Analytic File (SAF) for data period CY Features of Truven Health s 30-Day Readmission Measure: Data more current than in CMS 30-Day Readmission Reduction Program Only POA coded data is used in model CMS Planned Readmission Algorithm (PRA) is applied (not used in CMS model yet) Models utilize the same Condition Category groups derived from the Hierarchical Condition Category methodology that CMS uses to capture relevant comorbidities in the patient data Performance Measures for Informational Purposes Two new performance measures have been included for information only. They were not used in overall ranking and selection of winners. These measures are being evaluated for inclusion in future studies: CMS Compare OP-13: Outpatients who got cardiac imaging stress tests before low-risk outpatient surgery AHRQ IQI-25: Bilateral cardiac catheterization in CAD Both measure results are displayed as rates: OP-13 as a percentage and IQI-25 as a procedure rate per 1,000 discharges Truven Health Analytics. All rights reserved. 3 of 14
4 50 TOP CARDIOVASCULAR HOSPITALS, 2014 Sample HOSPITAL COMPARED WITH TOP 15 CARDIO TEACHING HOSPITALS 1 CLINICAL OUTCOME AND PROCESS MEASURES 6 5 ABBREVIATION KEY: PERCENT DIFFERENCE % % 49.5% -11.6% 2.7% 21.5% -% -2.9% AMI Mort HF Mort CABG Mort PCI Mort CABG Comp PCI Comp Core Meas CABG w IMA AMI Severity-Adjusted Mortality Index HF Severity-Adjusted Mortality Index CABG Severity-Adjusted Mortality Index PCI Severity-Adjusted Mortality Index CABG Severity-Adjusted Complications Index PCI Severity-Adjusted Complications Index Overall Core Measures Mean Percent CABG with Internal Mammary Artery Use (%) -1-2 AMI Mort HF Mort CABG Mort PCI Mort CABG Comp PCI Comp Core Meas CABG w IMA 1 Percent difference from benchmark median Truven Health Analytics. All rights reserved. 4 of 14
5 50 TOP CARDIOVASCULAR HOSPITALS, 2014 Sample HOSPITAL COMPARED WITH TOP 15 CARDIO TEACHING HOSPITALS 1 EXTENDED OUTCOME, ALOS, AND COST PER CASE MEASURES 2 PERCENT DIFFERENCE % -1.0% AMI 30D Mort HF 30D Mort 6.9% 2.3% AMI 30D Readm HF 30D Readm -1.3% AMI ALOS 7.5% 11.9% 3.8% HF ALOS CABG ALOS PCI ALOS -37.8% -9.5% AMI Cost HF Cost % % CABG Cost PCI Cost ABBREVIATION KEY: AMI 30D Mort HF 30D Mort AMI 30D Readm HF 30D Readm AMI ALOS HF ALOS CABG ALOS PCI ALOS AMI Cost HF Cost CABG Cost PCI Cost AMI 30-Day Mortality Rate HF 30-Day Mortality Rate AMI 30-Day Readmission Index HF 30-Day Readmission Index AMI Severity-Adjusted Average Length of Stay HF Severity-Adjusted Average Length of Stay CABG Severity-Adjusted Average Length of Stay PCI Severity-Adjusted Average Length of Stay AMI Wage & Severity- Adjusted Cost/Case HF Wage & Severity- Adjusted Cost/Case CABG Wage & Severity- Adjusted Cost/Case PCI Wage & Severity- Adjusted Cost/Case 1 Percent difference from benchmark median Truven Health Analytics. All rights reserved. 5 of 14
6 50 TOP CARDIOVASCULAR HOSPITALS, 2014 Sample AMI PATIENTS RISK-ADJUSTED MORTALITY 30-DAY READMISSION hospital is statistically AS expected hospital is statistically AS expected DAY MORTALITY RATE (%) % 13.0% 14.4% PERCENT s are the winners in the comparison group: n=15 2 s are the non-winners in the comparison group: n= Truven Health Analytics. All rights reserved. 6 of 14
7 50 TOP CARDIOVASCULAR HOSPITALS, 2014 Sample AMI PATIENTS SEVERITY-ADJUSTED AVERAGE LENGTH OF STAY DAYS jjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjjj WAGE- AND SEVERITY-ADJUSTED COST PER CASE DOLLARS 14,000 12,000 10,000 8,000 6,000 4,000 $11,718 $8,504 $9,689 2, s are the winners in the comparison group: n=15 2 s are the non-winners in the comparison group: n= Truven Health Analytics. All rights reserved. 7 of 14
8 50 TOP CARDIOVASCULAR HOSPITALS, 2014 Sample HF PATIENTS RISK-ADJUSTED MORTALITY hospital is statistically BETTER THAN expected. 30-DAY READMISSION hospital is statistically AS expected. 30-DAY MORTALITY RATE (%) % 10.5% 10.6% PERCENT s are the winners in the comparison group: n=15 2 s are the non-winners in the comparison group: n= Truven Health Analytics. All rights reserved. 8 of 14
9 50 TOP CARDIOVASCULAR HOSPITALS, 2014 Sample HF PATIENTS SEVERITY-ADJUSTED AVERAGE LENGTH OF STAY SEVERITY-ADJUSTED AVERAGE LENGTH OF STAY DAYS WAGE- AND SEVERITY-ADJUSTED COST PER CASE WAGE- AND SEVERITY-ADJUSTED COST PER CASE 10,000 8,000 $8,323 $7,602 $8,426 DOLLARS 6,000 4,000 2, s are the winners in the comparison group: n=15 2 s are the non-winners in the comparison group: n= Truven Health Analytics. All rights reserved. 9 of 14
10 50 TOP CARDIOVASCULAR HOSPITALS, 2014 Sample CABG PATIENTS RISK-ADJUSTED MORTALITY CABG w INTERNAL MAMMARY ARTERY USE (%) hospital is statistically AS expected. PERCENT % 96.5% 94.9% DESIRED 2 0 RISK-ADJUSTED COMPLICATIONS hospital is statistically AS expected. 0 1 s are the winners in the comparison group: n=15 2 s are the non-winners in the comparison group: n= Truven Health Analytics. All rights reserved. 10 of 14
11 50 TOP CARDIOVASCULAR HOSPITALS, 2014 Sample CABG PATIENTS SEVERITY-ADJUSTED AVERAGE LENGTH OF STAY DAYS WAGE- AND SEVERITY-ADJUSTED COST PER CASE 40,000 35,000 30,000 $36,687 $36,687 $37,887 DOLLARS 25,000 20,000 15,000 10,000 5, s are the winners in the comparison group: n=15 2 s are the non-winners in the comparison group: n= Truven Health Analytics. All rights reserved. 11 of 14
12 50 TOP CARDIOVASCULAR HOSPITALS, 2014 Sample PCI PATIENTS RISK-ADJUSTED MORTALITY SEVERITY-ADJUSTED AVERAGE LENGTH OF STAY hospital is statistically AS expected. DAYS RISK-ADJUSTED COMPLICATIONS WAGE- AND SEVERITY-ADJUSTED COST PER CASE hospital is statistically AS expected. DOLLARS 18,000 16,000 14,000 12,000 10,000 8,000 6,000 $15,462 $15,462 $16,563 4,000 2, s are the winners in the comparison group: n=15 2 s are the non-winners in the comparison group: n= Truven Health Analytics. All rights reserved. 12 of 14
13 50 TOP CARDIOVASCULAR HOSPITALS, 2014 Sample CORE MEASURES PERCENT Overall CM Mean PCI 90 Min Statin Disch Disch Instr Peri-Op Beta B Glucose Control CORE MEASURE ABBREVIATION KEY: Overall CM Mean PCI 90 Min Statin Disch Disch Instr Peri-Op Beta B Glucose Control Overall Core Measures Mean Percent Heart Attack Patients Given PCI Within 90 Minutes Of Arrival Heart Attack Patients Given Prescription for a Statin at Discharge Heart Failure Patients Given Discharge Instructions Surgery Patients Who Were Taking Heart Drugs Called Beta Blockers Before Coming to the, Who Were Kept on the Beta Blockers During the Period Just Before and After their Surgery Heart Surgery Patients Whose Blood Sugar (Blood Glucose) is Kept Under Good Control in the Days Right After Surgery DESIRED 1 s are the winners in the comparison group: n=15 2 s are the non-winners in the comparison group: n= Truven Health Analytics. All rights reserved. 13 of 14
14 50 TOP CARDIOVASCULAR HOSPITALS, 2014 Sample OUTPATIENT CORE MEASURE: CARDIAC IMAGING FOR PREOP RISK ASSESSMENT FOR NON-CARDIAC LOW-RISK SURGERY RATE (%) % 5.9% 5.9% PERCENT IQI: BILATERAL CARDIAC CATHETERIZATION IN CAD RATE (per 1,000 discharges) PROCEDURE RATE NOTE: These measures are being displayed for informational purposes only. They are not included in the winner selection process. 1 s are the winners in the comparison group: n=15 2 s are the non-winners in the comparison group: n= Truven Health Analytics. All rights reserved. 14 of 14
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